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 left corner of this page

Practice Exam

2016 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
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Practice CPC Exam Package Review – 150 Question CPC Practice Exam, Answer Key, With Full Rationale, Medical Coding Certification Study Guide

What I like most about this CPC Practice Exam Package is that the full answers and rationales are given for all 150 questions. It also refers you to the relevant part of your textbook. They also provide the answer keys to each CPC exam question, so you can go through each one and see if your rationale is correct when testing yourself. I also found the CPC Exam Study Guide very helpful as it summarizes the whole textbook for you. As the CPC exam is an open book exam, you can actually mark your book or highlight the important texts or codes to help you search for the codes faster during the test. Do practice answering all 150 questions of the practice test within 5 and a half hours, make it to 5 hours if you can so you will have time to go back and check your answers.

The CPC Medical Coding Practice Exam is delivered as an electronic download (in the PDF format), which means it’s instantly accessible after purchase. The good news is that it’s priced at only $37.

This Price Includes:

Practice Exam

CPC Practice Exam and Study Guide Package

What is included in this package?

  • The Full 150 Question CPC Practice Exam
  • Answer Key, With Full Rationale
  • Scan Tron Bubble Sheets
  • The Exam Study Guide, including:
    Common Anatomy Terminology Handouts
    Common Medical Terminology Prefix, Root Word, and Suffix Handouts
  • The Official AAPC Proctor-to-Examinee Instructions (read out loud on the day of the CPC exam)

Download the full CPC Practice Exam Package here and receive your bonus at www.cpcmedicalcodingcertificationexamprep.org/cpcpracticeexam

By: Katherine Dawson, Certified Professional Coder

CPC Exam Review Video

Click to watch Laureen show you her proprietary “Bubbling and Highlighting Technique”

Download your Free copy of my “Medical Coding From Home Ebook” at http://www.cpcmedicalcodingcertificationexamprep.org

 

We specialize in preparing students for the AAPC CPC Medical Coding Exam and also the AHIMA CCS-P exam.

 

We also have a CPC Practice Exam Package With Full Study Guide which is very popular because it simulates the 150 Questions in the actual CPC Exam, and we also provide the answer keys and full rationale for each and every question. It even refers you back to the relevant part of your textbook. To get a copy of this sample CPC practice test paper, you can visit http://curemydisorder.com/links/cpcexampracticequestions

 

You’re most welcome to visit http://curemydisorder.com/links/cpcexampracticequestions to practice CPC exam questions and to learn more about our proven and effective medical coding exam preparation & studying techniques.

 

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More CPC Sample Exam Questions – Comes With Correct Answer And Full Rationale For Each Question

 CPC Exam Review Video

Click to watch Laureen show you her proprietary “Bubbling and Highlighting Technique”

Sample CPC Exam Question 2: Musculoskeletal

OPERATIVE NOTE

PREOPERATIVE DIAGNOSIS: myelopathy secondary to very large disc herniations at C4-C5 and C5-C6.

POSTOPERATIVE DIAGNOSIS: myelopathy secondary to very large disc herniations at C4-C5 and C5-C6.

PROCEDURE PERFORMED:

1. Anterior discectomy, C5-C6

2. Arthrodesis, C5-C6

3. Partial corpectomy, C5

4. Machine bone allograft, C5-C6

5. Placement of anterior plate with a Zephyr C6

ANESTHESIA: General

ESTIMATED BLOOD LOSS: 60 mL

COMPLICATIONS: None

INDICATIONS: This is a patient who presents with progressive weakness in the left upper extremity as well as imbalance. He has a very large disc herniation that came behind the body at C5 as well and as well as a large disc herniation at C5-C6. Risks and benefits of the surgery including bleeding, infection, neurologic deficit, nonunion, progressive spondylosis, and lack of improvement were all discussed. He understood and wished to proceed.

DESCRIPTION OF PROCEDURE:

The patient was brought to the operating room and placed in the supine position. Preoperative antibiotics were given. The patient was placed in the supine position with all pressure points noted and well padded. The patient was prepped and draped in standard fashion. An incision was made approximately above the level of the cricoid. Blunt dissection was used to expose the anterior portion of the spine with carotid moved laterally and trachea and esophagus moved medially. I then placed needle into the disc spaces and was found to be at C5-C6. Distracting pins were placed in the body of C6. The disc was then completely removed at C5-C6. There was very significant compression of the cord. This was carefully removed to avoid any type of pressure on the cord. This was very severe and multiple free fragments noted. This was taken down to the level of ligamentum. Both foramen were then also opened. Part of the body of C5 was taken down to assure that all fragments were removed and that there was no additional constriction. The nerve root was then widely decompressed. Machine bone allograft was placed into C5-C6 and then a Zephyr plate was placed in the body C6 with a metal pin placed into the body at C5. Excellent purchase was obtained. Fluoroscopy showed good placement and meticulous hemostasis was obtained. Fascia was closed with 3-0 Vicryl, subcuticular 3-0 Dermabond for skin. The patient tolerated the procedure well and went to recovery in good condition.

a. 22554, 63081, 63082, 20931, 22845

b. 22551, 63081, 20931, 22840

c. 22551, 63081, 63082, 20931, 22845

d. 22554, 63081, 20931, 22840

Rational:

Answer: A

Per. Paul Cadorette and the American Medical Association article titles, “Coding Guidance for Anterior Cervical Arthrodesis”, “When a spinal fusion (arthrodesis) is performed, the first thing a coder needs to recognize is the approach or technique that was utilized. With an anterior (front body approach)to cervical fusion the incision will be made in the patient’s neck, so the key terms to look for are platysma, esophagus, carotid, and sternocleidomastoid. These structures will be divided and/or protected during dissection down the vertebral body. After dissection, the procedure can proceed on one of three ways:

1) When the interspace is prepared (minimal discectomy, perforation of endplates) then 22554 would be reported.

2) When a discectomy is performed to decompress the spinal cord and/or nerve root(s) report 22554 for the arthrodesis along with 63075 for the discectomy procedure.

3) When a partial corpectomy (vertebral body resection) is performed at C5 and C6 report CPT code 22554 for the arthrodesis with 63081 and 63082. Two codes are reported because the corpectomy procedure is performed on two vertebral segments (C5 and C6). CPT codes 63081-63091 include a discectomy above and/or below the vertebral segment, so code 63075 (discectomy) would not be reported if performed at the C5-C6 interspace.

Once the decompression procedure has been completed, a PEEK cage can be placed within the interspace or a structural bone graft can be fashioned to fit the vertebral defect created by the previous corpectomy. Insertion of the PEEK cage would be reported with a biomechanical device code 22851. This code is only reported one time per level even if two cages are placed at C5-C6. When a structural bone graft is used, determine whether it is an allograft (20931)) or an autograft (20938). The bone graft codes are only reported one time per procedure and not once for each level. Finally, the physician will place an anterior plate with screws (22845) across the C5-C6 interspace to stabilize the area fusion”.

Some guidance on coding such procedures can also be located in the Spine (vertebral column) coding guidelines (above code 22010).

Learn more of these CPC exam questions with full answers and explanation at http://curemydisorder.com/links/cpcexampracticequestions

By: Katherine Dawson, Certified Professional Coder

Download your Free copy of my “Medical Coding From Home Ebook” at http://curemydisorder.com/links/cpcexampracticequestions

 

We specialize in preparing students for the AAPC CPC Medical Coding Exam and also the AHIMA CCS-P exam.

