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Again I am scheduled to take the COSC. And again, the study guide and practice test are the same as last year. And to make me feel like this is a racket,II obtained the 2015 study guide, and it IS THE EXACT SAME as the current. The only difference is ICD-9. I was told by AAPC that the guides are updated when there are coding changes. So, apparently there have been no Orthopedic coding changes since 2015?
Hello all, I took my CPC exam a week and a half ago and got a failing score. Im scheduled to take it again next month and I was wondering, Do I have to take the whole thing again or do I just retake the sections I did poorly on?
Pam Brooks
Pam Brooks
You will be expected to take the entire examination over.
Autopsy (Necropsy), Exam done. what CPT we have to give, there is no other information in report.

Thanks in advance.
Billing manager just informed me NY Medicaid does not have CPT code 33274 in their fee schedule and to find another CPT code similar. I've been checking the CPT code and cannot find one. Has anyone in NY bumped into this issue with Medicaid?
I don't get it why its not in their fee schedule when I thought MCD follows Medicare guidelines. Can anyone help?
Pam Brooks
Pam Brooks
If 33274 is the code that exactly reports the service provided, then you may not 'find a similar code that will get paid". This is inappropriate coding, and your billing manager needs to be educated on compliance.
NC Medicaid- I would like to know if anyone know how to bill for the facility fee and if so- what's the code?
Pam Brooks
Pam Brooks
This is a loaded question. Facility fee for what? OP clinic? Surgical suite? It's not this simple. Consult your chargemaster manager at the hospital to determine the methodology for determining facility charges. This is typically posted from the department, not from coding (and definitely not from a physician's practice coder). Not sure you're on the right track. At the very least, we need more info.
Yes, premixed. We are simply providing it (being billed by the vendor) and administering it. I concur with your thoughts of using 95120 vs. 95165. I feel if it is given to us premixed then billing 95165 would be fraudulent since 95165 includes in the definition "supervision of the preparation." If it is premixed, how can we bill for "preparation" or "supervision of preparation"? Do you have a background in allergy?
Very minimal. But I teach CPC curriculum.
You seem to know a lot about Annual Wellness visits. I have a quick question, maybe you could help. If a patient comes in for an annual wellness visit, is seen, but leaves before the provider can complete of a plan of care for the diagnoses, is there anything the provider can bill since she spent time with the patient?
I'm currently certified as CPC-A for ICD10-CM but I'm trying to look for a training program and go for certification in ICD10-CA. Where can I start looking into this? Anyone that can suggest a training program or agency who specialize in..
Anxiously awaiting results of my 2nd attempt at CPMA certification. Just out of curiosity - has anybody ever taken a test a 2nd time and realize you received the EXACT same version as the 1st attempt? That would be odd lol.

After I get results, I'll be posting some issues I have with the CPMA exam. Not necessarily "trick" questions but the answer choices should have been better though-out.
I used the AAPC study guide for CPMA. You will need it to pass the exam, unfortunately. It's only 80 pages of material and most of the hyperlinks they provide are no longer valid.
David, sorry to hear you did not pass (you will next time). Was the second test the same or different? Thank you
In the class for CPMA, they ask questions like that where the case study is incomplete but tells you to choose and e/m.
Hello, Ms. Mitchell
I was wondering if you might be able to provide me with some examples of proper use/improper use of Aftercare and Follow-Up Diagnosis Codes in the Orthopedic Setting.

I've seen all of your comments regarding this topic, however I am now trying to explain the difference to my providers. I'm confused about when a Follow-UP code would be used vs. Aftercare. thanks a lot.
can you report a dx based off the documentation in the HPI?
Pam Brooks
Pam Brooks
HPI is generally a subjective narrative, based on the patient's answers to questions I would cautiously abstract from the HPI, only if you can support the validity of the diagnosis with a reference to treatment, management, or other assessment or evaluation. I generally educate providers to bring HPI information down to the assessment and plan so that the diagnosis is confirmed.
I have very eager to learn IP DRG coding
if anyone can expert please help me:):)
Pam Brooks
Pam Brooks
AAPC does have the CIC study guide and examination. Another choice would be to look at the CCS examination from AHIMA. I only know enough to be dangerous. I recommend a training course, or very intensive on-the-job training.
QUESTION: Medicare is denying TD with the Z23 modifier. there are injury codes. I used an AT, GY modifier, but Medicare isn't recognizing the dx code Z23. any ideas??
If documentation supports injury codes, you may need to add the injury dx codes.
You must submit with the injury codes as the dx. Cannot use Z23.
Hi All

I have an question on pathology and Laboratory services requires 26 Modifier when performed in any specific criteria are met?

