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Revenue Cycle Insider
December 2025 Articles
December 2025 Articles
Dec 24, 2025
Primary Care Coding:
Capture ‘Chronic’ Nature of Tonsilitis Diagnosis
Question: An 8-year-old patient has come in complaining of sore throat six times over the ...
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Dec 24, 2025
Diagnostic Radiology Coding:
Teach AI to Compare Mammogram Views, Part 2
Learn what a 0.96 AUC score means. The mammogram screening process captures X-ray picture...
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Dec 24, 2025
Neurology & Pain Management Coding:
Code Every Service on This Headache Encounter
Question: The pain management (PM) specialist sees a new patient suffering from “horribl...
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Dec 24, 2025
Path/Lab Coding:
Follow 3 Tips to Perfect Your Bone Marrow Pathology Exam Coding
Look to this advice to avoid overbilling. Bone marrow cases with multiple specimens and s...
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Dec 23, 2025
Compliance:
Don’t Silo Your CDI Specialists From Your Coders, Part 1
As external audits increase, bolster your compliance by making sure your teams are working...
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Dec 23, 2025
General Surgery Coding:
Use 11400-11446 Code Range for Dermal Lesion Excisions
Question: A surgeon excised a benign lesion from a patient's left arm. The excised diamete...
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Dec 23, 2025
Practice Management:
Follow State Law When Reporting Surgery Assistance
Question: What are the appropriate modifiers to append for providers who assist during sur...
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Dec 23, 2025
Practice Management:
Center Your Revenue Cycle on People, Part 1
Prioritizing patient care and perspective can make your revenue cycle healthier. Even tho...
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Dec 22, 2025
Compliance:
Keep These Reference Books and Resources On Hand
Question: I'm putting together a little in-house library for coders, billers, and our inte...
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Dec 22, 2025
Urology Coding:
Add Modifier 50 for Bilateral Renal Tumor Ablations
Question: Over the past few months, I've had several op notes that show the urologist perf...
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Dec 22, 2025
Oncology/Hematology Coding:
Get the Answers to Your Frequently Asked PIN Service Questions
Understand the difference between PIN and PIN-PS. Coders and billers in oncology still ha...
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Dec 22, 2025
ICD-10-CM Coding:
Yule Be Smart to Review These Dangers of the Holidays Codes
Add “Knowing how to code these common situations” to your holiday prep checklist. Dur...
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Dec 19, 2025
ICD-10-CM Coding:
Use This Route When Coding Gout
Question: My coworker and I are trying to determine the reason for a claim denial we recei...
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Dec 19, 2025
Neurosurgery Coding:
Infection, Immunization Evidence Matter for This Encephalopathy Dx
Question: Encounter notes indicate that the neurosurgeon performed critical care on a 5-ye...
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Dec 19, 2025
E/M Coding:
Check Thresholds for Critical Care Code Reporting
Question: Two critical care providers saw a patient on the same day. I reported 99291 for ...
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Dec 19, 2025
Cardiology Coding:
Use Add-On Code +92972 Correctly
Question: I submitted a claim with 92972 to report a percutaneous transluminal coronary li...
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Dec 18, 2025
Pediatric Coding:
Query for Cough Specificity
Question: I'm fairly new to pediatric coding and my practitioner only noted that the patie...
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Dec 18, 2025
Anesthesia Coding:
Know Medicare Particulars for Radiologic Anesthesia Coding
Question: I'm reporting radiologic anesthesia services performed on a Medicare beneficiary...
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Dec 18, 2025
Anesthesia Coding:
Stay Up to Date With Acute Pain Management, Part 1
Find some expert tips for coding anesthesia pain management services. Acute postoperative...
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Dec 18, 2025
Cardiology Coding:
Find Mitral Valve Repair Code Options
Question: A cardiologist performed a mitral valve repair. According to the documentation, ...
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Dec 17, 2025
Medicare Regulations:
Prepare for TEAM, Coming January 1
Hundreds of facilities are impacted nationwide. Are you part of this new mandatory model? ...