 

We also have a CPC Practice Exam Package With Full Study Guide which is very popular because it simulates the 150 Questions in the actual CPC Exam, and we also provide the answer keys and full rationale for each and every question. It even refers you back to the relevant part of your textbook. To get a copy of this sample CPC practice test paper, you can visit http://curemydisorder.com/links/cpcexampracticequestions

 

You’re most welcome to visit http://curemydisorder.com/links/cpcexampracticequestions to practice CPC exam questions and to learn more about our proven and effective medical coding exam preparation & studying techniques.

 

Practice Exam

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

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How To Crack CPC Exam At Your First Attempt

CPC Exam Review Video

Click to watch Laureen show you her proprietary “Bubbling and Highlighting Technique”

The CPC Exam is one of the most feared terms in the dictionary of a medical coding student. It is a challenge for some, cause of panic for few especially if they are not well prepared and yet for many it is just a process that can help them move forward as their preparations and merit get evaluated and certified. Certified Professional Coder (CPC) examination is quite a tough paper without proper preparation, and amongst the medical coding students, they often find it quite essential to practice CPC exam questions before sitting for the actual paper.

CPC and some facts: No one can be completely prepared for an exam, but they can give their all during exam preparation and do their best during the exam. During the preparation phase, finding the courses and sample questions and completing them in the allotted time is very much needed. There are many institutes who provide the medical billing and coding courses online. They also provide assistance for the preparation of the CPC exam practice test.

The idea there is not only to practice the CPC exam questions but also having an expert guide that helps in gathering detailed knowledge, and giving the full rationale answers and reference to the textbook. As the CPC exam is an open book exam, it is essential that every medical coder knows where to flip through the medical code book. The CPC exam practice test helps the students to practice the questions as if in the real exam, within the stipulated time of five and a half hours. This makes them not only certified but also gain recognition as they read the medical charts and assign the correct diagnosis and procedures more precisely.

Online Medical Coding Course And The Facilities:

The medical billing and coding courses online have its own share of advantages. These can be done at any own convenience from the comforts of the home. Laureen Jandroep has developed a Medical Coding Certification Review Blitz Videos for this purpose, which is available both online in video format, plus she also ships a physical copy of the videos in DVD format right to your home. The wonderful thing about these CPC Review Blitz Videos are that they are very affordable and genuinely helpful in your exam preparation, and even helps in your day to day work as a medical coder after you’re certified. These videos along come along with a detailed guide on the CPC Exam, which is an exhaustive review of all the various diagnostic and therapeutic procedures covered in the exam. These medical billing and coding courses online helps to get in touch with the experts such as Laureen Jandroep who demonstrate her proprietary study techniques such as the bubbling and highlighting technique and also teaches you how to make best use of the examination time allowed.

The video blitz reviews and the CPC exam practice test are exhaustive in nature and hence cover for every therapeutic and diagnostic procedure which form part of the exam syllabus. It also covers the physician based medical coding procedures, medical terminology and anatomy courses. When the students practice the CPC exam questions, it helps them in understanding the time allocation also. It is important because though some may say five and half hours is lot of time for an open book exam, in reality it actually feels otherwise. Hence, rather than feeling disheartened and scared for the exam, it is better to begin thorough preparation with the help of all the guides available online. Staying focussed and remembering the tips of the experts of the medical billing and coding courses online holds the key to cracking the exam at your first try.

By: Katherine Dawson, Certified Professional Coder

Download your Free copy of my “Medical Coding From Home Ebook” at http://curemydisorder.com/links/cpcexampracticequestions

 

We specialize in preparing students for the AAPC CPC Medical Coding Exam and also the AHIMA CCS-P exam.

 

We also have a CPC Practice Exam Package With Full Study Guide which is very popular because it simulates the 150 Questions in the actual CPC Exam, and we also provide the answer keys and full rationale for each and every question. It even refers you back to the relevant part of your textbook. To get a copy of this sample CPC practice test paper, you can visit http://curemydisorder.com/links/cpcexampracticequestions

 

You’re most welcome to visit http://curemydisorder.com/links/cpcexampracticequestions to practice CPC exam questions and to learn more about our proven and effective medical coding exam preparation & studying techniques.

 

Practice Exam

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

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Best Compilation of Sample CPC Exam Questions – Followed With Full Answer And Rationale

laureen-jandroep-bubble-highlight

Click to watch Laureen show you her proprietary “Bubbling and Highlighting Technique”

Sample CPC Exam Question 3: ICD-9-CM

Jim was at a bonfire when he tripped and fell into the flames. Jim sustained multiple burns. He came to the emergency room via an ambulance and was treated for second and third degree burns of his face, second degree burn on his shoulders and forearms, and third degree burns on the fronts of his thighs.

a. 941.20, 841.30, 943.25, 943.21, 945.36, 948.42, E897
b. 941.30, 943.29, 945.36, 948.42, E897
c. 941.09, 943.09, 945.09, 948.64, E897
d. 941.30, 943.29, 945.36, 948.64, E897

Rational

Answer: B

Burn codes always have no less than three codes: A burn code, a total body surface area code (948.XX), and an E code. You can have more than three codes but never less. Burn codes have the following rules (which can be found at the beginning of the ICD-9 book under general guidelines), always code one location to the highest degree (Ex. 1st and 2nd degree burns on the arm, only code 2nd degree). When sequencing burn codes always list the highest degree first (Ex. 1st degree burns to the face and 3rd degree burns to the arm. List the arm burn first and then the face burn). Answer B is the answer because its codes describe the highest degree burn to each anatomical location, it sequences the burn codes in order of highest to lowest degree burns, the 948 (TBSA code) has the correct calculation, and the E code correctly describes the bonfire incident.

Sample CPC Test Questions 4: Anesthesia

When does anesthesia time begin?

a. After the induction of anesthesia is complete
b. During the pre-operative exam prior to entering the OR
c. When the anesthesiologist begins preparing the patient for the induction of anesthesia
d. Once the supervising physician signs over the patient’s care to the anesthesiologist

Rational

Answer: C

The answer to this question can be located in the anesthesia coding guidelines under the title “Time Reporting”

Go Through more of these Sample CPC Test Questions with full answers and explanation at http://curemydisorder.com/links/cpcexampracticequestions

Proctor to Examinee Instructions

Proctor to examinee instructions for CPC exam

Practice Exam

CPC Practice Exam and Study Guide

Get the latest updates on the CPC Exam at http://curemydisorder.com/links/cpcexampracticequestions

By: Katherine Dawson, Certified Professional Coder

Download your Free copy of my “Medical Coding From Home Ebook” at http://curemydisorder.com/links/cpcexampracticequestions

 

We specialize in preparing students for the AAPC CPC Medical Coding Exam and also the AHIMA CCS-P exam.

 

We also have a CPC Practice Exam Package With Full Study Guide which is very popular because it simulates the 150 Questions in the actual CPC Exam, and we also provide the answer keys and full rationale for each and every question. It even refers you back to the relevant part of your textbook. To get a copy of this sample CPC practice test paper, you can visit http://curemydisorder.com/links/cpcexampracticequestions

 

You’re most welcome to visit http://curemydisorder.com/links/cpcexampracticequestions to practice CPC exam questions and to learn more about our proven and effective medical coding exam preparation & studying techniques.