Anyone help for this
Good afternoon , one Q, do you know if can we code 99397 + G0439 together ?
I think no, but in my job they are using. becasuse i'm new 😬
Pam Brooks
Pam Brooks
Since 99397 is statutorily excluded from CMS payment, this won't bump up against an edit, however both are preventive type visits. A commercial payer may allow them, if they additionally cover the G0439, which is a Medicare code. We typically won't bill 99397 to Medicare patients because of the non coverage, unless they specifically ask.
Hello! I am ready to work now but I am having a hard time finding a job without experience. Can somebody help me, please? I live in Mesa AZ. Thank you.
Hello everyone,

I am looking to to volunteer or shadow a medical coder. I live in Orlando, Florida and been looking at getting more experience. If you know a place I can go to or someone that work as a coder from home please let me know.

Thank you so much

In the patient setting, is it allow to use "consistent with" or "compatible with" to code a diagnosis?
thank you in advanced for your help
Neurologist is seeing a patient for followup of radiculopathy and neuropathy. She performs a neurological exam including cranial nerve exam, motor exam, sensory exam, coordination, and gait exams.

Under motor exam, she has a table/grid containing numerical values for each muscle strength tested. Is this information enough to assign CPT 95834? Not sure if this grid of numerical values per muscle constitutes a 'formal written report of the findings' that CPT Assistant references must be present in order to code this. (CPT Assistant, December 2003 Page: 7 and , November 2001 Pages: 4, 5). Otherwise, this manual muscle testing is included in the Physical Examination component of the E/M. Neurologist has coded E/M 99213 only but was wondering if the motor exam could be coded separately with documentation of the grid values per muscle.
We should not code 99213 and 95834 together. As per NCCI edit-These codes cannot be billed together in any circumstances.
But Yes, if only 95834 is billed then muscle strength numerical values is sufficient to allow CPT 95834-but there should be total evaluation of body including hands documented [Both the Lower extremities, Upper extremities, Trunk and Hand {Fingers}].
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Hello, I code for a ASC ( surgery center ) and I was wandering if you can bill a CPT code with a Modifier when billing for ASC?
good morning. i was just wondering if u live in maryland and if u had any luck findin a job
Hi I need a little help if anyone can help me out? When is the right time to use the 76 modifier? I have a situation where the surgeon did 2 different procedures with 2 seperate incisions but the codes are the same (almost) for both procedures and the dx is the same.
In order to let the payer know that your clinician repeated the procedure, you will have to append the modifier 76 (Repeat procedure or service by the same physician or other qualified health care professional) to the second unit of the code that you are reporting. This should not only allow you to get 100% reimbursement for the repeat procedure, it should also restart the global period for the procedure.
I apologize for posting this as a visitor message. I was hoping to be able to respond via PM, however your PM Box is full and not allowing me to do so.

Debra -
Thank you for your prompt reply. I did read your original response and questioned you again because I have not met many coders who have been coding in every single field at once. I was not trying to suggest you did not have experience, and it was not my intent for you to feel demeaned in any way. I was merely trying to understand your background, as the specifics of your hematology/oncology experience are not listed anywhere in your profile, or the bio's that exist in the coding world for you.
Perhaps we will never agree on every point we make, which is what makes the world an interesting place & is completely reasonable. I appreciate the information you have shared with me & I wish you the best in the future.
Helene Roberts, CPC, CMIS, CHOC
Can anyone help me with billing for rib loc plating for open repair of rib fracture with internal fixation? The code is 0245T, however my billing dept is giving me grief over it. Can anyone give me a ballpark figure of what they are charging and does anyone have any reimbursement info (from Medicare) on it. Thanks. I really need help with this one. :)
Hello members I have just joined this group trying to network in the coding field. I have had my CPC for about 5 years and I have had such a hard time getting a coding job. Can anyone help me to find what direction do I go. I applied and they all say that you need at least 3-5 years experience. The question is how do you get the experience if no one gives you a chance? Any suggestions?
Hi, I am looking for someone who bills for podiatry to help me learn some ends and outs. Can you help?, Just started podiatry coding and need some pointers, can you email me at if you are interested