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

Knee X-ray Series question

When a provider orders the following:
Right knee series includes bilateral AP, Bilateral weight bearing PA, lateral and bilateral Merchant views ordered and obtained.

What would the proper billing be? The way I understand it is the physician is looking at 3 views of the affected knee, 2 of the unaffected knee and then the Bilateral standing. Most insurance do not pay for the unaffected side as comparisons so would
73565
73562-rt-59
be appropriate? It has been shown to me that NCCI edits do not bundle these two codes and that 73562 is allowed with 73565 with modifiers.
I am finding quite a bit of conflicting information and most of the sources are from old dates, so I’m asking for advise.

Medical Billing and Coding Forum

X-ray billing help!

I’m new to an ASC facility and when it comes to x-rays (almost always performed along with a surgery), I am told that we code professionally with -26 modifier but don’t bill at all for the facility side. It was explained to me that x-rays are included in the global surgery package for facilities, so we will only get reimbursed for the professional side of it.

Is this correct? If so, can someone explain this further to me? I thought that for all x-rays if the facilities and doctors split bill, then the doctors append modifier -26 and facilities append modifier -TC and that both will get reimbursed. Or is this not the case when performed along with a surgery?

Thanks!

Medical Billing and Coding Forum

X-ray dicated vs X-ray order

Good Afternoon,

I am being told by our compliance officer that an x-ray dictation does not have to match an x-ray order given. The example I have is that our physician dictated in the note that he did an AP and Lateral of the right tib/fib but when I went to code/bill this out I saw that the order was for the right ankle. I was told that I should bill this out as it is dictated and that the order didn’t have to match the x-ray taken. I found documentation online that completely contradicts what they are telling me. I disagree with their answer but am forced to code this way. I would like another compliance officers opinion on this.

Thank you in advance!

Medical Billing and Coding Forum

Bilateral X-ray Modifiers

I work in Rheumatology and we are having an issue with United Healthcare paying for bilateral x-rays of any sort. I bill out with the LT/RT modifier per Medicare guidelines and United is denying them asking for 1 line with 50 modifier. Is anyone else having this issue? How did you rectify this? Thanks for your input

Medical Billing and Coding Forum

Billing professional component of x-ray

This has to be one of the most basic radiology coding questions, but if a physician sends a patient from the office to the hospital (outpatient) for an x-ray and then back to the office where the doctor interprets the film, how is the professional component billed with regard to place of service? Of course, the CPT would need the 26 modifier. Additionally, if the doctor did not actually look at the film until a later date, what would be the date of service?

Medical Billing and Coding Forum

Digital X-ray VS Computed X-ray

One of our offices recently acquired a digital x-ray system, while the other still has the cassette system. When billing Medicare for x-rays, we bill for the technical component and send the x-rays out to be read by another company. Should I be using different modifiers to distinguish which type of system was used. Example: for a chest x-ray, 2 view, I usually bill 71046 TC.

Medical Billing and Coding Forum

Foot x-ray denial due to many/frequency of service

Hi everyone,

Our Podiatrist performs foot xray in the office. But we received a denial from Medicare for CPT codes 73600 (LT ankle x-ray), 73630 (LT foot x-ray), 73590 (LT tibia/fibula x-ray) on the same day of service due to "Payment adjusted because the payer deems the information submitted does not support this many/frequency of services". I checked guideline, all three CPTs with maximum unit for single day of service are 3 units, we did not exceed the daily maximum, all CPT were reported with 1 unit on the same day of service.

On the other hand, the same patient has three consecutive office visits DOS 03/24/2017, 04/26/2017 and 05/12/2017 been submitted with all these XRAY CPT (73600, 73630, 73590) and all CPT with 1 unit per visit. And DOS 05/12/2017 has been paid, but for DOS 03/24/2017 is still pending and DOS 04/26/2017 was denied with too many frequencies. By any chance that Medicare is not covering it because procedures have been performed once a month?

Thank you very much for any input!

Medical Billing and Coding Forum