 

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Tips For Passing CPC Exam – Practice CPC Exam Questions

If you are preparing for CPC exam then it is always recommended for you to take the CPC practice exams first, and timing yourself to finish within the stipulated five and a half hours. It is important that the practice CPC exam questions and answers are well crafted, and that full rationale answer keys are provided as this is where you will learn the most from, by learning where to refer for the answers in your medical codebook manual (as the CPC exam is an open book test). The medical coding practice exams that you can take are listed below:

  1. 1.      Downloadable 150 Question Medical Coding Practice Exam comes with a e-book for study tips and the exam questions, price of this whole package is $37 which includes all of the below:

a)      The Full 150 Practice CPC Exam Questions

b)      Answer Key, With Full Rationale

c)      Scan Tron Bubble Sheets

d)      The Exam Study Guide, including:

e)      Common Anatomy Terminology Handouts

f)       Common Medical Terminology Prefix, Root Word, and Suffix Handouts

g)      The Official AAPC Proctor-to-Examinee Instructions (read out loud on the day of the CPC exam)

Practice Exam

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

 

  1. The Medical Coding Certification Review Blitz Videos 2013 version, costs $179 for online access plus all free bonuses, or $247 for online access plus all free bonuses with the addition of a physical complete 6 DVD set and book being shipped to you:

medical-coding-blitz-video-2013

 LaureenJandroepMedicalCodingReviewVideos

Click to watch Laureen show you her proprietary “Bubbling and Highlighting Technique”

a) 9.5 hours of CPC Exam preparation video (immediate access online, also available in 6 DVDs)

01 Introduction To The Program

02 Medical Terminology CPC® Exam Prep

03 HCPCS CPC® Exam Prep

04 Modifiers CPC® Exam Prep

05 ICD-9 CPC® Exam Prep

06 E&M Section CPC® Exam Prep

07 Anesthesia Section CPC® Exam Prep

08 Radiology Section CPC® Exam Prep

09 Path & Lab Section CPC® Exam Prep

10 Medicine Section CPC® Exam Prep

11 Integumentary System CPC® Exam Prep

12 Musculoskeletal System CPC® Exam Prep

13 Respiratory System CPC® Exam Prep

14 Cardiovascular System CPC® Exam Prep

15 Digestive System CPC® Exam Prep

16 Urinary System CPC® Exam Prep

17 Genital System CPC® Exam Prep

18 Endocrine/Nervous System CPC® Exam Prep

19 Eye/Ear System CPC® Exam Prep

b) 60 minute one on one telephone support – Still have questions about coding? Getting a job in your area? Having problems with a particular area? Just send Laureem an email to the members area support and schedule a free 60 minute bonus call- one on one with her!

c) Yahoo Groups: Coding and Reimbursement News- This is a group of dedicated medical coders just like you.Join a thriving Yahoo Groups community and learn from those already in the field- and those looking to become coders too!

d) Monthly Training Webinar- Once a month Laureen Jandroep holds a special Q and A webinar session. Listen in as Laureen interviews other successful medical coders and take your questions!

e) Bubbling and Highlighting Technique- Use this technique to organize your manuals to use during your exam- and also when you actually are working! It will save you tons of time and make your work super- effective. Laureen’s students swear by it!

 

Laureen’s medical coding video review program prepares you for the following exams:

A) Certified Professional Coder (CPC) exam by the American Academy of Professional Coders (AAPC) and the

B) Certified Coding Specialist-Physician Based (CCS-P) exam by the American Health Information Association (AHIMA).

This is both a review of the subject matter and a guide to doing well on the exam. You will not only have an exhaustive review of all the various diagnostic and therapeutic procedures covered on the exam, the program will also demonstrate ways to go through the process of taking the exam in the most efficient manner, making best use of the time allowed. Since this is an open-book exam, the program teaches you my proprietary “bubbling and highlighting technique”. This technique demonstrates how to mark and highlight your coding manual to make it easier to choose the correct answer of the choices given for any question on the exam. You’ll see how to best manage some questions you might find more difficult than others.

The best approach for preparing for CPC exam is to take the second choice which is the CPC Exam Preparation Video Reviews, however it is more costly than the first choice, but well worth the money. The first choice CPC practice exams are online based and you’ll have instant access to the questions and full rationale answers. The method of this exam is really great and you get to learn alot from studying the full rationale answers.

This practice exam was previously available in the printed pattern but has recently been updated to the digital format and allows the exam to be done using downloadable PDF files. The download is quick and the exam provides great rationales as well. The package comes with a mini study guide that contains tips that you should follow for the preparation of the exam. The approach for it is great as you can solve it while using your computer or you can even print it out on the paper and then solve and maybe you want to scan tron it to have yourself a real CPC exam simulation.

IF you want to prepare a little more which you should; given the difficulty level of the CPC exam and your budget allows it, then you should also consider adding Laureen Jandroep’s CPC Certification Exam Video Reviews to your CPC exam practice preparation.

Tips for passing CPC exam:

-          Practice the CPC exam questions while referring to your medical codebook, without distraction and when you are completely ready. Attempt the questions like the real CPC exam simulation, timing yourself to exactly five and a half hours.

-          Time management is key, make sure you divide your CPC exam sections and spend a maximum time on each section.  Do not give a hard question too much time, just skip the ones you’re not sure of and come back to it later.

-          My students have found starting from the back of the paper saves them more time, because the questions in the CPC exam paper are typically more advanced and difficult at the end. So this way they get to tackle the toughest questions in the beginning, breezing through at the end.

 

By: Katherine Dawson, Certified Professional Coder

Download your Free copy of my “Medical Coding From Home Ebook” at http://curemydisorder.com/links/cpcexampracticequestions

 

We specialize in preparing students for the AAPC CPC Medical Coding Exam and also the AHIMA CCS-P exam.

 

We also have a CPC Practice Exam Package With Full Study Guide which is very popular because it simulates the 150 Questions in the actual CPC Exam, and we also provide the answer keys and full rationale for each and every question. It even refers you back to the relevant part of your textbook. To get a copy of this sample CPC practice test paper, you can visit http://curemydisorder.com/links/cpcexampracticequestions

 

You’re most welcome to visit http://curemydisorder.com/links/cpcexampracticequestions to practice CPC exam questions and to learn more about our proven and effective medical coding exam preparation & studying techniques. Learn the latest updates and tips for passing CPC exam for 2013.

 

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Practice Test For CPC Exam – How To Pass The AAPC Coding Certification Exam

If you are preparing for the AAPC CPC exam then it is always recommended for you to take some practice exams first. The practice tests that you take in order to prepare for the exam and the method of the exam is very important. You should always rely on the practice tests that are close to the actual exam schedule and question level.

AAPC exam for Certified Professional Coder can be quite a tough exam and many of us feel extreme need of integrated assistance for the exam. The exam can be hard to pass in the first attempt without proper guidance and practice, and that is why many people realize the need of a good quality practice exam to prepare for the exam in their second attempt for it.

CPC Practice Exam Package

A good practice exam should fully prepare its examinee for the real exam. Knowing what to expect and not being surprised on exam day are important.

