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

Welfare and Pension through Emdeon….= Aetna???

I wonder if anyone else is having difficulty with Welfare and Pension regarding electronic claims submission?
I received a hospital facesheet indicating an address and phone# for her insurance carrier. I called and the automated system says,
"Welcome to Welfare and Pension Provider Line" it goes on to tell the caller to "Submit your claims electronically through Emdeon… which is what I did! I have proof of filing and acceptance from Emdeon and proof it was passed and accepted by Welfare and Pension.
I submitted a high dollar claim to W&P through Emdeon… as instructed to do when I called their telephone#.
Claims accepted per Emdeon submission report. Sorry to repeat myself but I am a little stunned here.
TIME GOES BY…
Patient calls and says she called them, this is months later and no claims on file, can I send to them to W&P again… I did.
Months later and past timely filing, patient calls again to say no claims on file per W&P.
I call and am told they sent out letters both times stating to send my claims to Aetna. This is past timely now
and Aetna of course denies for timely even with the information attached showing claims filed to W&P timely, twice.

Fast forward past timely – patients W&P Claims manager calls me and ultimately states I need to write the balance off because I failed to submit to Aetna timely. We are not par-providers with either company. I asked her if W&P is her insurance carrier or Aetna? It is W&P she says but they contract Aetna to receive, scrub and price the claim then send to W&P for payment. So ultimately Welfare and Pension will receive the claim in the end anyway!
Anyone else having issues with an insurance comapny requesting claims subnmittal to other than themselves and denying timely if you happen to send to the actual insurance company???

Medical Billing and Coding Forum

30th anniversary celebration: Leading through fear

30th anniversary celebration

Follow your instincts

by Patty T. Sheridan, MBA, RHIA, FAHIMA

When I look back on 30 years of involvement with HIM, it’s hard to believe that I was also passionate about another profession at one time. But I actually came to my career as a coder by way of my associate’s degree in veterinary science. As I explored my options to pursue a bachelor’s degree, my veterinary colleagues suggested I speak with a career counselor at a nearby college, and the counselor helped me to connect the dots between my personal strengths and aptitudes. My love of medicine, science, and information became evident.

I weighed out the pros and cons of a career in veterinary science and one in medical records. This is how I came to realize that I wanted a career that built upon my professional interests in healthcare and information management. My love of animals has translated to my personal life, so I have realized the best of both worlds!

 

A trifecta of HIM advantages

When I began pursuing my degree back in the mid-80s, we didn’t have a choice to join AHIMA. It was expected. We were expected to join, volunteer, and be fully engaged in our profession, even as students. As I became exposed to more aspects of the profession, I realized there were three critical advantages provided by AHIMA.

First, building a network of professionals would help me advance my career and provide mentors for the road ahead. Second, I had access to just-in-time information regarding my profession as part of working on committees addressing HIM practice issues. But more than anything, being actively involved in HIM helped me grow and evolve as a professional, as I was constantly pushed beyond my comfort zone in many areas related to management and leadership.

HIM, like the healthcare industry as a whole, has had to adapt to changes and trends in the world around us. I love that HIM is constantly evolving to respond to the needs of healthcare. There are specific points in our history when change has been particularly marked, and the current environment ranks among the most exciting and dynamic time of change.

A foundation of relationships

The value of networking was evident to me early on. However, I wish I had realized the value of forming deeper professional relationships when I was younger. A strong relationship foundation in the workplace leads to good things. Collaborating and asking for help gives you the skills needed for managing anxious situations, getting past conflicts, doing meaningful work with others, and improving your own outcomes. Not only are peer-to-peer relationships vital, but so are cross-departmental relationships, as well as an ability to work closely with managers at all levels.

The foundation of a good relationship is built on honest conversations, even when difficult, because that is how you create mutual respect and get things done. I do wish I had learned earlier on the importance of collaboration, rather than trying to solve problems on my own. The power of a group of experts, all giving their very best ideas to resolve a problem, can change the trajectory of a healthcare system in an environment where change can be difficult.

 

Getting ahead of the curve

One accomplishment I can say I’m most proud of is my work as an early adopter of technology in the late 80s and early 90s, which resulted in solving problems related to health information access and exchange. As an early pioneer working on document imaging solutions, I was in a unique position to make meaningful contributions to my workplace and to healthcare reform activities. To this day, I look for innovative ways to apply technology in my role?it can be incredibly powerful.

I’ve also experienced great satisfaction from my work as a coding supervisor in a large healthcare system. DRGs were just being implemented when I took on a supervisory role in my late 20s. I had the opportunity at a young age to build a collaborative effort among coders, physicians, and C-suite executives to ensure successful DRG implementation. This experience led me to appreciate leadership on a deeper level and realize that leadership is more than just a line on an organizational chart. I have come to think of leadership as something anyone can exercise regardless of their title. We are all responsible for exercising leadership and doing our job to the best of our abilities, no matter what our title is.

