Advanced Search

Revenue Cycle Insider

Compliance:

Look to These Resources for Compliant Overpayment Recoupment

Published on Tue Aug 26, 2025

You’ve reached your limit of free articles. Already a subscriber? Log in.

Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:

Simple explanations of current healthcare regulations and payer programs
Real-world reporting scenarios solved by our expert coders
Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
Instant access to every article ever published in Revenue Cycle Insider
6 annual AAPC-approved CEUs
The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles of

August 2025

Pediatric Coding:
Smooth Over These Common Skin Conditions
Know payer policies to prevent issues with cosmetic procedure coverage. Recent studies have shown that [...]

Orthopedic Coding:
Analyze Arthroscopic Shoulder Surgical Procedure Coding Rules
Don’t report 2 codes when only 1 is needed. Orthopedic procedures on the shoulder can [...]

ICD-10-CM Coding:
Be Agile When Coding Conditions That Might Require PT
One code in ICD-10-CM may be useful to describe several different conditions. If you see [...]

Neurosurgery Coding:
Use Combo Codes to Reduce Dx Coding Burden
Question: An established patient reports to the practice with a diagnosis of right-sided sciatica and [...]

Podiatry Coding:
Don’t Let Your Lisfranc Coding Skills Fall Flat
Often misdiagnosed and overlooked, Lisfranc injuries aren’t easy to spot. The Lisfranc joint is where [...]

General Surgery Coding:
Build Your Understanding of Bariatric Surgery Coding
Find out how to report unlisted codes for reimbursement. Bariatric surgery, also known as weight [...]

Anesthesia Coding:
Check Your Knowledge of Anesthesia Billing Myths
Don’t try to add extra time at the beginning — or the end! Anesthesia can [...]

Anesthesia Coding:
Use These Two Modifiers to Show Anesthesiologist and CRNA Work
Question: We recently had a situation where the anesthesiologist and a certified registered nurse anesthetist [...]

Neurosurgery Coding:
Anesthesia Question Important in This Manipulation Scenario
Question: When the surgeon performs spinal manipulation for a patient, what CPT® code is most [...]

Pulmonology Coding:
Report Pulmonary Hypertension Due to Bronchiectasis
Question: A 75-year-old patient presented to the emergency department (ED) with shortness of breath, fatigue, [...]

Primary Care Coding:
Find Appropriate Z Code for Evaluation Encounters
Question: A patient scheduled an appointment because they needed to have a physical before they [...]

Anesthesia Coding:
Don’t Bill for PCA as Anesthesia Service
Question: A patient was receiving remifentanil as patient-controlled analgesia (PCA) for pain control while in [...]

Otolaryngology Coding:
Don’t Sneeze at This Rhinitis Coding Advice
Question: How do I code allergic vasomotor rhinitis? It seems like there’s a code for allergic [...]

Otolaryngology Coding:
Determine Degree of Drainage in This Parotid Abscess Encounter
Question:Our otolaryngologist admitted a patient with parotitis to the hospital. Three days later, the patient [...]

Technology & Innovation:
Use These 6 Tips to Select Secure Healthcare Vendors
Don’t trust vendors even if you have a BAA. During their AAPC HEALTHCON 2025 session, [...]

Technology & Innovation:
Could a Trip to Space Offer a Treatment for Osteoporosis?
Question: I’ve read articles in the past about astronauts returning to Earth, and they’ve lost [...]

Urology Coding:
Report Laparoscopic Pyeloplasty and Cysto Stent Placement Together
Question: A urologist performed a laparoscopic pyeloplasty. They also placed a stent via cystourethroscopy by [...]

Practice Management:
Document Your Way to Success With the D.E.E.D. System
Take your professional fate into your own hands. During the HEALTHCON 2025 presentation, “Demand Excellence [...]

Pulmonology Coding:
Diagnose Your Sleep Apnea Coding Skills
Look to the ICD-10-CM G codes for sleep apnea diagnoses. Sleep apnea is a condition [...]

Optometry/Ophthalmology Coding:
Use This Guide to Code Congenital Eye Conditions Correctly
Learn how often congenital glaucoma occurs. From conception, the eye begins to develop as early [...]

Optometry/Ophthalmology Coding:
Use a 7th Character to Identify the Macular Degeneration Stage
Question: I have a report for an ophthalmology visit with a 70-year-old patient who has [...]

Oncology/Hematology Coding:
Code Chemo Complications Quickly and Correctly
Not all negative reactions to antineoplastic medications should be coded as adverse effects. The scenario [...]

Urology Coding:
Learn How to Approach Prostatectomy Coding – Part 3
Identify the difference between laparoscopic and robotic prostatectomies. In the third installment on prostatectomies, we [...]

Urology Coding:
Is 52260 or 52265 Correct for Cystourethroscopy With MAC?
Question: A urologist performs hydrodistention under monitored anesthesia care (MAC). Is MAC considered the same [...]

