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

Pain coding – Right lateral epicondyle injection with ultrasound guidance

HELP!
This is the procedure:
Procedure: Right elbow extensor tendon ultrasound guided corticosteroid injection.
Consent: Written consent was given after the risks, benefits, and alternatives of the procedure were explained and patient agreed to proceed with the injection. Indication for ultrasound guidance procedure includes avoidance of further ulnar nerve damage, obesity.
Description of Procedure: Right elbow extensor tendon injection: With the arm pronated, the proximal forearm close to the lateral epicondyle was prepped in standard sterile fashion and appropriate sterile cover and gel were used for ultrasound procedure. Using a Sonosite M-Turbo 15-6MHz linear array probe scanned both in long and short axis and injected in short axis visualizing elbow extensor tendon clearly. Procedure note: Written consent was given after the risks and benefits of the procedure were explained and pt agreed to proceed with the injection. The pt remained seated for the procedure with the left fully relaxed. After standard sterile preparation with Chloraprep. The extensor forearm was then injected utilizing the "peppering" technique with redirection of the needle several times with 1cc of 1%lidocaine without epinephrine and 40mg kenalog (NDC # 0003-0293-05) with intermittent negative withdrawal of heme. The needle was withdrawn. The pt tolerated the procedure well and there were no complications. There was immediate relief of symptoms. A sterile bandage was applied. Pt was given instructions to avoid more than 5 lbs lifting or pulling with right hand for 2 weeks. may ice today only..

Should this be billed as a trigger point? My doctor is wanting it billed as a 24357.
Any guidance will be appreciated. Thanks in advance.

Medical Billing and Coding Forum

Ultrasound Billing Question

We are an ambulatory clinic with a mid-level provider that is also a licensed sonographer. Sometimes he will preform ultrasounds on our patients to help determine a diagnosis. The images are never forwarded to a radiologist so we do not have official radiology reports. How do we bill these scans (or should we be billing them at all?) Thanks!

Medical Billing and Coding Forum

Intraoperative Ultrasound during Thyroidectomy

Hi all,

In all my 7 years of coding for ENT, this is the first time I’m coming across this and I wanted to know if what is being done is tip-toeing on the edge of over-utilization or not medically necessary….

Endo surgeon performs thyroidectomies and lobectomies all the time without any intraoperative ultrasound. All of the sudden now EVERY single case has included 76536 (Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation) and I’m concerned that this is not medically necessary. I haven’t been able to find a single scholarly article, coding article, or even Physician membership board mentioning that this is somehow routine (or even a new way of performing the surgery). I’ve worked with 2 different ENT groups and this is the first time I’m seeing them bill for 76536; 1-2 cases here and there, I can understand…this is literally every single patient on their list all of sudden.

Most of the documentation is verbatim in every op report and reads: "After induction of general endotracheal anesthesia, Intraoperative neck sonography was performed for incision site planning and to rule out interval development of malignant adenopathy or extrathyroidal extension of tumor. The patient was then prepped…"

Medical Billing and Coding Forum

Complete retroperitoneal ultrasound w/ bladder scan

One of the urologist physicians that I work for wants to report CPT 76770 along with CPT 51798 (Measurement of post voiding residual urine). Per AUA, a complete retroperitoneal ultrasound (CPT 76770) can be reported if complete evaluation of the kidneys and urinary bladder has been done and with clinical history suggesting urinary track pathology. AUA has added that "when an abdominal ultrasound and pelvic ultrasound are performed to evaluate the kidneys and bladder, technically both a 76705 and a 76857 are performed to evaluate each of these organs. However, the American Medical Association has determined that CPT code 76770 should be billed if the clinical history suggest urinary tract pathology." Based on this information, CPT 76705 + 76857 = 76770 (for evaluation of kidneys and urinary bladder). In addition, AUA indicates that "if the urologist performs bladder US to view the anatomy, the architecture , or the morphology of the full bladder as well as to DETERMINE PVR AFTER VOIDING, use CPT code 76857." My questions, is our physician wrong to report CPT 51798 if based on the information from AUA, the PVR is included in the complete retroperitoneal study? Or in what cases CPT 51798 can be unbundled since the it has indicator 1 when CPT 76770 and 51798 are report together? Hope I am making sense. Thank you in advance for any response

Medical Billing and Coding Forum