AAPC’s CPC exam is 150 questions and must be completed in 5 hours and 40 minutes or less.

Practice Exam

Click here to try out some sample CPC exam practice questions which come with the full rationale answers

There are three main sections to the CPC exam:

1)      Medical Concepts

2)      Surgery and Modifiers

3)      Remaining CPT codes

Each of these three sections are then further divided into the following smaller headings.

 

1)      Medical Concepts:

**The following sub-divisions are each assigned 5-10 category specific questions**

Guidelines

Payment management

Medical terminology

Anatomy

ICD-9-CM codes

HCPCS codes

 

2)      Surgery And Modifiers:

**This section is mainly sub-divided to reflect the surgery section of the CPT book and assigns 5-10 category specific questions to each of the following sub-divisions**

Integumentary

Musculoskeletal

Respiratory

Cardiology

Hemic/Lymphatic systems

Mediastinum/Diaphragham

Digestive

Urinary

Male and Female reproductive organs

Maternity/ Endocrine system

Nervous system

Eyes/Ears

 

3)      Remaining CPT Codes:

**This portion of the exam focuses on the remaining CPT codes and assigns 5-10 category specific questions to each of the following sub-division**

Evaluation and Management

Anesthesia

Radiology

Pathology

Medicine

 

This 150 question CPC practice exam was created using the structure listed above in order to emulate the actual CPC exam as closely as possible. We felt that by doing this examinees would know exactly what to expect on examination day. By utilizing this structure examinees can better prepare for the exam by focusing on category specific questions and identifying areas of weakness. Knowing what to expect in detail also tend to help calm pre-test anxiety.

AAPC’s CPC exam is 150 questions long. Questions range from true and false, to 1-2 sentences, to full page operative notes.

 

Questions on the CPC exam do not cover just specific medical codes. Questions can be very diverse, testing the examinees knowledge on:

 

Coding Guidelines

Understanding of Conventions

Correct Modifier Use

Bundling and Global Packages

Medical Terminology and Gross Anatomy

 

We have taken into account the wide spectrum of diversity the CPC exam offers and have constructed the questions on our CPC Practice Exam to reflect those on the actual exam as closely as possible.

In addition to our well constructed questions we are also providing a full rationale for each question.

 

These rationales provide the correct answer for each question as well as a full explanation as of why this option is correct, why the other three options are incorrect, and where in the medical coding books the answer can be located.

 

Studying the rationale of an answer may very well be the easiest and most efficient way to learn how to pass the CPC exam.

The best approach for preparing for CPC exam is to take the Laureen Jandroep’s program for Medical Coding Practice Exam. The benefit of this package is that it allows you to have more closer and real time exam experience to the CPC exam. The method of this exam is really great and you get to learn a number of things from this exam session. The CPC practice exam offers 150 questions that are closely based on the method and level used by the CPC exam and the student has to attempt all questions in the time of 5 hours and 40 minutes. The practice exam tries to test your abilities of the following-

-The knowledge of coding guidelines

-The understanding of conventions

-use of the suitable modifier

-Knowledge of package types- bundling and global

-The knowledge about the terminology used in medical coding.

The CPC practice exam is available at reasonable price of $37. The package consists of 150 well constructed questions for the practice of the CPC exam, and an answer key for the paper. The package also consists of study material containing essential parts of the medical science which is important for the preparation of the exam and each question is supplied with a rationale. You can easily prepare for the CPC exam by studying the rationales provided in the CPC practice exam, and this is an effective way of preparing for actual exam scenario. The package also consists of additional matter as the official instructions guide for the AAPC exam and scanned copy of the bubble sheet for the practice exam so that you can actually take the exam in real exam environment.

The CPC practice guide contains questions with great consideration for the CPC exam and the questions are to provide realistic practice for the CPC exam. The questions given are of all types from true/false to the one liner and the full page questions, based on all three sections in the exam, which are Medical Concepts, Surgery and Modifiers, and Remaining CPT codes.

Some following tips are also useful while preparing for the CPC exam-

-           Take the exams like the real exams without distraction and when you are completely ready. Attempt the question like the real exam simulation.

-           Divide the questions with equal time management and don’t give a hard question too much time.

-           Go over the wrong answers and learn to fix the mistake.

Practice Exam

Click here to try out some sample CPC exam practice questions which come with the full rationale answers

CPC Exam Review Video

Click to watch Laureen show you her proprietary “Bubbling and Highlighting Technique”

By: Katherine Dawson, Certified Professional Coder

 

Download your Free copy of my “Medical Coding From Home Ebook” at http://medical-coder-certification.com

 

We specialize in preparing students for the AAPC CPC Medical Coding Exam and also the AHIMA CCS-P exam.

 

We also have a CPC Practice Exam Package With Full Study Guide which is very popular because it simulates the 150 Questions in the actual CPC Exam, and we also provide the answer keys and full rationale for each and every question. It even refers you back to the relevant part of your textbook. To get a copy of this sample CPC practice test paper, you can visit http://curemydisorder.com/links/cpcexampracticequestions

 

You’re most welcome to visit http://curemydisorder.com/links/cpcexampracticequestions to practice CPC exam questions and to learn more about our proven and effective medical coding exam preparation & studying techniques.

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Medical coding review videos as your exam prep

There are a lot of options out there when it comes to getting help to get you certified as a medical coder fast. You may have the experience and coding knowledge to take the CPC exam, but it is still a good idea to invest a little to get further coaching and advice as part of your preparation. There are no shortage of practice exams, books, prep courses, certified trainers, and review classes that you can use.

Let’s add one more unique choice to the list: coding review videos. Video engage more of our senses, so when we study using coding review videos or DVD, we simply absorb more due to the fact that it is in an audio and visual form. Laureen Jandroep has released her blitz review videos for coding and CPC exam for some time, and since it’s release has been helping students to pass the CPC exam on their first or next try.

So lets review again why Laureen Jandroep’s coding blitz videos or DVD are so much better as review materials:

First of all, you simply get more value from the videos or DVD because you get Laureen personally guiding you through all the steps you need to do to pass the certification exam. Every aspect is covered from identifying areas to focus on, how to maximize your study and exam time, how to mark up your CPT book, time management, and more. Check out her credentials as a certified medical coding and billing trainer and you’ll see why she has a long list of testimonials from past students.

When you do your review in videos, you absorb more information. She is speaking directly to you in the videos, so you pay more attention. You also get to follow along with her explanations and illustrations. Also, videos are less likely to make you fall asleep. If you commute a lot, why not download the videos onto your iPod or MP3 player to squeeze out more review time. When you’re at home, just pop in the DVD.

Not everyone studies at the same pace, so in a classroom environment you are usually either ahead or behind. The blitz review videos is like your virtual classroom, you get to pause, rewind, and fast forward your teacher. And if you have questions that aren’t answered in the videos, you still have her telephone support and access to her private community of experienced coders and billers.

Click here now to see a special video presentation for you by Laureen herself!

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Tips for taking the CPC exam

Nobody wants to know how to fail the AAPC CPC exam, so the following tells you what to look out for. You just need to be aware of certain CPC exam rules that can result in you getting disqualified or automatic failure. You can consider this as a quick checklist of what not to do when you’re in the medical coding certification or AAPC CPC exam hall. So let us discuss what are the things you shouldn’t do that breaks the exam rules.