Adaptive change

As HIMB celebrates 30 years of HIM, it’s obvious that much about HIM has changed. But the guiding principles of information management and the importance of following my instincts and adapting have remained constant. Given how quickly change is happening, it has become less important to try and predict what will happen in the future and instead remain flexible when change occurs.

As HIM professionals, we can model what it looks like to break through silos, improve data quality, innovate HIM processes, encourage patient engagement, and remove barriers to accessing and sharing information. Every day, I ask myself, what do I need to do today to be a responsible leader? It’s a question that always helps me to stay focused and keep moving forward.

 

Editor’s note

Patty Thierry Sheridan, MBA, RHIA, FAHIMA, is the senior vice president of HIM services for CIOX Health in Alpharetta, Georgia. She is a trailblazer who is passionate about health information management (HIM), leadership, and volunteerism. She has a track record of leveraging HIM, business, and leadership experiences to create innovative HIM solutions and develop successful leaders. Prior to joining CIOX Health, she was the president of Care Communications, Inc., and has also held senior roles at the American Health Information Management Association (AHIMA) and HIM roles in acute care teaching facilities.

She is the recipient of AHIMA’s Distinguished Member Award and the Illinois Health Information Management Association’s Professional Achievement award. She has published research articles and authors the column "Hands-on Help" in the online magazine, Advance for Health Information Professionals and Executive Insight. She is a frequent speaker on the topics of health information management and leadership. She is the Chair of the Resurrection University Board of Directors for the College of Nursing and College of Allied Health, and a member of the AHIMA Foundation Research Network.

 

Leading through fear

It is often said that people fear public speaking even more than they fear death. I am one of those people. When I was asked to speak early in my career, even just at a meeting, I would literally get sick to my stomach. My heart would race and I would get nauseated. I understood, though, that if I failed to conquer this fear, it would limit my career growth. I wanted to make a difference, and that’s hard to do if you’re silent!

Over the years, my fear got worse, not better. I enjoyed hearing others and learning from them, and I know my colleagues wanted to hear my ideas as well. So, to overcome my fear, I looked for opportunities to speak at workplace meetings and at conferences. Throughout this journey, many people encouraged and coached me, including professional presenters. I learned how to regulate my breathing and speak without notes. I realized the importance of not hiding behind a podium so I could connect with my audience.

Over time, I trained myself to speak confidently. I still get nervous to this day before getting up in front of a group. However, once I begin talking, my fears dissipate. This has proven to be a valuable leadership lesson for me. I overcome obstacles by pushing through them rather than avoiding them, and look for help from strangers and mentors when I need it.

HCPro.com – HIM Briefings

Case study: Saint Anthony cuts a swath through catheter infections with hospitalwide huddles

In just two years, Saint Anthony Hospital in Chicago faced down HAIs, cutting its HAI rate by 90% and saving itself $ 498,000. The hospital even won the Illinois Health and Hospital Association’s (IHA) “Innovation Challenge: Partners in Progress Award.” 

HCPro.com – Briefings on Accreditation and Quality

Preicardial window through diaphragm incision

I need some guidance on this one:
Trauma patient had and exploratory laparotomy, which was negative. The diaphragm was then "grasped and incised. Pericardium was visualized and opened." The pericardium was examined and determined negative. Does anyone know a CPT code to use for the diaphragm incision with examination of the pericardium?

Medical Billing and Coding Forum

Laparoscopic Assisted Combined abdominal and perineal pull through

Good morning everyone,

I couldn’t find a CPT code for the above procedure. The diagnosis is Imperforate anus, urethral fistula.
Procedure Performed: Laparoscopic mobilization of rectum and separation of urethral fistula, perineal approach for repair of high imperforate anus with pull-through. Surgeon also did on-table colostogram. The closes code I can find ranging from 46735 to 46742. However, they all are open techniques w/different approach. Do I have to use the unlisted code? What’s about the colostogram? Can we charge for this? Please help!

Thanks for any inputs and have a happy Friday:)

Angie

Medical Billing and Coding Forum

Medical Centers – Meeting Growing Demands Through Expansion

Medical centers must grow alongside growing communities and an increasing population. Many general hospitals provide a number of healthcare services, offering patients convenience as they take care of all their needs in one location. Comprehensive medical centers meet the varied needs of patients by providing high quality medical care using advanced technologies.

Home Care

Many general hospitals offer patients specialized services in addition to 24-hour emergency care, in-patient care, and surgical care, including cardiopulmonary rehabilitation, dedicated heart centers, and care in a patient’s home.

