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Compliance:

Use This Website to Help Identify Fraud and Stay Compliant

Published on Tue Jul 01, 2025

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Other Articles of

July 2025

Anesthesia Coding:
Check With Payers for Modifier 51 Specifics
Question: Can I use modifier 51 on secondary or other additional post-op pain blocks? Delaware [...]

Optometry/Ophthalmology Coding:
Identify Inflammatory Sclera Conditions for Your Claim
Don’t forget to specify laterality with a 6th character. The eye is made up of [...]

General Surgery Coding:
Examine These 5 Skin Biopsy Myths
Learn how to bill multiple biopsies with different techniques. Skin biopsies are simple procedures that [...]

Orthopedic Coding:
Break Down Drug Volume Measurements
Question: How many billing units should I report for 1 cc of 4 mg per [...]

Optometry/Ophthalmology Coding:
Correct This Hyaloid Membrane Detachment Claim
Question: I have an op note that states the surgeon started a posterior vitreous detachment [...]

Orthopedic Coding:
Learn 5 Tips to Strengthen Your Spinal Fusion Coding
Find out how to recognize cage codes. Spinal fusion surgeries can be complicated to code, [...]

Pediatric Coding:
Try Your Hand at These Tick Removal Scenarios
Prepare to see more tick-related visits with summer amping up. As summer reaches its peak, [...]

General Coding:
Fine Tune Your Timely Filing Skills
Knowing the deadlines for each payer is key to success. Timely filing refers to the [...]

Pediatric Coding:
Query to Kick the Confusion in This Conjunctivitis Case
Question: A 7-year-old patient was seen for conjunctivitis, or “pink eye,” in our office recently. [...]

Otolaryngology Coding:
Remove This Code From Your PE Tube Removal Claims
Question: I am trying to find the correct way to code removal of tympanostomy (PE) [...]

Practice Management:
Understand Differences Between MOLST, POLST Forms
Question: Our patients sometimes ask our providers about MOLST or POLST forms during an encounter. [...]

Anesthesia Coding:
Bill Modifier 22 Confidently With These Tips
Hint: Don’t expect consistency across different payers’ policies. Anesthesia coders often improve their coding by [...]

Diagnostic Radiology Coding:
Use a Sprain Code for an ACL Tear
Question: A patient presented to our radiology practice with pain and swelling in the right [...]

E/M Coding:
Remember Necessity and Criteria to Bill Incident-to
See how you can bill more services at 100 percent of the physician fee schedule [...]

RCI Bonus Content:
Get the Answers to All Your Big Beautiful Bill Questions
Stay on top of this major government legislation and know what may lie ahead. By [...]

Neurosurgery Coding:
Use This Total Disc Arthroplasty Guide to Nail Claims
Make sure claim proves medical necessity for TDA. Total disc arthroplasty (TDA), also known as [...]

Primary Care Coding:
Understand Expansive Options for Purpura Dx
Question: I work for primary care providers at a family practice, and one of our [...]

Practice Management:
Look Into EHR Options for Billing Statements
Question: The vendor we used to use to print our paper billing statements just sent [...]

Technology & Innovation:
Identify CCTA Code With AI Analysis in 2026 MPFS Proposed Rule
Question: Will the 2026 Medicare Physician Fee Schedule (MPFS) include reimbursement for artificial intelligence (AI) [...]

Otolaryngology Coding:
Get the Answers to These 3 Frequently Asked Head and Neck Cancer Questions
Learn how to navigate the ICD-10-CM Alphabetic Index and Table of Neoplasms. While they only [...]

Diagnostic Radiology Coding:
Puff Up Your Chest to Confidently Code X-Ray Procedures
Can you report 71101 and 71111 with an AP view? The upper body is home [...]

Neurology & Pain Management Coding:
Know Alternate Terms for All Types of Schizophrenia
Question: Encounter notes indicate that the physician treated a patient with “hebephrenic schizophrenia.” Which type [...]

Technology & Innovation:
Address Staffing Shortages With Robots
Question: With staffing shortages in healthcare, are there any technological options to help ensure providers [...]

Urology Coding:
Know When to Ask for Urinary Incontinence Clarification
Question: I have an encounter note where the urologist documented the diagnosis as “urinary incontinence.” [...]

Pulmonology Coding:
Learn How to Code a Complete PFT
Question: A 55-year-old patient presented to the pulmonologist with swollen ankles and difficulty breathing. The [...]

Neurosurgery Coding:
Check for Laterality in CPT® Code Descriptors
Question: A patient suffering from “thoracol. Spondylosis, no radiculopathy/myelopathy” reports to the neurosurgeon. They perform [...]

Optometry/Ophthalmology Coding:
Can You Report 67010 Separately From Cataract Surgery?
Question: I have an op note for a complex cataract surgery where the surgeon performed [...]

Otolaryngology Coding:
Tackle This Tracheitis Coding Conundrum
Question: What is the correct way to code for tracheitis? Maine Subscriber Answer: The answer [...]

