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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

Do you use your local MAC to see last visit

I am wondering if anyone uses there local MAC to look up patients to see when they had there IPPE or Initial/Subsequent Wellness Visit? In the MLN booklet put out by Medicare it says you can check AWV eligibility information through HIPAA Eligibility Transaction System(HETS) or through the provider call center Interactive Voice Responses (IVRs).

Does anyone have experience doing this and do you feel as if it is effective? I’m trying to find a better way to make sure we are capturing the correct level of service when we do our HCCs. Noridian is our carrier.

Thank you.

Medical Billing and Coding Forum

Wiki initial hospital visit with EPF history

Hello Guys ,

still a big confusion .can anyone help with this :

If all three key elements of the minimum initial hospital visit are not met, would you instead submit subsequent hospital codes ? (Ex: initial hospital visit case is leveling out to History – EPF, Exam -EPF and MDM – Moderate). Being the lowest level is detailed/detailed/low, I’m not sure how to proceed. Any insight appreciated, thank you!

please provide reference.

Medical Billing and Coding Forum

PE annual and office visit for tick bite?

Would it be appropriate if patient presents with a tick bite and bull’s eye rash to bill an office visit with a PE annual when patient is also being seen for this?
In this case the MD ordered labs to check for Lyme’s and gave Rx for doxycycline, in addition to performing an Annual Physical Exam to a non-Medicare patient.
Would a PE code for non-Medicare/commercial insurance and 99213 be appropriate to bill together?
Thank you

Medical Billing and Coding Forum

99231 for a follow up visit after a C-section

Is it appropriate to bill 99231 when our anesthesiologist visits the patient bedside to evaluate and document her post op intrathecal pain control.
Details are given for 2 of these 3 components:
A problem focused history,
problem focused exam
and medical decision making of straightforward or low complexity.

If you have any resources will you please share them?

Medical Billing and Coding Forum

Nurse visit and office procedure

My office is wondering why I do not bill the nurse visit(99211) with office procedure(granulation tissue removal). I explain that it is a NCCI edit. My office would like to have documentation stating why. I tried looking the NCCI website for further clarification. Do anyone know where I could find references for regarding E&M and procedures(office)?

Medical Billing and Coding Forum

97110 by General Practitioner or Family medicine in office Visit

Hello,

Request to guide that, can we report 97110 (Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility) for below scenario ?

In the office visit of Worker’s Compensation of California by general practitioner or family medicine, provider documents below paragraph with the heading of therapeutic exercises.

THERAPEUTIC EXERCISES
The patient was personally trained in appropriate warm up, strengthening and stretching exercises. These rehabilitative exercises were reiterated, demonstrated and reinforced; while the patient actively participated. This is also intended to be performed at home on a daily basis. The rehabilitation routine decreases inflammation, increases flexibility and strength of the specific structures in the injury adjacent locale to include both agonist and antagonist muscle groups, intrinsic flexor, extensor and rotary muscles as well as supporting structures. The exercises were intended to increase strength and range of motion and decrease pain. The minimum time required for CPT 97110 was exceeded for this patient.

Medical Billing and Coding Forum

Office visit sent to ER

Hello, this is my first time using the forum, so I wasn’t sure how to make a post/thread. Hopefully someone can help me out or point me in the right direction. I bill for an Internal Med office and the doc says there is a modifier to use when a patient is seen in the office and then later transported to the hospital. I have one now that was seen for new pt visit but half way through, the ambulance was called and transported the pt to hospital. The doc wants me to bill 99204-AI-25 with 99354, can anyone provide any insight, please?

Medical Billing and Coding Forum

New patient office visit with new patient physical/preventive

For commercial insurance, is it better to have patient come back for an annual PE just after patient presents as a new patient? (for 2 separate visits)
In other words, when a patient moves to a new area, and they are due for a Physical/preventive, is it usual for practices to schedule a new patient visit and have the patient come back another day for their annual?
Or, if they are to be billed together, (regarding non-Medicare only, not Wellness) what are the requirements necessary for the providers to document in order to bill both on same day? (PE-annual and office visit same day billing)
Thank you

Medical Billing and Coding Forum