Click here for more sample CPC practice exam questions with Full Rationale Answers

Practice Exam

Click here for more sample CPC practice exam questions and answers with full rationale

Practice Exam

CPC Practice Exam and Study Guide Package

Practice Exam

What makes a good CPC Practice Exam? Questions and Answers with Full Rationale

CPC Exam Review Video

Laureen shows you her proprietary “Bubbling and Highlighting Technique”

Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page

Practice Exam

2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

Practice Exam

Click here for more sample CPC practice exam questions and answers with full rationale

Give Your Patients the Digital Experience They Want

Kyruus survey shows that patients prefer the convenience of digital avenues when scheduling appointments and researching care options. To ensure that your healthcare facility offers a positive interaction with potential and existing patients, it is important to understand what patients want and, increasingly, expect. Kyruus recently announced the findings from its fifth annual survey, published […]

The post Give Your Patients the Digital Experience They Want appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

CO 252 rejection code – what information are they lacking?

Hi everybody!

This is the first time I’m writing here. I have a strange claim that was denied with CO 252 code and the appeal wasn’t successful either. The clinical was attached but they still say that after consideration they don’t think that the visit is as complex as they need for 99205 (new patient). Here are they ICD-10s that were billed accordingly:
R10.84 Generalized abdominal pain
R11.2 Nausea with vomiting, unspecified
F41.9 Anxiety disorder, unspecified
F41.0 Panic disorder without agoraphobia

What am I doing wrong?

Thanks!

Medical Billing and Coding Forum

Medicaid as primary or secondary- Can we charge the patient if they dont pay?

if a patient has Medicaid as secondary can we trasnfer the balance to the patient if Medicaid does not pay? Because I know if the pateint has MEdicaid we can’t trasnfer the balance to the patient; however, if Medicaid does not pay is it still okay to charge the patient the balance? not sure if that applies when its primary and secondary or only primary.

Medical Billing and Coding Forum

Switching AOs: Kettering Health answers why they changed from Joint Commission to HFAP

 Kettering Health Network (KHN) is a non-profit network of eight hospitals, 10 emergency centers, and over 120 outpatient facilities in southwest Ohio. In 2016, the network reported more than 1 million outpatient visits, nearly 62,000 patient discharges, and about 315,000 emergency visits. KHN used to be accredited primarily by The Joint Commission, before deciding to switch all its facilities to HFAP in 2011. 

HCPro.com – Briefings on Accreditation and Quality

Identify Code Edits Before They Hold Up Claims

Section-specific examples have been added to the Medicare National Correct Coding Initiative (NCCI) Policy Manual. These examples reveal the rationales behind the edits contractors use to vet medical claims for incorrect code combinations. Take the Initiative to Correct Coding The Centers for Medicare & Medicaid Services (CMS) implemented the NCCI to promote national correct coding methodologies […]
AAPC Knowledge Center

Medical Miracles – Do They Still Happen Today?

Doctors are very wary about the idea of medical miracles but the idea of miraculous healing has been around for thousands of years. For those people who are facing terminal or severe chronic illness the desire for a miracle healing can be immense. Is this a legitimate hope or a false hope?

Whether miracles still happen today depends on your definition of the word miracle. If by miracle you mean that something is totally against the laws of nature then I would suggest that they never did happen.

However, if by miracle you mean a turn around in serious, or terminal illness when the doctors thought there was very little chance of recovery, then, of course they do still happen.

How can I be so sure? Most doctors who have been practicing for years have stories of people who have done much better than could have ever been expected given their diagnosis, prognosis (expected outcome) and treatment. Discussion on them is usually kept to the coffee room rather than the research unit.

It is also a matter of logic. If you have 100 people with a terminal condition then not all of them die at the same instant. They die one at a time. And for every 100 people then the last 10 will die later than the first 90. That is logical. And someone has to take longer to die than all of the others in that group of 100. Also within that group of the last survivors are some people who have such a good quality of life that some would describe them as miracle survivors.

The important question is whether there is a reason for some to take longer to die than others, or whether it is just chance? Fortunately research has answered some of these questions for us. While chance is probably always a component there are many things that those who survive much longer than others all have in common.

Ground breaking research was published in the academic journal Qualitative Health Research in 2008 which described the quality of such survival as personal resilience. What was really interesting is that all of the survivors had a very large number of personal qualities and ways of interpreting life that were in common to all of them regardless of whether the person was male or female, how old they were (23 – 90 years) or how much education they had during their lives (18 months to graduate degrees and further training).

The survivors decided early on in their illness to live each day with the best quality that they could make. They lived each day to the fullest and their quality of life was self defined. These were people who came to live their own lives, not controlled by others or by their disease process, but so that they could take charge for today.

Of course they were often constrained by their illness. If you are on a drip and confined to one room there are lots of things that you can’t do. However within those constraints there were still lots of things the survivors chose as important for that time, such as being in charge of their own toileting or choosing to put make-up on for visitors. They did not allow their quality of life to be defined by their illness but by their own values and the way they chose to live on that day. The focus was on what was possible not on what they could not do.

Every person was different in the way they chose to define what was quality for them. However it was really interesting to find that by focusing on their own interpretation of quality of life that each person did come to a quality of life that anyone, whether medical carer or dispassionate observer would agree was quality. Each person ended up symptom free for at least an extensive period of time. Their disease remitted or apparently disappeared.

