Focus on Date for Problems Addressed, Unaddressed
January 2025
Understand the Complexities of Shoulder Arthroplasty Coding
Know when to report arthroplasty revisions. Patients experiencing pain and stiffness in their shoulders might [...]
Code Incontinence Claims With Confidence
Add all relevant codes linked to the diagnosis to avoid denials. Coders must be meticulous [...]
Prevent a Surfactant Administration Coding Collapse
Can you report 94610 with critical care codes? Find out. Babies who are born prematurely [...]
Find Differences Between Apnea Types
Question: When I see documentation that says a newborn patient has apnea, is it always [...]
Break Down the Differences Between ‘Excision’ and ‘Destruction’
Question: I have an operative note that states the surgeon “removed” a 1.6 cm basal [...]
Alter EMG Coding When NCS Occurs
Resort to add-on codes for EMG in certain scenarios. When a patient reports to the [...]
Are Strabismus Surgery Procedure Codes Bilateral?
Question: I have an operative note detailing an ophthalmologist’s strabismus surgical procedure on both eyes [...]
Learn How to Report Monthly Hydrophilic Lens Renewals
Question: Which code should we use to report monthly toric contact lens replacements? Oklahoma Subscriber [...]
Skip the Breast Biopsy Codes for an Axillary Lymph Node Biopsy
Question: A patient presented for a superficial axillary lymph node core needle biopsy. The procedure [...]
Know Obligations in Case of Bankruptcy
Question: Does a medical practice have any obligations to Medicare or Medicare Administrative Contractors (MACs) [...]
Stay in Your Lane, Modifiers
Question: I’m new to medical coding and still don’t fully understand the role of modifiers; [...]
Find Out if You Can Report 45380 and 45385 Together
Question: I have the following documentation in an operative note: A single sessile 5 mm [...]
Use an Additional Code for This Chronic Ulcer Case
Question: A patient with a history of moderate alcohol dependence presented for a follow-up visit [...]
Err on the Side of Symptoms When X-rays are Negative
Question: A patient presented to their primary care physician (PCP) with left shoulder pain that [...]
Put the Pieces Back Together to Accurately Code Skull Fractures, Repairs
It’s the small details that make or break an accurate diagnosis. Patients who suffer from [...]
Test Your Thyroidectomy Coding Skills With This Quiz
You may have your thyroidectomy work cut out for you. Question 1: What is the [...]
Get to the Bottom of This Ankle Fracture Coding Case Study
Find out when ‘and’ means ‘or’ in diagnosis coding. Broken bones are one of the [...]
Learn Which Code to Use for a Bone Fragment Diagnosis
Question: I have a radiology report that documents a “redemonstration of the distal ulnar fracture [...]
Look for Reasons for Noncoverage Before Providing Services
Question: My practice performed a trigger point injection (TPI) and used ultrasound guidance for the [...]
Get Answers to Trach Coding FAQs
Know what separates tracheotomies and tracheostomies. Tracheotomies and tracheostomies are two procedures that often get [...]
Clarify Your Cataract Extraction Coding Knowledge — Part 1
Understand reporting of simple, complex, and combined procedures. With age comes wisdom, experience, and for [...]
Documentation Vital to Securing Critical Care Pay
Does your claim include a provider statement? Patients who report to the emergency department (ED) [...]
Understand How SDOH Affects Your Patients — and Your Bottom Line
Hint: Don’t forget comorbidities when you’re coding. As the first stop in many healthcare situations, [...]
Don’t Miss This Patient Privacy Exception
Question: Can I release a patient’s balance over the phone or in person to someone [...]
Know Your Responsibilities for FMLA Certifications
Question: What information do we need to provide for a patient who’s seeking leave through [...]
Consider Physical Status Exception
Question: A healthy patient with an uncomplicated seven-month pregnancy requires surgery for ankle surgery unrelated [...]
