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

United Healthcare Commercial Reimbursement Policy Updates effective from Sep 1st, 2019


The modifier “GN, GO or GP” will be required on Always for “Therapy codes” to align with the Centers for Medicare & Medicaid Services (CMS).

According to CMS, certain codes are “Always Therapy” services regardless of who performs them, and always require a therapy modifier — GP, GO or GN — to indicate that they are provided under a physical therapy, occupational therapy or speech language pathology plan of care

“Always Therapy” modifiers are necessary to enable accurate reimbursement for each distinct type of therapy in accordance with member group benefits

Reference: UHC Modifier Updates


Coding Ahead

Cardiovascular Associates, P.C. Consents to Pay the United States Over $399,000 to Settle False Claims Act Allegations Relating to Improper Billing Practices

Cardiovascular Associates, P.C. has consented to pay $ 399,230.35 to settle asserts that they submitted false cases to the United States for administrations not rendered. Cardiovascular Associates P.C. is a therapeutic practice with workplaces situated in Rockville, Olney, Laurel and Germantown, Maryland.

Read The Full Story Here!

The post Cardiovascular Associates, P.C. Consents to Pay the United States Over $ 399,000 to Settle False Claims Act Allegations Relating to Improper Billing Practices appeared first on The Coding Network.

The Coding Network

United States Reaches $125,000 Civil Settlement

The US Attorney’s Office for the Eastern District of Missouri announced today that the US, Foot Healers, and its subsidiaries (Foot Healers) reached a civil settlement that will resolve the US’s claims against Foot Healers under the False Claims Act for knowingly submitting false claims to Medicare for podiatry services.

Click here for the full story!

The post United States Reaches $ 125,000 Civil Settlement appeared first on The Coding Network.

The Coding Network

United States of Care: Healthcare over Politics

A diverse group of leaders, including former Acting Administrator of the Centers for Medicare & Medicaid Services (CMS) Andy Slavitt, have come together to form a new movement that will champion the cause of affordable healthcare without mucking up the works with politics. They call it United States of Care. Serving as Board Chair of United […]
AAPC Knowledge Center

United Behavioral Heath withholding reimbursement for IRS reasons????

I was going to post this in the Behavioral Health section, but this is more about general payment.

Our facility (which has only been open since August 2016) has had a portion of all UBH payments withheld on a special memo line with a remittance code the states: "The IRS requires us to withhold a percentage of benefits paid to the above taxpayer name and ID number. This amount has been sent to the IRS as prepaid federal taxes. The patient is not responsible for this payment."

Our facility is out of network and these plans are mostly self funded, but I have never heard of taxes being paid on insurance benefits, especially when they are assigned to the provider. The claims reps from UHC cant even see the withholding since it appears to be after adjudication so it only shows up on the remittance. One UHC rep suggested that we might owe back taxes but as I mentioned before our facility had only been open 17 months and there is no way any sort of lien would happen on the 2016 taxes and we haven’t even begun to file our 2017 taxes.

If anyone can shed any light that would be great. I do have 3 separate investigations going on at UBH, but they wouldn’t elevate this to the management level as of yet. I need to get resolution to this soon since its taking 28% of our revenue from UHC (which is are largest payer)

In 10 years of doing this I have never seen anything like this. Please help.

Medical Billing and Coding Forum

United Healthcare and Moderate Sedation

United Healthcare will not separately pay codes 99152 and 99153. I have tried modifier XS, 59, and most recently 51. I, however, cannot find any medical policy stating that it is not separately payable as well. I called UHC and spoke to a representative who told me that they are separately payable, but he could not tell me what modifier they accepted.
Does anyone have any assistance they can give with this? I have been going back and forth with them since July.

Any help is much appreciated, any brainstorming is much appreciated.

Thank you all in advanced.

Alli

Medical Billing and Coding Forum

United health care detox rev codes denials

Is anyone seeing a trend for denials for auths description does not match codes.

I have been billing uhc 0126 h0008 – detox sa, and now denied due to uhc shows description sa detox residential.

Is there a more effective rev code to bill uhc for detox loc. ?

Any insight would be great

thank you,

Medical Billing and Coding Forum