The fact that remission is physically possible means that there is a biological pathway for remission to occur in anyone and so hope is legitimate. Doctors worry about giving what they call false hope. However if there is just one case ever that has gone into remission means that there must be hope and when there is hope there is justification for exploring possibilities for improving the quality of life for those who are seriously and terminally ill.

Dr Harriet Denz-Penhey is an internationally recognized health researcher who has done groundbreaking research into patient self care in serious illness. Want to learn more about unexpected recovery from terminal illness? Claim Harriet’s popular free e-course, available at http://www.beatthemedicalodds.com/.

Lemons – Are They a Medical Miracle?

“Martha Stewart showed up at Manhattan FBI Headquarters to have her finger prints taken and pose for a mug shot. Then Martha explained how to get ink off your fingers using seltzer water and lemon juice,” said Conan O’Brien.

Ok, Conan meant that as a joke, but thrifty and smart families know some of the real (and sometimes surprising) uses for lemons – the special fruit with practical and health benefits dating back centuries.

Ancient Egyptians believed that lemons provided protection against a variety of poisons. Today it’s known that lemons have antibacterial and immune-boosting powers, can help with weight loss and digestion problems, and make a thrifty natural cleaning product.

Here are a few of the medicinal uses for lemons and lemon juice:

A few drops of juice in hot water are believed to clear the digestive system and purify the liver.
Lemon juice makes an effective mouthwash. It removes plaque, whitens teeth and strengthens the enamel.
Added with a pinch of salt in warm water lowers cholesterol levels and aids in weight loss.
Apply to the sites of bites and stings of certain insects relieves its poison and pain.
Use as a hair rinse controls dandruff and makes hair shiny and soft.
Lemon juice can be used to treat acne.
Remove odors, such as fish, onion, or bleach by rubbing with fresh lemon.

Lemon juice for cleaning:

Clean pots and pans with a mixture of lemon juice and baking soda.
Mix with olive oil to make a great furniture polish.
Brighten your white laundry by adding to the wash.
Use to remove soap scum in your bath and shower.
Lemon juice can be used to clean and shine brass and copper

Better known uses for lemons – cooking and garnishing:

Old-Fashioned Lemonade!
Lemon cake.
Lemon chicken.
Garnish for drinks, soups, and desserts.
Used as a marinade to help tenderize tougher cuts of meat.
Help vegetables such as potatoes and turnips maintain their white color.

Lemons are versatile – having many more uses than included here. Remember they need to be stored in the refrigerator.

Maybe it’s actually a lemon a day that keeps the doctor away!

Janet B Pearson is the editor of http://www.thrifty411.com. She is married and a mother of 2 with a grand-daughter, and a new grandson! She recently completed an ebook “Thrifty Living: Be Thrifty, Make A Budget, and Save Money!”

Couple of case sceneros, are they fraud?

I have a couple case sceneros I’d like some opinions or thoughts on, if they would be considered fraudulent. It concerns a friend of mine, and I feel they are or at least unethical, but my friend was told they weren’t by another friends office manager she spoke to about it. She is fairly young and has only been working as a medical receptionist for a few years with this one office.

A supervisor has been over the practice for only a short period of time. (About 2-3 years) The past few months she has been working the aging reports, and having the office clerks sending out statements.Some/Most of the claims are well past timely filing limit. From 1 to 7 or 8 years or even older. Unless a patient calls in and says they have Medicaid 2nd, and state they can’t afford to pay. They are billed until they pay. If they do call in, the office clerks are to tell them they will need to come in with their card to show proof (alot of the patients live hours away) and only then will she provide a write off. If they do not do this, she says they are responsible for the balance and collects from them.

None have a ABN on file, in almost all cases the patients were not verbally notified or there is nothing noted in their accounts to show that they were, told the practice is a non-par. And again alot of the claims are aged by two years or more.

Also the office clerks are not to enter the Medicaid card (in inactive status)into the patient account to show reference for check in, check out or billing that the patient has medicaid secondary even just for informational purposes.

The 2nd scenero…
A clerk has a patient call in to pay her bill. This patient has Cigna coverage only, she has been paying religiously on a large surgical bill for the past few months. The office clerk finds when she pulls up the account it was showing a insurance credit balance of over $ 5,000. And a patient credit balance of $ 75.00. The clerk remembers this was an account that she herself had found the charges were actually billed out twice a couple of months ago and had already brought it to the supervisors attention, and at that time the supervisor told her to contact Cigna to recoup one of the payments, the clerk did… But clearly the patient had been continuing to recieve a statement and pay payments. Even though there is a credit balance in the system.

The clerk placed the patient on hold, and consulted with the supervisor, and was told "tell the patient the balance had been satisfied." Then continues to tell her that she "did not need to tell the patient she had a credit balance, nor that the surgery was billed out twice. Just that she did not owe anything else."

The patient understandably confused, asked for a print out of the fiancial history for her records. So the clerk, sent the patient a copy, and it shows the patient credit balance as well as the insurance credit, so the patient will see she is owed a refund.

But am I wrong thinking the supervisor is committing fraud or at the very least extremely shady? This is only 2 situations of several others, she has confided in me about. I’d just like to hear some thoughts on the best way to advise her.

Thanks for taking the time to read. I know it’s lengthy.

Medical Billing and Coding Forum