Learn How to Identify Intestinal Fistula Codes
Know the ins and outs of coding the conditions and treatments. As a gastroenterology coder, [...]
In Asthma Notes, Know Difference Between Extrinsic and Intrinsic
Question: I work at a family medicine practice and our providers see patients with asthma. [...]
Take the Right Steps to Footwear and Insole Coding Knowledge
Ace this quiz to keep your orthotic and specialty shoe skills sharp! Question 1 scenario: [...]
Direct Your AI Device Development With FDA Guidance
Question: Technology and artificial intelligence (AI) advance incredibly quickly, but have developers thought about what happens [...]
Code This Chemo Infusion Administration Scenario
Don’t forget to pay attention to 2025 HCPCS deletions and revisions. Coding infusions is perhaps [...]
Look to Laterality to Bill Concha Bullosa Services Correctly
Question: What is the CPTÒ code for this? This is all that is documented: “Using [...]
Bolster Continuity of Care Through Documentation
Question: I feel like providers are grateful for billers and coders for sorting through so [...]
Monitor Senior Patients in Rural Locations
Question: We have several senior patients who live in rural areas far from our clinic. [...]
Rely on These Resources for CDI Research
Question: Which resources are useful in the daily workflow of clinical documentation integrity (CDI) specialists? [...]
Use This Trick to Distinguish Rheumatic From Non-Rheumatic Valve Disease
Question: How do I know when to report a diagnosis code for valve disease that [...]
Use an Additional Code for ACP Conversation
Question: My provider is conducting conversations about advance care planning (ACP) during annual wellness visits [...]
When Reporting Revascularization, Don’t Code These Steps Separately
Question: My provider takes really specific notes during revascularization procedures, and I’m not sure whether [...]
EMTALA Means No Patient Left Behind
Question: I am relatively new to emergency department (ED) coding, and I’ve heard a few [...]
Let Documentation Determine Correct Repeat Service Modifier
Question: Five days after draining a peritonsillar abscess, our otolaryngologist had to drain it a second [...]
Avoid Coding Surgeon-Induced Injuries
Question: A patient was scheduled to receive a penile prosthesis. However, because of a urethral [...]
Keep SCAT5 Coding in E/M Realm
Question: Encounter notes indicate that a patient presented to the emergency department (ED) after being [...]
Focus on Date for Problems Addressed, Unaddressed
Question: When I’m looking at a patient’s medical record, how do I know whether the [...]
Note This MUE to Bill Antibody Stains Correctly
Question: Our lab is having issues billing for 88341, 88342, and 88360. Fairly regularly, we [...]
Code This Slippery Subsequent Scenario
Question: A patient came to our office after visiting the emergency department (ED) where they had [...]
Refresh Your Knowledge on Diagnosis Coding for Substance Abuse and Behavioral Health
Do you know how to accurately use the F10.- to F19.- code range? The 10th [...]
Code Umbilical Granuloma Scenario With Confidence
Question: Our pediatrician saw a 6-day-old baby for the first time and diagnosed an umbilical [...]
Aspirin Use Could Lead to This Condition in Younger Patients
Question: A 15-year-old patient reports to the neurosurgeon’s practice with complaints of confusion and seizures [...]
Keep These Tips in Mind When Leveling Time
Question: Which aspects of a provider’s services count for time when leveling evaluation and management [...]
Identify These Common Rashes in Pediatric Patients
Hint: Some rashes may be specific to newborns. Pediatric rashes can develop for various reasons [...]
Don’t Get Left in the Dark by Dx Documentation
Question: One of our physicians is not putting diagnoses on their on-treatment visit (OTV) note. [...]
Avoid This Metatarsal Modifier Mishap
Question: What is the correct laterality modifier to bill with 28122? I first billed it with [...]
Dive Deep Into Anesthesia Modifier Hows and Whys
Hint: Modifiers can show payers which anesthesia professional performed a service. Getting paid correctly with [...]