Leave your cell phone behind

First of all, you’re not allowed to bring your cell phone to the exam. This also goes for any electronic devices like smart phones, tablets, mobile gaming consoles, etc. You wont have any place to stow them during the exam anyway, so the best solution is to just not bring them at all.

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Bring the right tools

With that said, make sure you do bring the required items for the medical coding certification exam. Check with the CPC exam proctors several days beforehand to know what you’ll need. Basically you’ll need a picture ID, your member ID, #2 pencils, as well as the CPT, ICD-9CM, and HCPCS II manuals.

Keep up to date

Remember that the code sets for each coding book are updated every year, so it’s essential for you to have up to date books. Using out of date books would obviously puts you at a disadvantage, with substantial penalization. The exams are updated every January for the new code sets, so you can’t use upcoming year’s book for the exam. Do keep in mind that the exam proctors may not clarify test questions during the CPC exam.

Tabbing your coding books

You’re permitted to tab your coding books for quick reference, whether you inserted, glued, pasted, taped, or stapled it in the manuals. Having handwritten notes in the coding books are also acceptable only if they pertain to daily coding activities. The guideline is that they should be used with the intent to earmark a page with words or numbers, not supplement information in the book.

Keep it to yourself

Finally, any attempt to smuggle exam materials out of the exam hall will result in you failing the AAPC CPC exam. If you exhibit collaborative or disruptive behavior, then it can be cause for immediate action by the proctors. Because the CPC exam materials are confidential, you may not copy or discuss the questions with others during or following the examination. Now that you know how to fail the AAPC CPC exam by breaking the exam rules, be sure to keep all the points here in mind and you’ll do well to pass the AAPC CPC exam.

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What’s inside Laureen Jandroep’s Medical Coding Videos?

Click here for the latest updates.

You’ll get immediate online access to all her hours of videos, presented by Laureen Jandroep to personally coach you towards passing the AAPC CPC/AHIMA CCS-P exam. The videos are divided into chapters of about 20-35 minutes of videos each. The topics include:

1. Introduction to the program
2. Medical Terminology
3. HCPCS CPC
4. Modifiers
5. ICD-9 (new ICD-10 updates here)
6. E&M Section
7. Aneshesia Section
8. Radiology Section
9. Path & Lab Section
10. Medicine Section
11. Integumentary System
12. Musculoskeletal System
13. Respiratory System
14. Cardiovascular System
15. Digestive System
16. Urinary System
17. Genital System
18. Endocrin/Nervous System
19. Eye/Ear System

The videos cover all you need for the exam. You will learn Laureen’s proven study technique bubble and highlighting” to help you organize your notes and manuals so come exam time, you’ll be looking up codes faster than those without this strategy. Exam tips, pitfalls, and time management strategies are also covered by Laureen to help you along. These are study and exam techniques that apply equally well to any other open-book exams.

In addition to the videos, you’ll receive support from Laureen herself personally in the form of a telephone calls. Anything you’re not sure of have questions will be answered by Laureen herself. Not only that, you get access to her monthly webinars to interview and ask questions of medical coding success stories. And to ensure your continued success after passing the exam, you also get invited to her community of medical coders. This is where you can introduce yourself and meet others in this field to share ideas, discuss issues, or to help each other out!

Paradigm Spine Agrees to Resolve False Claims Act Allegations

Recently, the US Department of Justice made an announcement that Paradigm Spine has agreed to resolve false claim accusations levied against it concerning the coflex-F® device. The department has stated that Paradigm Spine has allegedly provided its health care providers with incorrect information on claiming reimbursement for the coflex device.

Read the full article here: https://www.justice.gov/usao-md/pr/paradigm-spine-agrees-resolve-false-claims-act-allegations

The post Paradigm Spine Agrees to Resolve False Claims Act Allegations appeared first on The Coding Network.

The Coding Network

2015 MU Attestation Deadline Approaching


If you are an eligible professional participating in the Medicare EHR Incentive Program, you have until 11:59 p.m. ET on February 29, 2016 to attest Meaningful Use for 2015 EHR reporting period. 

If you are participating in the Medicaid EHR Incentive Program, please refer to your state’s website for attestation information.

If you are a Medicaid participant who is subject to Medicare penalties and you’re attesting for the first time in 2015, you can demonstrate Meaningful Use on the Medicare attestation portal by February 29th to avoid penalties in 2016 and 2017. You will still need to submit a Medicaid attestation with your state to earn incentives. If you are a returning Medicaid MU participant who is eligible for Medicare penalties but unable to meet the 30% patient volume threshold, then also you can demonstrate Meaningful Use on the Medicare attestation portal by February 29th to avoid 2017 penalties.

Medicare Attestation Portal: https://ehrincentives.cms.gov/hitech/login.action


Coding Ahead

Medicare will hold HCPCS codes G0477 through G0483 till April 04, 2016


CMS discovered systems errors affecting claims with new drug testing laboratory codes (HCPCS codes G0477 through G0483) with dates of service on or after January 1, 2016. Your Medicare Administrative Contractor (MAC) will be holding these claims until April 4, 2016. No provider action is required. However, should you wish to avoid your claims from being held, you can remove codes G0477 through G0483 and submit the rest of the services on the claim. When the system is updated in April, you can submit an adjustment claim to add these HCPCS codes. Your MAC will correct any claims previously returned to you in error with these codes and reason code W7006 after the system is updated


Coding Ahead

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New Payment Models and Rewards for Better Care at Lower Cost

Originally Published by CMS.gov

On July 25, 2016, the Department of Health & Human Services (HHS) proposed new models that continue to shift Medicare reimbursements from quantity to quality by creating strong incentives for hospitals to deliver better care at a lower cost. These models would reward hospitals that work together with physicians and other providers to avoid complications, prevent hospital readmissions, and speed recovery.

Background

Under the proposed episode payment models, the hospital in which a patient is admitted for care for a heart attack, bypass surgery, or surgical hip/femur fracture treatment  would be accountable for the cost and quality of care provided to Medicare fee-for-service beneficiaries during the inpatient stay and for 90 days after discharge. Participating hospitals will receive a separate target price for each MS-DRG under the model. All providers and suppliers would be paid under the usual payment system rules and procedures of the Medicare program for episode services throughout the year. At the end of a model performance year, actual spending for the episode (total expenditures for related services under Medicare Parts A and B) would be compared to the Medicare quality-adjusted target episode price that reflects episode quality for the responsible hospital. Hospitals that work with physicians and other providers to deliver the needed care for less than the quality-adjusted target price, while meeting or exceeding quality standards, would be paid the savings achieved. Hospitals with costs exceeding the quality-adjusted target price would be required to repay Medicare.

Episode Payment Model Details

Setting Target Prices for Specific Conditions

Each year, CMS would set target prices for different episodes based on historical data on total costs related to the episode for Medicare fee-for-service beneficiaries admitted for heart attacks, bypass surgery, or surgical hip/femur fracture treatment, beginning with the hospitalization and extending 90 days following discharge. Target prices would be adjusted based on the complexity of treating a heart attack or providing bypass surgery. For example, CMS proposes to adjust prices upwards for those heart attack patients who need to be transferred to a different hospital during their care to reflect the most resource-intensive cardiac care provided during the hospitalization. For heart attack patients, target prices would also differ depending on whether the patient was treated with surgery or medical management.

