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What is the code for continued care of chronic conditions for Medicare patients?
What is G2211
When can you use 99201?
What is never! Was removed in 2021
What does CHDP stand for?
What is Child Health and Disability Prevention program
Remember this coveres PREVENTIVE visits and vaccines for low-income kids; in ventura is funneled through Gold Coast
What lab can Gold Coast patients go to?
CMH preferred
Can also go to Quest
How do you code for a patient you see for a wellness exam and chest pain in the same visit?
What is Use a preventive code 99397 and an E&M code 99213 PLUS MODIFIER -25
What are you required to provide a patient after a Medicare Wellness visit?
What is a written plan of their screening exams
What does ABN stand for and what is it?
What is an Advanced Beneficiary Notice - Medicare patients must sign if you are ordering a lab or procedure you suspect is not covered.
Where can Seaview patients have mammograms?
What is Only at Rolling Oaks
True or false? Covid boosters are free
False - they were initially when provided under pandemic emergency acts but this is no longer the case.
Make sure you bill for this! $150 + vaccine admin code
What are three requirements of a TOC visit?
Must make contact with the patient within 48 hrs of d/c
must have been hospitalized within the last 14 days for a serious illness
Must reconcile medications
review records or speak with inpatient team
{and only for Medicare patients?}
What does HCC stand for?
What is heirarchical condition category... ICD10 codes of complex chronic conditions..
Who can qualify for SDI?
Who are Patients who are unable to perform their usual job for more than 7 days for a medical reason.
What three Prop 56 "bonuses" can you earn on all adult Gold Coast patients?
What are alcohol screening, tobacco screening and Depression screening
What 7 EXAM elements are required for Medicare Wellness visits?
What are:
BP
BMI (Ht, Weight)
Hearing
Cognition
Get up and Go
Mood
Memory
What does RAF stand for?
Risk adjustment factor -- factor that takes into account patients age, gender and chronic conditions - the higher the RAF, the more we are paid
True or false? If you are aseeing a self-pay patient without insurance, you should "down-code" - ie charge a 99212 or 99213 instead of 99214.
What is False - this is FRAUD.
You need to charge/code the same for all patients regardless of insurance status. We do provide a sliding scale and discount if they pay cash at the time of the visit.
How many times a year can you claim Prop 56 for A1cs in diabetics?
What is Four
How many minutes are you expected to spend on a 99214 visit?
What is 30-39 minutes
what are A and J codes?
A and J codes are HCPCS codes - for tangible things - meds, splints, nebulizer MACHINES, etc.
Healthcare Common Procedure Coding System (HCPCS) - these are for THINGS
CPT codes are for services
(If you give a neb you charge 94640 for the set up and J7620 for the med) NOT A7017 - this is for the machine
how many ROS systems are required to bill a 99214?
What are NONE
HPI/ROS/PSH/PMH are no longer required for billing for OUTPATIENT visits