Look to G0317 for Nursing Facility Prolonged Service Codes
Hint: Time spent on services the day before and after the visit may count. Sometimes [...]
Look to History When Coding This Breast Symmetry Encounter
Question: In 2019, a patient had a bilateral mastectomy and bilateral breast reconstruction. The patient [...]
Traverse This Transvaginal Procedure
Question: My urologist recorded a laparoscopic transvaginal correction of a urinary bladder tear. I was originally [...]
Code This Ruptured Achilles Repair
Question: The surgeon’s notes indicate that a patient was seen due to a ruptured right Achilles [...]
Get a Quick Look at These 2025 Path/Lab NCCI, MUEs, and PLA Code Updates
Don't miss these two increases to Medicare MUEs. Want to get your 2025 off to [...]
Understand When to Append Modifier 62
Question: I’m new to coding. When is it appropriate to append modifier 62? RCI Subscriber Answer: Modifier [...]
Be Direct, Bill for Both These Bilirubin Tests
Question: If our lab performs both a total bilirubin and a direct bilirubin test, can [...]
How Do I Determine the Duration for Acute vs. Chronic Conditions?
Question: I’m new to coding and am having trouble finding information as to when I should [...]
Ask Doc for Sleep Apnea Details
Question: When a patient suffers from sleep apnea, how do I choose the correct ICD-10-CM [...]
Craniotomy Isn’t Always Separately Reportable With Skull Insertions
Question: The surgeon inserted a skull-mounted cranial neurostimulator pulse generator in a patient with vascular [...]
Note These IQ Level Ranges for Intellectual Disability Dx
Question: The neurologist treats a patient with an intellectual disability. Encounter notes indicate that the [...]
Pocket These Tips for Categorizing Medicare and VA Claims Correctly
Don’t let confusion about where to submit a government payer claim derail your reimbursement. Last [...]
Identify 3 Common Devices Your Cardiologist May Use
Hint: ICDs treat ventricular tachycardia. Sharon Jane Oliver, CPC, CDEO, CPMA, CRC, discussed various devices [...]
Master Medicare’s ‘Carve Out’ Rule
This modifier tells Medicare that the service isn’t covered. If you need to estimate what [...]
Finger or Fingers? It Doesn’t Matter With This Dx
Question: If a patient has stress fractures in multiple fingers, would you report an ICD-10-CM [...]
Break Down the Established Patient Definition
Question: We bill for a multispecialty clinic, which has a cardiothoracic surgeon, a cardiologist, and [...]
Find Out if Epidural Catheter Placement Timing Matters
Question: If an epidural catheter is inserted with the intention of providing postoperative pain management, [...]
Deliver Healthcare to Patients in Other Countries Via Telehealth
Remember to obtain consent. Telehealth’s popularity in recent years has allowed healthcare providers to deliver [...]
Consider Alternate Terms For This Synovitis Dx
Question: Encounter notes indicate that the surgeon treated a patient with “synovitis, toxic/wrist.” I cannot [...]
Rh-Negative Status: What Dx Code Should I Use?
Question: What is the most accurate diagnosis code for Rh-negative status during pregnancy? Arkansas Subscriber [...]
Report Nebulizer Demonstration and Treatment Together
Question: A pulmonologist performed a nebulizer treatment for a patient’s asthma and demonstrated how to [...]
Untangle Modifiers 25, 57 With This Advice
Question: My ob-gyn decided a patient needed surgery, but I’m confused whether to report modifier [...]
Understand the Importance of History Documentation for E/M Coding
Remember the eight components of HPI when you’re looking at documentation. Since the evaluation and [...]
Know Your Rights and Responsibilities in Possible Healthcare Fraud Cases
Honesty really is the best policy. Government enforcement efforts under the False Claims Act are [...]
Negotiate Your Payer Contracts With Confidence
Think about why your practice deserves a raise. “Most people will take ‘no’ for an [...]