Target prices would be based on a blend of hospital-specific data and regional historical data:

July 1, 2017 – December 31, 2018 (performance years 1 and 2): Two-thirds participant-specific data and one-third regional data;

2019 (performance year 3): One-third participant-specific data and two-thirds regional data; and

2020 – 2021 (performance years 4 and 5): Only regional data.

 

Paying More for Higher-Quality Care

Under the proposed bundled payment models, hospitals that delivered higher-quality care would be eligible to be paid a higher amount of savings than those with lower quality performance. Specifically, an individual hospital’s quality-adjusted target price would be based on a 1.5 to 3 percent discount rate relative to historical spending, with the lowest discount percentage for those hospitals providing the highest-quality care. Payments would be based on a quality-first principle: only hospitals meeting quality standards would be paid the savings from providing care for less than the quality-adjusted target price.

Hospitals would be assessed based on quality metrics appropriate to each episode, using performance and improvement on required measures that are already used in other CMS programs and submission of voluntary data for other quality measures in development or implementation testing:

Heart attacks:

Hospital 30-Day, All-Cause, Risk-Standardized Mortality Rate Following Acute Myocardial Infarction (AMI) Hospitalization (NQF #0230)   
Excess Days in Acute Care after Hospitalization for Acute Myocardial Infarction
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey (NQF #0166)
Voluntary Hybrid Hospital 30-Day, All-Cause, Risk-Standardized Mortality eMeasure (NQF #2473) data submission

 
Bypass surgery:

Hospital 30-Day, All-Cause, Risk-Standardized Mortality Rate Following Coronary Artery Bypass Graft (CABG) Surgery (NQF #2558)
HCAHPS Survey (NQF #0166)

Hip/femur fractures (same measures as in the existing Comprehensive Care for Joint Replacement (CJR) model):

Hospital-Level Risk-Standardized Complication Rate Following Elective Primary Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty (TKA) (NQF #1550)
HCAHPS Survey (#0166)
Voluntary Total Hip Arthroplasty (THA)/Total Knee Arthroplasty (TKA) Patient-Reported Outcome (PRO) and Limited Risk Variable data submission

As part of implementing the new models, CMS would provide hospitals with tools to help them improve care coordination and deliver higher-quality care. Proposed activities include providing participants with relevant spending and utilization data, waiving certain Medicare requirements to facilitate development of novel approaches to the delivery of care, and facilitating the sharing of best practices between participants through a learning and diffusion program.

Phased Implementation

Recognizing that hospitals will need time to adapt to the new models and establish processes to coordinate care, the proposed rule includes a number of measures to ease the transition, including gradually phasing-in risk.

Downside risk (possible repayments to Medicare) would be phased in:

 July 2017 – March 2018 (performance year 1 and quarter 1 of performance year 2):  No repayment;
April 2018 – December 2018 (quarters 2 through 4 of performance year 2): Capped at 5 percent;
2019 (performance year 3): Capped at 10 percent; and
2020 – 2021 (performance years 4 and 5): Capped at 20 percent.

Gains (payments from Medicare to hospitals) would be phased in:

 July 2017 – December 2018 (performance years 1 and 2): Capped at 5 percent;
2019 (performance year 3): Capped at 10 percent; and
2020 – 2021 (performance years 4 and 5): Capped at 20 percent.

The first performance period would run from July 1, 2017 to December 31, 2017. The second through fifth performance periods would align with calendar years 2018 through 2021.

How the Bundled Payments Would Work: An Example

Consider hospitals in model years 4 and 5 in a region where Medicare historically spent an average of $ 50,000 for each coronary bypass surgery patient, taking into account the costs of surgery as well as all related care provided in the 90 days after hospital discharge. Target prices would reflect the average historical pricing minus the discount rate based on quality performance and improvement.

Hospital A is performing at the highest overall level on quality measures and its discount rate is 1.5 percent for the episode. As a result, its quality-adjusted target price for bypass surgery is $ 49,250 (or $ 50,000 minus the discount of $ 750). By taking measures to avoid readmissions and other unnecessary costs, Hospital A is able to reduce average total hospitalization and related 90-day post-discharge costs for bypass surgery patients to $ 48,000. Hospital A would be paid average savings of $ 1,250 per patient. Hospital B in the same region also reduces its average costs to $ 48,000 per patient. However, it achieves only acceptable overall performance on quality measures. Its discount rate is 3 percent and its quality-adjusted target price is $ 48,500 (or $ 50,000 minus the discount of $ 1,500). Hospital B would be paid average savings of only $ 500 per patient. Hospital B in the same region also reduces its average costs to $ 48,000 per patient. However, it achieves only acceptable overall performance on quality measures. Its discount rate is 3 percent and its quality-adjusted target price is $ 48,500 (or $ 50,000 minus the discount of $ 1,500). Hospital B would be paid average savings of only $ 500 per patient. 

Participants in the New Bundles

For the new cardiac bundles, participants would be hospitals in 98 randomly-selected metropolitan statistical areas (MSAs). Hospitals outside these geographic areas would not participate in the model.  There is no application process for hospitals for these models.

Because the hip/femur fracture surgeries model builds upon the existing CJR model, CMS proposes to test these bundled payments in the same 67 MSAs that were selected for that model.

Rural counties are excluded from the models. In addition, CMS proposes to limit financial risk for the remaining rural hospitals that are located in participating MSAs, such as sole community hospitals, Medicare-dependent hospitals, and rural referral centers.  Specifically, these hospitals’ total losses are limited to 3 percent for the second through fourth quarters of 2018 and 5 percent for 2019 through 2021.

Collaboration with Other Providers

One of the major goals of bundled payments is to encourage coordination among all providers involved in a patient’s care: for example, collaboration between hospitals and physicians and skilled nursing facilities. Therefore, as in the CJR model, CMS is proposing to allow hospital participants to enter into financial arrangements with other types of providers (for example, skilled nursing facilities and physicians), as well as with Medicare Shared Savings Program Accountable Care Organizations (ACOs). Those arrangements would allow hospital participants to share reconciliation payments, internal cost savings, and the responsibility for repayment to Medicare with other providers and entities who choose to enter into these arrangements, subject to the limitations outlined in the proposed rule.

Evaluation

As noted above, preliminary results from other tests of bundled payments for cardiac and orthopedic care suggest that these models have strong potential to improve patient care while reducing costs. Because they will include a wide range of hospitals around the country, the models announced today will allow CMS to test the impact of bundles on quality and cost when implemented at scale and across all types of providers and patients.

CMS’s evaluation of the models will examine quality during the episode period, after the episode ends, and for longer durations such as one year mortality rates. CMS will examine outcomes and patient experience measures such as mortality, readmissions, complications, and other clinically relevant outcomes. The evaluation will include both quantitative and qualitative data and will use a variety of methods and measures in assessing quality. The outcomes examined will include: claims-based measures such as hospital readmission rates, emergency room visits rates, and the amount of care deferred beyond the 90-day post-hospital discharge episode duration; HCAHPS satisfaction and care experience measures; and functional performance change scores from the patient assessment instruments in home health agencies and skilled nursing facilities. In addition, CMS plans for the evaluation to include a beneficiary survey that will be used to assess the impact of the model on beneficiary perceptions of access, satisfaction, mobility, and other relevant functional performance measures.