Medical centers and clinics know patients feel better and tend to heal faster when they recuperate in the comfort of home. In-home treatment plans are a viable option for homebound patients or for patients who move from a hospital stay to home care.

General hospitals and home care clinics feature trained, licensed professionals in healthcare areas that include nutrition, speech therapy, occupational therapy, physical therapy, and nursing. Home care treatments can consist of many options like disease management, wound care, post-operative care, and rehabilitation.

Heart Clinics

Since the number one cause of death in America is heart disease, many general hospitals have technologically advanced heart clinics that respond to heart attack and stroke victims. These medical centers also assist patients with preventative measures that include accurate diagnoses, regular screenings, and heart and stroke education.

Heart clinics also have dedicated cardiac teams waiting on standby to provide patients bypassing the emergency room with immediate critical care. More advanced medical centers offer innovative ICE programs that involve cooling a patient’s body for 24 to 36 hours after cardiac arrest before slowly raising it to normal. This unique technology increases the survival rate above the national average. In addition, comprehensive medicals use heart clinics to endorse other community outreach programs.

Rehabilitation Programs

Patients suffering from cardiac arrest, stroke, or pulmonary disease recover quicker when participating in a cardiopulmonary rehabilitation program. The patients benefiting the most include those who suffered cardiac arrest and then underwent bypass surgery, coronary stent replacement, or a heart transplant.

Physicians watch and evaluate a patient in a cardiopulmonary rehabilitation program, monitoring the oxygen level, blood pressure, and heart rate of these patients during prescription exercises on therapeutic equipment.

Equally important, cardiopulmonary rehabilitation places emphasis on heart and health education after a patient’s hospital discharge and rehabilitation completion. This helps patients learn new healthy habits that aid in the recovery process and prevent future complications.

Medical centers understand the importance of offering comprehensive healthcare to their varied, growing communities. General hospitals provide patients with the individual care needed from a team of expert healthcare professionals dedicated to caring for the diverse needs of their patients.

Christine O’Kelly writes for the Citrus Memorial Health System, a premier Inverness medical center. Citrus Memorial Health System is a top Florida general hospital.

More Medical Coding Articles

Filling Medical Vacancies Through Locum Agencies

Finding locum doctors and nurses to fill temporary or part time positions can often be time consuming, and vacancies may often need to be filled quickly. If you are looking for locum staff to fill positions at a hospital, surgery or similar healthcare practice, then a locum agency which deals specifically with healthcare professionals may be the quickest and simplest way to find new staff.

A locum agency will often have access to a very wide range of healthcare professionals from all grades and specialisms, and it should be easy to find an appropriate candidate in your local area. Many applicants will be looking for temporary or part time positions to fit in around their home responsibilities or other work activities, so you should be able to fill any vacancies quickly and simply. It is often a good idea to look for a large locum agency which will be able to take a lot of the responsibility and work out of finding new staff. There can be a lot of technical details and paperwork to deal with when you are hiring new employees, and checks on qualifications, general health and police clearance amongst others should all be completed.

A good locum agency will be able to take care of these necessities and technicalities for you, and you should be provided with candidates who have been checked thoroughly, are fully qualified and have the correct experience and knowledge to fill the positions that you have advertised. Trying to find new staff members for a number of positions can also be a challenge, and managing a few vacancies at once can be confusing or time consuming. A good locum agency will be able to deal with any number of vacancies that you may have at any given time, which will relieve a lot of pressure and give your more time to spend on more pressing tasks.

If you are really pressed for time, then an experienced locum agency should even be able to give you advice and help you to organise your search. This could be in terms of creating a list of required qualifications and attributes that your candidates should have, or creating a vacancy profile or advertisement. Medical locum agencies which have a large client base and a solid background of extensive experience can help you in many different ways.

Finding an agency should be easy thanks to the internet, and any good medical recruitment agency will have a comprehensive website with a good range of information for you to peruse. You should be able to get a good idea of the kinds of services that they can offer, and most will also have staff on hand for to contact to get more information. Finding a locum agency that can offer a personal service is always a bonus, as this will ensure that your vacancies are advertised in the best possible way. A personal service is also important during the recruitment process, and you should be kept well informed and advised throughout.

For further information regarding http://www.id-medical.com/”> locum agency , please visit our website at http://www.id-medical.com

Find More Medical Coding Articles

CPT CODE for Drainage of ascites through a peritoneal port

Can anyone give us direction on which CPT code to use for a patient who comes in with an existing peritoneal port for drainage of ascites. This is the note:

Pt was placed in bedroom and positioned. Vitals taken. Site draped and was cleaned with iodine, alcohol and chlorhexidine. Peritoneal
port was accessed aseptically with no issues. Three liters removed via phlebotomy bottles with no issues. Vitals continuously
assessed. Pt deaccessed and observed for thirty minutes.

Medical Billing and Coding Forum