CPC Exam Day Tips and Tricks

The morning of your CPC exam can be filled with excitement and nerves. There’s a lot of things running through your mind — modifiers, books, sequencing, abbreviations, time management. Is there anything you’re forgetting??

I’ve got two tools to help you out!

There’s a video on my YouTube Channel, “Avoid These Mistakes With the CPC Exam” that details things you want to AVOID doing during your exam. Check it out and see what errors to avert and how to better prepare yourself for the CPC exam!

There’s also a handy checklist for the morning of your exam. Before you leave, make sure you have everything needed for your big exam day! Print off the list and make sure you have all your materials to be fully prepared!

CPC Exam Checklist

Download the checklist pdf here.

My final words of wisdom — medical coding is NOT about knowing all of the answers, it’s about knowing where to find them. Tab your books and know your guidelines!

ICD-10-CM 2020 Propose Further Codes for BRCA Gene

1 in 8 women will develop breast cancer in their lifetime. The switch from ICD-9 to ICD-10 brought more specific codes to better define breast cancer based on the location of the cancer in the breast. New codes have been proposed by the ICD-10-CM Committee to further classify BRCA gene mutations, which are indicators of higher risk for breast and/or ovarian cancer. BRCA1 and BRCA2 are genetic mutations that can be detected through a blood or saliva sample.

There has been an increase in insurance carriers covering prophylactic mastectomy and/or oophorectomy for patients at high risk of developing cancer. The need for more specific codes was warranted to identify the specifics of the mutations for tracking and reporting as well as providing better detail for insurance coverage.  

The table below depicts the new codes proposed. Oddly, they did not make it into the updates for 2020, but may still be in consideration for future updates.

Z15.011 BRCA1 genetic susceptibility to malignancy of breast
Z15.012 BRCA2 genetic susceptibility to malignancy of breast
Z15.019 Genetic susceptibility to malignant neoplasm of breast, unspecified
Z15.021 BRCA1 genetic susceptibility to malignancy of ovary
Z15.022 BRCA2 genetic susceptibility to malignancy of ovary
Z15.029 Genetic susceptibility to malignant neoplasm of ovary unspecified

Novitas Quietly Updates E&M FAQs

Novitas, a Fiscal Intermediate covering 12 states, quietly updated the Evaluation and Management FAQs on July 15, 2019. It now states that start and stop times are requirements for all time-based evaluation and management services.

Per Novitas:

The following must be in the patient’s medical record in order to report an E/M service based on time:
– The total length of time (start and stop times) of the E/M visit;
– Evidence that more than half of the total length of time of the E/M visit was spent in counseling and coordinating of care; and
– The content of the counseling and coordination of care provided during the E/M visit.

CMS directives such as the IOM and Evaluation and Management Guidelines show no requirement of start and stop times for time-based services.

Is this an indication that the 2021 E&M changes may enforce start/stop time requirements? Comment your thoughts!

Risk Adjustment Coding Course Now Online

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