Compliance:
Look to These Resources for Compliant Overpayment Recoupment
Question: Is there a specific window in which payers are entitled to recoup any overpayments? [...]

E/M Coding:
Find More Nitty-Gritty Details on Incident-To Requirements
Incident-to services are only appropriate for established patients and problems. If you’re interested in billing [...]

Diagnostic Radiology Coding:
Consider These 5 Coding Tips to Bolster Your Brain CT Billing
Recognize the difference between high and low osmolar contrast. Diagnostic radiology or diagnostic imaging CPT® [...]

General Coding:
Know Differences Between Workers’ Comp Types
Question: A patient has come to our practice for an injury sustained during their work [...]

General Coding:
Report State-Supplied Vaccines With This Modifier
Question: Our practice regularly administers vaccines, which are supplied by the state. Do I report [...]

Neurology & Pain Management Coding:
Pay Attention to Alternate Terms for Cerebral Palsy Dx
Question: Encounter notes indicate that the patient suffered from “dystonic CP.” Should I code this [...]

Emergency Department Coding:
Use Specific Codes for These I&D
Question: A 54-year-old patient presents to the emergency department (ED) with a painful, red, and swollen [...]

Emergency Department Coding:
Use This Dx Trio for Burn Patient
Question: A patient presented to the emergency department (ED) for a painful and blistered right [...]

Optometry/Ophthalmology Coding:
Learn How to Report Post-Op Visits Performed at a Different Location
Question: What should we bill for a post-op visit on a surgery performed elsewhere? Normally, [...]

Podiatry Coding:
Calculate Global Periods With Ease
Question: How do I find out the global periods for CPT® codes 28111 and 28810? Minnesota [...]

General Surgery Coding:
Does 25260 Include Exploration and Closure?
Question: A patient presented with a right forearm laceration. The surgeon extended the laceration to [...]

Compliance:
Know Who Can Record Diagnosis Information
Question: I’m new to coding and am looking over an internal audit at a skilled [...]

Path/Lab Coding:
Discover These New Oncology and Infectious Disease Testing PLA Codes
Prepare for 25 added and 2 deleted codes beginning Oct. 1, 2025. The AMA has [...]

ICD-10-CM Coding:
Get Your Footing With Pes Planus Dx
Question: A patient came in to see a provider due to foot pain. The provider [...]

Orthopedic Coding:
Separate ‘Limited’ From ‘Extensive’ Debridement
Question: I’m having trouble assigning codes based on the following information from an op note: [...]

Path/Lab Coding:
Locate Peptic Ulcer Codes Precisely
Question: Our pathologist examined a duodenum biopsy from an esophagogastroduodenoscopy (EGD) and they performed an H. [...]

Orthopedic Coding:
Use 27385 to Report Hamstring Tendon Repairs
Question: We reported unlisted code 27599 for a proximal hamstring tendon repair, but the claim [...]

Cardiology Coding:
Get the Details on FFR
Question: A patient’s records said they had a fractional flow reserve (FFR) as part of [...]

Otolaryngology Coding:
Listen to This Ear Condition Coding Advice, Part 1
Anatomic knowledge and a laterality guideline can help pinpoint codes quickly and precisely. From children [...]

E/M Coding:
Include Additional Info When Billing E/M Services by PA or NP
Question: I work in a multispecialty practice that has different providers, including nurse practitioners (NPs) [...]

Diagnostic Radiology Coding:
Is Contrast Required to Report 62290?
Question: Our interventional radiology (IR) department uses saline during discography injection procedures, but I thought [...]

General Surgery Coding:
Focus on Total Lesions Rather Than Laterality for Breast Biopsy Reporting
Question: I have a report that lists the procedure as percutaneous biopsies of lesions of [...]

Technology & Innovation:
Use a 3D Printer to Build a Comfortable and Accurate Prosthesis
Question: Have healthcare researchers examined the benefits and drawbacks of using 3D printers to build [...]

RCI Bonus Content:
Get Up to Speed With These Medicare Digital Mental Health Treatment Codes
Understand this latest advance in behavioral health services. The 2025 Medicare Physician Fee Schedule provides [...]

Cardiology Coding:
Report Counseling for TAVR After BAV Like This
Question: One of our cardiologists performed a balloon aortic valvuloplasty (BAV) to temporarily relieve stenosis while the [...]

E/M Coding:
Point Providers to E/M Differences
Question: A provider asked whether they can adjust their evaluation and management (E/M) coding to account [...]

Emergency Department Coding:
5 Tips Lead You to Laceration Repair Coding Success
Hint: Site, length, and depth all matter when reporting 12001-12057. When a patient presents to [...]