In addition to the formal evaluation, CMS is proposing continuous monitoring of arrangements between participants and collaborators and auditing of patients’ medical records to allow early detection of and intervention in any quality concerns.  

 

Additional Information

The Medical Management Institute – MMI – Medical Coding News & MMI Updates

Physician Orders for Lab, Radiology Services, and Other Services after ICD-10 Implementation


CMS is not requiring the ordering provider to rewrite the original order with the appropriate ICD-10 code for lab, radiology services, or any other services after ICD-10 implementation on October 1, 2015, including Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS).

Products and services that require a diagnosis code on the order will use ICD-9-CM codes if written prior to October 1, 2015. If the order is for a repetitive service that will continue to be delivered and billed after October 1, 2015, providers have the option to use the General Equivalence Mappings (GEMs) posted on the 2016 ICD-10-CM and GEMs web page to translate the ICD-9-CM codes on the original order into ICD-10-CM diagnosis codes.


Coding Ahead

Transition to ICD-10 easier than expected(ICD-10 slowdown of 14%)

The extreme predictions about the negative effects of moving to ICD-10 just didn’t happen. Now, over eight months later, one of the country’s leading organizations which has been tracking the ICD-10 transition says that there have been minimal effects at best.

Read the full story here: http://www.healthdatamanagement.com/news/the-transition-to-icd-10-was-easier-than-expected

The post Transition to ICD-10 easier than expected(ICD-10 slowdown of 14%) appeared first on The Coding Network.

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What is a Medical Coding and Billing Career Like After Schooling is Complete?

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Finishing the requirements for a certificate or associate degree in medical coding and billing is only the beginning. Now’s the time to begin applying for positions and testing your skills. Your job search likely won’t be long because the demand for medical coders and billers is high. The Bureau of Labor Statistics reports that employment in the health informatics field will grow faster-than-average by 15 percent through 2024. Healthcare providers can’t be reimbursed and remain profitable without medical coding and billing specialists. Here’s what this in-demand job will entail after graduation.

Daily Responsibilities

Medical coders and billers oversee crucial steps in the reimbursement process to keep the revenue cycle flowing. Medical coding specialists will carefully review patient files in the electronic health record system. By following the doctor’s notes, they’re able to assign numerical codes to the diagnosis and treatment provided. Coders flip through resource books to determine the right CPT or ICD-10 codes for each patient service. Every cost, including lab tests, consults, medications, and treatments, gets coded. Medical coding specialists often talk with physicians or nurses to clarify any unclear patient information.

For medical billing jobs, the daily duties will differ. Medical billers collect the records that have been coded to turn treatments into invoices. They assign financial values to patient services and submit insurance claims to the proper carrier. Billing specialists interact with the insurance company’s representatives to get claims processed. If coverage isn’t available, medical billers will send out bills to patients and follow up until they’re paid. When claims are denied, they also spearhead the appeals process on behalf of patients. Some medical billing specialists assume basic accounting roles by drafting accounts receivable reports.

Typical Work Environment

Medical coders and billers work behind the scenes in office cubicles for healthcare organizations. Most of their day is spent sitting at a desk, typing on the computer, and speaking on the phone. The desks of medical coding and billing specialists are often stacked with reference materials, claims forms, and patient files. They work independently because paying attention to detail is essential for accuracy. Direct patient contact isn’t common unless they must answer invoice questions from an uninsured individual. Medical coding and billing jobs are usually full-time with normal 40-hour weeks from nine to five, but part-time scheduling is offered too.

Virtually all healthcare organizations depend on a medical coding and billing team. The majority, around 38 percent, are employed in state and private hospital systems. Medical coders and billers also work in physician offices, outpatient centers, clinics, specialty hospitals, rehabilitation facilities, and managed care organizations. Others work on the opposite side of the claims process for health insurance companies. Experienced coders could work for government agencies like the Department of Health and Human Services (HHS). Although it’s important to beware scams, some medical billing and coding jobs are remote for working from home.

Career Advancement

Since medical codes and insurance laws continually change, schooling never really stops in this profession. Becoming certified is the best way to advance your career. The American Academy of Professional Coders offers the industry’s certifications. The Certified Professional Coder (CPC) credential is available to those with two years of coding experience and 36 continuing education units. There’s also the Certified Professional Biller (CPB) and Certified Risk Adjustment Coder (CRC) designations. Experience can lead to advancement in other avenues too. Coders can eventually become medical records technicians, coding managers, clinical data analysts, and health information directors.

Building a career in medical coding and billing provides many benefits without a long trek into higher education. Graduates of online or on-campus training programs will utilize state-of-the-art software technology to coordinate patient payments. The career path offers an average yearly salary of $ 40,430, or $ 19.44 per hour, with room for advancement. Medical coding and billing jobs place workers at the helm of keeping healthcare systems profitable and cost-effective.

Top Medical Coding Schools

University of Missouri settles health care fraud claim

Settling a claim that their health care program committed fraud, the University of Missouri has agreed to pay the United States government $ 2.2 million. The program had been accused of violations of the False Claims Act by submitting many claims for their radiology services to various federal programs (such as Medicare and Medicaid), and also for maintaining that radiology images had receive physician review.

You can read the full article here: http://www.kansascity.com/news/business/national-international/article87143042.html

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Top 10 Cringe-Worthy Things Wannabe Coders Say

My blog is over six years old!  Seriously, I just checked.  In the last six years as I’ve put myself out there as the Coder Coach, I’ve spoken either personally, over the phone, or via email to hundreds – okay, it’s really probably dozens – of coders and tried to answer their questions about what it takes to be a coder.  I’ve been amazed at how those answers have changed since then, from the evolution of technology, which allows most coders to work remotely to finally seeing ICD-10 come to fruition. So I figure it’s about time I published my top 10 list: the most cringe-worthy things people say when they tell me they want to be a coder.

Don’t get me wrong.  My intent is not to put anyone off, but over the last six years, this coding thing has really caught on and I wouldn’t want to steer anyone into a career that isn’t right for them.  So take a moment to read through the list and decide if you’re guilty of any of these. Since David Letterman’s Late Show is no longer a thing, consider this my replacement Top Ten List.

And before you get upset, please read the sign: I’m not arguing, I’m just explaining why I’m right.  In other words, I’m being a coder (occupational hazard).

Number 10:Which type of coder pays the most?

Answer:  A really good one.  Focus your efforts on landing a job and then mastering it.  If you choose your work setting solely for making money, you may find yourself miserable and (maybe) sort of well off.  If you choose to follow your passion, the possibilities – and pay check – are pretty much endless.  Employers are willing to pay good money for really good coders who don’t complain about how much they hate their jobs.  I don’t actually do any hiring, but if I did, I would hire the hungry novice coder with a good attitude and a willingness to learn over the experienced grouchy coder who seems to hate her job.

Number 9: Should I be a hospital or physician coder?

Have you ever seen the movie City Slickers?  The answer is in that movie when Jack Palance says the meaning to life is “one thing.”  Billy Crystal asks him, with great interest, what that one thing is.  The answer: that’s what you’ve gotta figure out.  You and only you can decide which setting is right for you and there is no right or wrong answer.  I love getting an inpatient hospital chart and trying to figure out the latest surgical procedures and how to code them.  I would rather poke my eyes out with a dull pencil than assign an E/M level to a physician’s chart.  I know other coders who love E/M coding.  It’s like being a cat person or a dog person.  You will probably find that you like one more than the other and there is no wrong answer (unless you are not a cat person, and then we can’t be friends anymore).