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Dec 17, 2025
Pulmonology Coding:
Boost Your Flu, COVID-19, and RSV Vaccine Coding Knowledge This Season
Learn what separates vaccines from monoclonal antibodies. Respiratory diseases are one of...
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Dec 17, 2025
Pediatric Coding:
Expertly Code This Eczema Case
Question: I'm unsure which ICD-10-CM code is appropriate based on the followin...
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Dec 17, 2025
Neurosurgery Coding:
Know All Spinal Decompression Types to Master Coding
Question: I'm new to neurosurgery coding, having spent the past few years coding for a neu...
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Dec 16, 2025
Orthopedic Coding:
Use a Total Knee Arthroplasty Revision Code for a Poly Revision
Question: An orthopedic surgeon performed total knee arthroplasty revision where they plac...
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Dec 16, 2025
Path/Lab Coding:
Wait to Match Surgical Pathology Level With Definitive Dx
Question: Our pathologist received a specimen that the op report identified as “soft tis...
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Dec 16, 2025
ICD-10-CM Coding:
Become Familiar With Otitis Media Codes
Question: How can I distinguish the difference between and correctly code the conditions o...
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Dec 16, 2025
Compliance:
Prioritize Data Organization
Question: I'm going through past audits and finding them so hard to search, as codes seem ...
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Dec 15, 2025
Neurosurgery Coding:
3 Tips Help You Collect for Spinal Osteotomies
Don't forget to check whether the surgeon used an anterior or posterior approach. When yo...
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Dec 15, 2025
Podiatry Coding:
Cast Off Doubt About Coding for Castings
Question: We have a practitioner specializing in foot and ankle care. Until now, they...
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Dec 15, 2025
Technology & Innovation:
Learn Which Networks Are Designated QHINs for TEFCA
Question: In the article “Everything You Need to Know About Participating in the TEFCA,...
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Dec 15, 2025
Optometry/Ophthalmology Coding:
Does This Cataract Surgery Fall Under a Complex Procedure?
Question: I have a report for a cataract surgery. The postoperative diagnosis is nuclear s...
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Dec 12, 2025
In Case You Missed It (RCI Bonus Content):
Lessons Learned From OIG Audits
Take to heart these lessons that others learned the hard way. In healthcare, every audit ...
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Dec 12, 2025
E/M Coding:
See How to Bill This NP Shared Service
Question: A doctor saw a patient with a nurse practitioner (NP). The NP recorded the docum...
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Dec 12, 2025
Pulmonology Coding:
Report an Abnormality Without a Pathology Report
Question: A 47-year-old patient presented to our pulmonology practice with a chronic cough...
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Dec 12, 2025
Pulmonology Coding:
Avoid Coding Signs/Symptoms When a Diagnosis Is Confirmed
Question: A senior patient visited the emergency department (ED) with difficulty breathing...
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Dec 11, 2025
Anesthesia Coding:
Navigate Metric Conversion for Successful J2003 Reporting
Question: How do I report the use of 2 cc of lidocaine used in an injection? I think I'll ...
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Dec 11, 2025
Orthopedic Coding:
Code This Colles’ Fracture Encounter
Question: A new patient was referred to an orthopedic practice with pain and swelling in t...
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Dec 11, 2025
Diagnostic Radiology Coding:
Clearly Code This Repeat Procedure
Question: I'm the newest coder in our radiology office and I'm confused about how I should...
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Dec 10, 2025
Medicare Regulations:
Organize a Template for Bariatric Surgery Claim Prep
Question: I now work for a surgeon who performs bariatric surgeries, and many of our patie...
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Dec 10, 2025
General Coding:
Be Wary of Using Unlisted CPT® Codes
Question: I'm an auditor and found a claim with 99499 billed and denied. Is there a situat...
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Dec 10, 2025
General Surgery Coding:
Use 31805 for an Intrathoracic Tracheal Wound Repair
Question: A patient was transported to the emergency department (ED) following a severe ca...
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Dec 09, 2025
Neurology & Pain Management Coding:
Remember Secondary Dx for These Huntington’s Patients
Question: A patient reports to the neurologist with a diagnosis of Huntington's disease. E...