Oncology/Hematology Coding:
Know When to Bill for Hydration Services
Question: If a patient received hydration for 45 minutes, then a chemotherapy infusion for 30 minutes [...]

Neurology & Pain Management Coding:
1-Sided Paralysis Highlights Hemiplegic Migraine
Question: Encounter notes indicate that a patient suffers from “hemiplegic migraine.” I’ve seen these codes [...]

Neurology & Pain Management Coding:
Can You Code Complex Regional Pain Syndrome Properly?
Pinpoint the right diagnosis and procedure codes for CRPS every time. When patients present with [...]

Medicare Regulations:
Experiencing Behavioral Health Denials? Here’s What To Do
Find out how to stay compliant and keep the payments coming. More Medicare beneficiaries (and [...]

ICD-10-CM Coding:
Lean on This Guidance When Reporting Multiple Codes for a Single Condition
Question: In what situations might it be appropriate to report multiple diagnosis codes for a [...]

Primary Care Coding:
Navigate Dementia Care With This 99483 Advice
And take note of all these validated cognitive assessment tools. If you’ve ever used 99483 [...]

General Coding:
Sleuth Your Way to Air-Tight Appeals Success — Part 1
Do you know what EOB remark codes are? Every medical practice has faced a claim [...]

Practice Management:
Take the Pressure out of Interviews
Question: I'm a brand-new practice manager with a solid background in healthcare, but not much [...]

Path/Lab Coding:
Bill a Test Without a Specimen? Think Again
Question: Our lab just brought on a new client, and a lot of the specimens [...]

Pediatric Coding:
Managing Medication Is Not the Primary Focus
Question: Is there a diagnosis code for medication management? For example, my provider sees patients [...]

Primary Care Coding:
Rely on Descriptor to Evaluate Appropriateness of Code
Question: A primary care provider performed an echocardiogram (EKG) in-office to see whether a patient [...]

Practice Management:
Get Acquainted With CMS Exceptions to Timely Filing
Question: In our office, we are normally very careful to submit our Medicare claims within the [...]

Diagnostic Radiology Coding:
Does Lidocaine Count for a ‘With Anesthesia’ Procedure?
Question: I have a medical record from an encounter at an outpatient radiology clinic. The [...]

Pediatric Coding:
Correctly Code This Asymptomatic STD Encounter
Question: If a patient is tested for a sexually transmitted disease (STD) but has no signs [...]

Pulmonology Coding:
Use 31629 for TBNA via Bronchoscopy
Question: A pulmonologist performed a transbronchial needle aspiration (TBNA) of a right upper lobe (RUL) cavity [...]

Neurosurgery Coding:
Know What Area Neuroplasty Is Treating to Code Correctly
Neuroplasty technique smarts are also important for successful claims. Neuroplasty (also known as epidural neurolysis [...]

Compliance:
OIG Finds Most Medicare Outpatient Hospital Payments for Hospice Enrollees Improper
See which issues they discovered and the key element you need to help reduce exposure. [...]

Medicare Regulations:
Find Clarity on Hospice Payment Responsibilities for Medicare Beneficiaries
Question: A beneficiary’s family has agreed that their family member is ready to be put [...]

Ob-Gyn Coding:
Find Out How to Capture Physicals and Birth Control Renewal
Question: My ob-gyn providers see a lot of patients for physical exams, and then they [...]

Cardiology:
Tilt Table Test Coding Made Easy: Essential Tips for Accurate Billing and Documentation
Why knowing who owns the equipment matters to your claim. Tilt table testing is commonly [...]

Podiatry Coding:
Puzzle Out This Podiatry Denial
Question: A patient came in with a large, non-healing wound on their lower leg. The [...]

Gastroenterology Coding:
Know How to Report for Each Polyp Removed
Question: I have a gastroenterologist that wants to bill for each polyp removed. Any advice [...]

Medicare Regulations:
Beware Phishing Attempts Regarding CMS
Question: I am hearing from other providers and even some suppliers that they are receiving [...]

Ob-Gyn Coding:
Master When to Start the Global OB Package
Avoid denials with confidence by knowing exactly when global care begins. With more new coders [...]

Gastroenterology Coding:
A Patient Can’t Have Both GERD With and Without Esophagitis
Question: Two of my gastrointestinal (GI) doctors have listed both gastroesophageal reflux disease (GERD) with [...]

Gastroenterology Coding:
Master These 4 Key Steps to Simplify Your Colon Polyp Coding
Here’s why you need more than the operative report. Colon polyps are common findings in [...]

Oncology/Hematology Coding:
Look to These Dx for CA 19-9 Immunoassay Necessity
Question: What ICD-10-CM code should I use to prove medical necessity if our provider orders a [...]

Ob-Gyn Coding:
Code Prophylactic Placement of Ureteral Stents
Question: If the ob-gyn placed catheters for identification of the ureters (52005) during a gynecological [...]

View All