Q #11: I’m an AAPC member, my test is scheduled for June. Will any CEU’s I get this year go towards what I need?
A: No, any CEUs that you get prior to getting certified don’t count. They used to, the month before. They gave you a 30-day window, but now they don’t do that anymore. So, you just have to come back and see us after you pass the CPC to get some CEUs.
Q #12: I’ve graduated in 2010… but have not taken the exam due to money issues. Will I still be able to sit for the CPC exam, and will I have to get a CPC-A instead?
A: OK, you can sit for the exam whenever. It doesn’t matter if you take a course or not. Therefore, it doesn’t matter when you complete the course. Obviously, the closer to when you finish when information is fresher, the better. You will get a CPC-A unless you have coding experience. The AAPC will waive one year of experience if you have a letter or proof from your school that you took an 80-hour equivalent course.
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Laureen: Our students who take our Physician Based Coding Course or PBC course, they waive one year, so you only need one more year of experience to get the A removed.
Q #13: Can prematurity be used as a diagnosis for a 2-year old being checked for his growth. The diagnosis given was 765.14? The insurance company denied the claim as inappropriate age for the patient.
Alicia: The thing about some of those codes, guys, is that one insurance company may like a code and another one not. But I suspect that is just the wrong code.
Laureen: OK. 765.14 – Other preterm infants; 1000 – 2499 grams
Alicia: Yeah, that’s a newborn. You look at the little icon she’s got over there, over on the right, the NB. That probably is going to tell you that can only be used on a newborn chart. Code 765.14 is for newborns only.
Laureen: It’s Newborn Edit. So you hit an edit.
Alicia: Now, there are other codes, there are other ICD codes that you can use to show that the child is underweight for their age, failure to thrive or something like that.
Laureen: And you might want to check too, they have local coverage determinations. They’ll let you know what codes are appropriate for that procedure. Now, the idea is you’re not supposed to use it as a shopping list. You’re not supposed to see what codes would get the claim paid. You have your codes for your patient and you see if any are on the approved list. But yeah, this just coding –
Alicia: The other thing guys, is if you’re doing this with the billing, you need to be comfortable in calling them just to ask.
Laureen: Yeah. Uh-huh!
Alicia: To say, “I’ve got this chart. I’m kind of confused. I thought this was the right code, I realized now it isn’t. Can you point me in the right direction?”
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