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CPT Sequencing Question

  1. Default CPT Sequencing Question
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    Hi. I am preparing for the CPC exam and there is a case study in my AAPC Study Guide that I am hoping someone can help me with. The rationale at the end of the text does not answer the following question:

    I have a case scenario where a woman had twins. She had the first baby vaginally and the second baby was delivered by cesarean due to complications. I am wondering why the cesarean delivery is coded first with the vaginal delivery coded second. What are the guidelines regarding sequencing for this type of scenario? Is it because the cesarean-section reimburses at a higher rate? Also, if anyone could direct me to other guidelines regarding CPT sequencing I would like to review these for the exam. Thanks so much!

    Rachel

  2. #2
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    Order is by RVU, You wont have access to the RVU on the test so they wont try to trick you by doing two different answers with the exact same codes reversed. If you try to narrow down answers by CPT order it will only screw you up. The only sequencing they will test you on is ICD-10 where sequencing matters the most.
    CRC (2018), CPC-P-A (2016), COC-A (2016), CPC-A (2015), PAHM (2010)
    Contract/Fee Specialist - Remote

    20 years health insurance experience: Audit, Claims, Customer Service, Payment Policy, Provider Relations, and Reimbursement

  3. #3
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    Quote Originally Posted by CodingKing View Post
    Order is by RVU, You wont have access to the RVU on the test so they wont try to trick you by doing two different answers with the exact same codes reversed. If you try to narrow down answers by CPT order it will only screw you up. The only sequencing they will test you on is ICD-10 where sequencing matters the most.
    Just curious, I've been told a few different things when it comes to sequencing. Not for exam purposes, but actual claim purposes. Should the CPTs be sequenced by RVU OR by total RVU? Can you point me in a direction where I can find some supporting information one way or the other. This has been a topic of discussion lately and would like to have some guidance and clarification. Thanks!

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