Number 8: No one will hire me with the coding credential I have; they all want something else

This is probably going to sting a bit, so brace yourself.  Why did you pay to get credential without first looking at local job postings and doing some research?  If you are reading this before going to school or getting certified, then do your homework before you pay any money to any educational institution.  All kinds of people will tell you anything to get your money.  Only local employers will be honest about what credentials they want.

Number 7: Where can I get free continuing education credits?

Free CEUs are out there, you just have to look for them.  Most AAPC local chapters offer free monthly educational sessions.  There are opportunities to summarize articles and get credit.  Coding Clinic offers a quarterly webinar that is free.  Other organizations offer free CEU credits.  Do an internet search and you may be surprised what you will find.  Did you do something, like attend grand rounds at a hospital, that you thought was very educational but you don’t have a certificate?  Contact the certifying body and see if they will grant you CEUs for it.

Number 6: I can’t afford to join AHIMA or AAPC

This one might sting too.  Find a way to make it happen.  As far as I’m concerned, when I hear this, it tells me you don’t want it bad enough.  Granted, I started very young and was still living at home when I first joined AHIMA, but make no mistake, I worked hard to get where I am today. Find a way to afford that membership and show people you are serious about a coding career.  And if you have a credential through and let your membership lapse, you likely lose the credential.  You worked hard for that credential – don’t let it go.

Number 5: This is my second (or third) career; I can’t afford to start at the bottom

This is a great second or third career for people who discover they missed their passion until later in life.  But here’s the reality: you still likely have to start at the bottom.  I’ve seen people find their way into coding by some very unusual means, but the ones who make it are the tenacious ones who won’t take no for an answer.  Pretty much no one starts out in their dream coding job.  You will have to pay your dues.  And please don’t think that means  I can’t appreciate your experience in your previous profession.  There are definitely things you can bring to the table, but remember that in coding, you are a novice.  I’m a great coder, but I’m pretty sure if I decided to change careers tomorrow and become an aerospace engineer, there would be a bit of a learning curve. 

Number 4: Will you mentor me?

It’s an innocent question and I’m flattered.  Really.  But I decided a long time ago that I would mentor from afar by penning this blog.  I don’t have a consistent schedule to be able to spend a lot of quality one-on-one time mentoring.  But if you email me a specific question, I will do my best to answer it.  My advice is to find someone local to mentor you.  Ask them if they can meet you once a month for lunch and come prepared.  What are the questions you want answers to?  What challenges have they had in their career that they wish someone would have told them when they were getting started?  This is a great entry into your local coding network.

Number 3: I went to school for (fill in the blank) months/years and I’m certified; I’m qualified to be a coder anywhere

No.  You’re really not.  I went to school too for two years and let me just tell you that even though I learned some good fundamentals, the real coding world is nothing like I thought it would be.  I learned everything I really needed to know about being a coder on the job, not in school.  I’ve now been coding for more than 20 years and I hold four different certifications and I have a news flash for you: I am not qualified to code anywhere.  I lack the practical experience of a physician office coder.  I find coding radiation oncology charts waaaaaayyyy outside my comfort zone.  And please don’t ask me to fill out an IRF-PAI for inpatient rehabilitation.  In other words, after 20 years, I am not all that and a bag of chips, so please don’t insult the world of experienced coders by thinking you have this all figured out.  I learn something new each. and. every. day.  Keep an open mind and be willing to learn – and admit when you’re in over your head.  Natural curiosity and a willingness to learn is a good thing.  Acting too big for your britches is not.

Number 2: How can I get experience if no one will hire an inexperienced coder?

I would give anything if people would stop asking me this question.  Because honestly, I don’t know the answer.  I don’t know what your background is.  I don’t know what your aptitude for coding is – and it is a skill that many people don’t possess.  I don’t know where you’ve applied or how hard you’ve tried to sell yourself.  And probably most importantly, I don’t have a clue what it’s like to try to get a job today because the atmosphere is so different from 20 years ago.  But this is what I do know.  Don’t limit yourself to coding jobs.  Find a job – any job – that will require you to have coding knowledge.  When you do an online job search, search on the code sets (ICD-10 or CPT) and not the word coder.  There are so many jobs out there that revolve around coding that aren’t traditional coding jobs.  Getting your foot in the door is one step closer to getting that traditional coding job – or something even better than you ever imagined.  And don’t forget to network.  If you want to work with coders, surround yourself with coders.  Who you know may be your golden ticket.

And the Number 1 Cringe-Worthy Thing Wannabe Coders Say is: I want to be a coder because I want to work from home

AACK!!!!  Not a good lead in!  And if this is the first statement out of your mouth when you go into an interview, you probably won’t get hired because here’s a huge industry secret: hiring managers hate hearing that’s why you’re there.  It’s like going on a first date with someone you just met and gushing about how badly you want to get married and have 6 kids. It’s just not done.  If this is the real reason you want to be a coder, please re-evaluate.  Coding is a great career if you love it.  If you don’t love it, you will be miserable for 8 hours every day.  And if you are miserable at home for 8 hours a day, that can be really depressing.  Also think about the child care aspect.  I often hear people say they want to work from home because they can’t afford child care.  Many coding contracts require you to have child care in place.  Coding takes intense concentration and you can’t babysit a kid at the same time.  Working from home is a great perk, I will admit, but it is not the reason I have the job I have.  I refer you back to Number 10 above: follow your passion.  If you’re lucky, you can make some good money while you do what you love… from home… in your bathrobe.

Coder Coach

Showing Patient Payments in CMS 1500 form


Most of the practices would collect copayments from the patient at the time service. Although it’s not a violation for participating providers to accept payment prior to rendering services, there are specific guidelines to follow, especially when reporting these payments.

Additionally, some providers who accept assignment have a concern that Medicare issues partial checks to beneficiaries. Such checks are generally issued because of a patient paid amount in item 29 of the CMS-1500 (02/12) claim form.

Here are a few guidelines to follow;

Medicare Part B recommends not to collect copay amounts prior to a claim being submitted to Medicare since it is difficult to predict when deductible/coinsurance amounts will be applicable (and over-collection is considered program abuse). So, it is recommended that providers not to do so until Medicare Part B payment is received.

If you believe you can accurately predict the coinsurance amount and wish to collect it before Medicare Part B payment is received, note the amount collected for coinsurance on your claim form. It is recommended that providers do not collect the deductible prior to receiving payment from Medicare Part B because, as noted above, over-collection is considered program abuse. In addition, this practice can cause a portion of the provider’s check to be issued to beneficiaries on assigned claims. 

Do not collect money from the patient for the preventive services for which copayment and coinsurance are waived. Please refer Preventive Services covered by Medicare.

Do not show any amounts collected from patients if the service is never covered by Medicare Part B or you believe, in a particular case, the service will be denied payment. Where patient paid amounts are shown for services that are denied payment, a portion of the provider’s check may go to the beneficiary.

There is no need to show a patient paid amount in item 29 of form CMS-1500 (or electronic equivalent) when assignment is not accepted.

Reference: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c26.pdf


Coding Ahead