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Dec 09, 2025
Medicare Regulations:
Check Payer Policies for Consultation Codes
Question: A physician in my practice saw a patient who has Medicare, as well as a commerci...
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Dec 09, 2025
Path/Lab Coding:
Go Unlisted for Single NGS Multiple Gene Analysis
Question: A provider ordered a full gene sequence analysis of BRCA2 plus a BRCA1 known fam...
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Dec 08, 2025
Podiatry Coding:
Get the Skinny on Skin Substitute HCPCS Updates
Question: Are there any HCPCS Level II updates related to skin substitution codes coming i...
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Dec 08, 2025
Podiatry Coding:
Stay Ahead of Audits in Your Office
And learn to perfect your podiatry modifier usage going into 2026. During her HEALTHCON R...
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Dec 08, 2025
Diagnostic Radiology:
Familiarize Yourself With X{EPSU} Modifiers
Question: I've only been coding in radiology for a few months and I'm having a hard time u...
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Dec 05, 2025
Emergency Department Coding:
Get Body Surface Area Correct Before Coding Burn Treatment
Question: A patient presents to the emergency department (ED) with second-degree burns to ...
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Dec 05, 2025
Gastroenterology Coding:
Learn How to Report Control of GI Bleed Following CRC Screening
Question: I have an op note for a second colonoscopy performed the day after the patient e...
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Dec 05, 2025
Gastroenterology Coding:
Locate the Code for Appendicitis With Localized Peritonitis
Question: A patient presented to the emergency department (ED) at 3 a.m. with severe abdom...
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Dec 04, 2025
Otolaryngology Coding:
Defer to Provider for Otitis Media Timeline Guidance
Question: My otolaryngologist documented otitis media with effusion for one patient a...
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Dec 04, 2025
Emergency Department Coding:
Differentiate Modifiers 25 and 57 to Stay Compliant
The key for ED providers is to count the global days. When your emergency department (ED)...
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Dec 04, 2025
Technology & Innovation:
Avoid Doubling Your Workload by Using Coding-Aware AI
Question: What's the difference between coding-naive and coding-aware artificial intellige...
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Dec 03, 2025
Ob-Gyn Coding:
Dive Deep Into Hysteroscopy Coding With This Guide, Part 2
Learn how to report IUD removal and reinsertion. In the first part of this article series...
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Dec 03, 2025
Urology Coding:
Should You Use 40818 or 15240 for Buccal Mucosa Grafts?
Question: I have an operative note for a urethroplasty procedure where the surgeon harvest...
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Dec 03, 2025
E/M Coding:
Find Even More Tips for Distinguishing Inherent From Separate Services
Find out what information you need to append modifier 25 correctly and with confidence. M...
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Dec 02, 2025
Cardiology Coding:
Use These Tips for Coding Thrombolytic Therapy
Hint: There are 3 main types of thrombolytic therapy procedures. Thrombolytic therapy, or...
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Dec 02, 2025
Ob-Gyn Coding:
Code This RFA Fetal Reduction C Section Scenario
Question: The patient had a radiofrequency ablation (RFA) fetal reduction of twin A at 18 ...
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Dec 02, 2025
Ob-Gyn Coding:
Be Careful on Prior Authorizations for PT for Pregnant Patients
Question: Payers are denying prior authorizations for our pregnant patients who are experi...
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Dec 01, 2025
Oncology/Hematology Coding:
Look to This Scenario to Master Metastatic CSF Cancer Coding
Question: A patient had a lumbar puncture that showed metastatic breast cancer to the cere...
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Dec 01, 2025
Gastroenterology Coding:
Follow These CRC Testing Requirements to Bolster Your Claims – Part 2
Find out where you won't find clear guidance. Correctly coding colorectal cancer (CRC) sc...
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Dec 01, 2025
General Coding:
Appeal Insurance Denials and Get the Reimbursement You Deserve
Question: As a medical coder working in a neurosurgical practice, I often encounter freque...
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Available Years:
2025
2024