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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

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

Urgent Care Claim presentation – POS

Currently, we believe that some our small procedure’s done ( i.e. 94640 with UHC manage care) in Urgent Care are getting denied because our claim on the 1500 has it as 19 instead of 20 These Urgent Cares are freestanding and they have medical groups next to them as well. Since this is considered a class B emergency department, do we utilize the PO/PN modifiers, and if so when do we use them? Has anyone experience the same situation? .If so, what are the steps were taken to rectify?

Medical Billing and Coding Forum

CareWell Urgent Care Center Agrees to Pay $2 Million to Resolve Allegations of False Billing of Government Health Care Programs

The United States Attorney’s Office reported today that CareWell Urgent Care Centers of MA, P.C., CareWell Urgent Care of Rhode Island, P.C., and Urgent Care Centers of New England Inc. (CareWell), the proprietors and administrators of earnest consideration focuses situated all through Massachusetts and Rhode Island, have consented to pay $ 2 million to determine charges that they abused the False Claims Act by submitting swelled and upcoded cases to Medicare, Massachusetts Medicaid (MassHealth), the Massachusetts Group Insurance Commission (GIC), and Rhode Island Medicaid.

Read The Full Story Here!

The post CareWell Urgent Care Center Agrees to Pay $ 2 Million to Resolve Allegations of False Billing of Government Health Care Programs appeared first on The Coding Network.

The Coding Network

Need Podiatry Coding Help **URGENT**

Hi Everyone –

Can someone please assist with coding this visit note? I am getting 5 different answers from my coding team of 5 coders.

99212 – is this separately reportable, why or why not?
11720 – is this separately reportable, why or why not?
G0127-XU – is this separately reportable, why or why not?

In your opinion, what would be the final coding. See attachment.

This is for WYOMING MEDICARE
https://www.aapc.com/memberarea/foru…&thumb=1&stc=1

Thanks in advance for any help with this.

Attached Images

Medical Billing and Coding Forum

urgent help please on coding a stillborn delivery

New to INPT OB coding for the facility. I had a mom that was 16 weeks came in because of PROM, no fetal heart tones… So I have my principal dx as the missed abortion and I understand that you do not code the weeks of gestation and the outcome. However, patient was given cytotec, and stayed in hospital until she delivered the baby. I am looking only for what PCS code I should be using for this. Should I be coding the induction with cytotec 3EOP7GC and also a NSVD or a abortion code.. 10A07ZK

Medical Billing and Coding Forum

Urgent payment question

I have a question and need an answer as soon as possible. Pretty sure i am going to be giving my notice today due to this but want to make sure i am right first.

We see patients for mva, we were paid by geico and the patient had a 78.00 co-insurance balance per geico.

When the case settled the attorney and our owner agreed upon a 500.00 payment and there is nothing that says the patient owes that. In the email i got it said the owner felt the reduction was incorrect so he and the attorney agreed on the 500.00 full and final.

I do not think this is legal or allowed because if he disagrees with the payment he would have to take it up with the insurance not money from the patient’s settlement, correct? And if they reduction was incorrect, it was not 500.00 worth of incorrect.

They are telling me it is not illegal and that he is in the right accepting the 500.00 and i disagree and i am worried i should not stay in this office under the circumstances, i do not want my name on any of this as the billing manager.

Please any advise would be helpful. I really in a bad place right now with this.

Dorthi

Medical Billing and Coding Forum

In Urgent Care setting, Can a Physcian Assistant bill a new pt using his/her own NPI?

Hi coder family:)

I guess my question is can P.A’s see new patients in Urgent Care?

I am auditing our P.A.’s who see patients Monday-Sunday in Ortho Urgent Care. My question is, if a new patient comes in to be seen and a P.A. see’s them for the first time. Would the P.A. be able to bill under their own NPI or because the patient is new and a treatment plan has not been established, P.A. would need to bill incident to and bill using the Supervising doc’s NPI? I think a P.A has to use their own NPI when supervising doctor has no involvement in patients treatment?

Any help is appreciated and if anyone has reference materials to back it up, that would be awesome. Thanks!

Medical Billing and Coding Forum

E&M in the Urgent Care

A lot of my visits are new problems with a work up. Then very often sent onto the ER for the differential dx’s indicated in the MR.

#1 With this being said one example a pt comes in with abdominal pain, lets say some labs were done and and exray. Mr says sends pt to er for further evaluation. then shows differential dx of poss appy, etopic pregnancy.

Can I used those differential dx in the urgent care in my mdm or only the abdominal pain??? How would you guys score this for a new pt and for an est pt.? (any links to support would be helpful)

#2 pt comes in with chest pain, sent to the Er. MR states chest pain differential dx of MI. exray done. How would you code this for new pt and for est pt.

Thanks
Ginger, CPC, COC

Medical Billing and Coding Forum

Urgent Care-FALLS

Since there is not an Urgent Care specific forum, this is the next closest place 😉

In Urgent Care billing, how would you code a child who comes in with parent, to be "checked out" after a fall, but is completely normal upon physical exam? Not crying. No bumps/lumps/bruising, NOTHING.

W Codes, for falls, cannot be billed as sole and/or primary DX.

So, what would you code, in addition to the fall?

Z04.3? (Encounter for examination and observation following other accident) ? However, this is most likely to be denied, right?

Medical Billing and Coding Forum