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Secrets To Passing The Medical Coding CPC | Free CPC Exam Questions

Are you preparing for the medical coding CPC exam? If so, the best way to prepare is with CPC exam practice questions. You can get free questions at Medical Coding Pro. Best Medical Coding Course!

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Look Good in Orange?

Billing Expert Offers Tips for Avoiding Fraud Charges by Michael Vlessides San Diego—Few physicians ever seriously consider the possibility of becoming formally acquainted with the Office of Inspector General or the FBI.

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Pre-Cataract Surgery Coding Myths You Should Bust

Improperly coding IOL Masters or A-scans can cost your practice $30 per patient.

Calculating intraocular lens power for patients facing cataract surgery has gotten more precise as A-scan and IOL Master technology has advanced. But to make sure your practice is getting fairly reimbursed each time, you need to understand the bilateral rules for 76519 and 92136.

Could one of these myths be damaging your claims?

Include Bilateral and Unilateral Components in Global Code

Myth: If the ophthalmologist calculates IOL power in both eyes, you should report 76519 (Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation) or 92136 (Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation) twice (e.g., 76519-RT and 76519-LT, or 76519-50).

Reality: You should not report 76519 or 92136 with modifier 50 even if the ophthalmologist calculated the IOL power of both eyes, warns Maggie M. Mac, CPC, CEMC, CHC, CMM, ICCE, Director, Best Practices-Network Operations at Mount Sinai Hospital in New York City. To understand why, it’s helpful to know how Medicare’s Physician Fee Schedule values the procedures.

As it does with many other diagnostic tests, CMS divides the A-scan (76519) and the IOL Master (92136) into two components. The technical component (the actual performing of the test) is denoted with modifier TC, and the professional component (viewing and interpreting the results) is denoted with modifier 26.

For most procedures, the technical and professional components have the same bilateral status – for example, 92250-TC and 92250-26 (Fundus photography with interpretation and report) are both considered inherently bilateral, denoted with modifier indicator “2” on the fee schedule. The reimbursement for all components of 92250 is based on both eyes being tested.

Exception: For both 76519 and 92136, the technical component has a different bilateral status from the professional component. You can find…

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Medical Coding: 4 Tips To Eliminate Your Breast Implant Coding Challenges

Don’t lose 19342 pay for delayed insertion.

Your general surgeon may perform breast reconstruction following cancer, infection, trauma, or burns, or in some cases, strictly for cosmetic reasons. Make sure you capture appropriate implant pay, when that’s part of the surgical scheme, by following our experts’ tips.

Tip 1: Prosthesis’ Purpose Drives Coding

Breast implants commonly serve two functions — cosmetic breast enhancement or breast reconstruction following a disfiguring event such as mastectomy for cancer or a traumatic injury.

CPT divides implant codes based on the function, so that’s the first distinction you need to make when selecting the proper code.

Differentiate augmentation: Use 19325 (Mammoplasty, augmentation; with prosthetic implant) when the surgeon implants a breast prosthesis for breast enlargement. “Code 19325 describes cosmetic implants only,” emphasizes John F. Bishop, PA-C, CPC, MS, CWS, president of Tampa, Fla.-based Bishop and Associates.

When the surgeon implants a prosthesis to reconstruct the breast following mastectomy, you need to look elsewhere for a code. For silicone or saline implants involved in reconstruction, CPT provides the following two codes:

  • 19340 — Immediate insertion of breast prosthesis following mastopexy, mastectomy or in reconstruction
  • 19342 — Delayed insertion of breast prosthesis following mastopexy, mastectomy or in reconstruction.

Tip 2: Timing is Everything for Implant Placement

CPT provides 19340 and 19342 for breast prosthesis associated with mastectomy or mastopexy. You’ll decide between those two codes based on when your surgeon performs the implant procedure.

How it works: For patients whose physiology will accommodate a full-size saline- or silicone-filled prosthesis, your surgeon may place the implant immediately following the mastectomy. “If the surgeon inserts a breast implant at the same operative session as the mastectomy, you should report 19340,” Bishop says.  “For our mastectomy patients who opt for reconstruction, immediate treatment is the most common…

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Get a Free Medical Coding Practice Exam

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Medical Coding Practice Exams

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Medical Coding Exam Preparation

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Medical Coding Pro is the coders destination for information.

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Medical Coding Practice Exam

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Medical Coding Pro is the coders destination for information.

The Medical Coding Certification Practice Exam and Strategy in Value Bundle at a great price!

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Medical Coding Test Preparation

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Medical Coding Pro is the coders destination for information.

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Medical Coding Practice Tests

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Medical Coding Pro is the coders destination for information.

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Medical Billing and Coding Practice Exam

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Medical Coding Pro is the coders destination for information.

Get a free medical coding practice exam. Just visit our site, enter your email, and instantly it is on its way!

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Get a Free Medical Coding Practice Exam

http://www.medicalcodingpro.com. Medical Coding Pro is the coders destination for information. Get a free medical coding practice exam. Just visit our site, enter your email, and instantly it is on its way!

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Tip #2 on How to Pass the Medical Coding Certification Exam

http://www.medicalcodingpro.com. Medical Coding Pro is the coders destination for information. Learn how to pass the medical coding certification exam. Watch this valuable tip.

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Tip #4 on How to Pass the Medical Coding Certification Exam

http://www.medicalcodingpro.com. Medical Coding Pro is the coders destination for information. Learn how to pass the medical coding certification exam. Watch this valuable tip.

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Tip #3 on How to Pass the Medical Coding Certification Exam

http://www.medicalcodingpro.com. Medical Coding Pro is the coders destination for information. Learn how to pass the medical coding certification exam. Watch this valuable tip.

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