Anesthesia Coding:
Don’t ‘Date Range’ Your Anesthesia Claims
Question: The provider I work for performed an anesthesia service for a Medicare beneficiary that [...]

Compliance:
Using AI? Prioritize These Regulations and Rules
Question: Our practice leadership wants to incorporate more artificial intelligence (AI) into our coding workflow. [...]

General Surgery Coding:
Report a Surgical Wound Exam During a High BP Follow-Up
Question: I have a report from a follow-up encounter between a patient and their primary [...]

Neurology & Pain Management Coding:
Know Neurologic Exam Components for Potential Strokes
Question: Encounter notes indicate that a patient presented with stroke-like symptoms, and the neurologist performed [...]

Neurosurgery Coding:
Know Area Where Encephalocele Occurred
Question: Encounter notes indicate that the neurosurgeon treated a newborn patient with an encephalocele. What [...]

ICD-10-CM Coding:
Distinguish ‘Other’ From ‘Unspecified’
Question: I just got my CPC-A credential, and I’ve noticed that a lot of ICD-10-CM [...]

Medicare Regulations Understand Regulations for Hospice Attestation
Question: Does a provider need a particular credential to be able to perform an attestation [...]

Compliance:
Be Wary of Varying Billing Practices Between Payers
Question: Our orthopedic practice sometimes has situations where patients come in with the same issue [...]

Oncology/Hematology Coding:
Know How Social Determinants Affect Oncology Coding
Capture the complexity of cancer care by painting the full patient picture. According to the [...]

Urology Coding:
Learn How to Approach Prostatectomy Coding – Part 2
Does a prostatectomy code require a modifier for a biopsy? In the first article of [...]

Oncology/Hematology Coding:
Make Your Way Through the Malaise of This Coding Muddle
Question: A patient on a course of chemotherapy for lymphoma came in complaining of fatigue. [...]

RCI Bonus Content:
CMS Releases Proposed Rule for 2026 Physician Fee Schedule
Surprise: Get ready for two conversion factors. The Centers for Medicare & Medicaid Services (CMS) [...]

Oncology/Hematology Coding:
Code This ESA Scenario With Ease
Question: We are treating a Medicare patient with Procrit using J0885. The patient has anemia [...]

Practice Management:
Bolster Your Knowledge of Contracts With a Matrix
Use this tool to track contract specifics with each payer. Staying on top of each [...]

Podiatry Coding:
Handle Heel Pain Coding With Ease
This grievance is a top reason for podiatry visits. Heel pain is a very frequent [...]

Orthopedic Coding:
Can You Report Grafts Separately With Rotator Cuff Repairs?
Question: We have an orthopedic surgeon who performs arthroscopic rotator cuff repairs with and without [...]

Emergency Department Coding:
Look for Specifics on Eye FB
Question: If a patient reports to the emergency department (ED) with a foreign body (FB) [...]

Urology Coding:
Understand if Modifier 52 Is Needed for a Unilateral Vasectomy
Question: A patient who had a testicle removed five years prior due to cancer presented [...]

Pulmonology Coding:
Simplify Your Spirometry Claim
Question: I have a report where the pulmonologist performed spirometry, then administered a long-acting bronchodilator [...]

Medicare Regulations:
Find These Coding Options for Skin Substitutes
Question: My provider does wound care for patients, including Medicare beneficiaries, with skin substitutes. What [...]

General Surgery Coding:
Add G89.18 to Your Surgical Claims for Post-Op Pain Management
Question: I code surgical procedures for an outpatient facility. I have an operative note that [...]

Gastroenterology Coding:
Recognize the Correct Foreign Body Removal Code
Question: A physician used a flexible sigmoidoscopy to remove a foreign body from a patient’s [...]

Emergency Department Coding:
Remember These Clues for Manipulation Question
Question: A patient reported with an anterior displaced fracture of the sternal end of the [...]

Gastroenterology Coding:
Distinguish Between Modifier XS and 59 Use for Separate Procedures
Question: I have a report that documents one of our gastroenterologists performed a screening colonoscopy [...]

ICD-10-CM Coding:
Check Out ICD-10-CM Coding Guideline Updates for FY 2026
New updates affect specific conditions and some bigger-picture coding conventions. The U.S. Department of Health [...]

Podiatry Coding:
Avoid Getting Caught Stuck on This EDL Release
Question: I want a second opinion for coding the following procedure: Extensor digitorum longus (EDL) [...]

Path/Lab Coding:
Advance Your Understanding of Drug Test Coding, Part 2
Make sure you answer the mini quiz at the end. Last month, we looked at [...]

General Coding:
Clarify These Coding Components
Question: How do I look at a code and know if it can be billed [...]

Cardiology Coding:
Don’t Miss This Key Rule on Vascular Families in Cath Coding
Question: If a cardiologist performs catheterizations of the right vertebral artery (third order) and left vertebral artery (second [...]

Cardiology Coding:
Here’s How to Code Orthostatic Hypotension Correctly
Question: My cardiologist documented that the patient has orthostatic hypotension. What’s the correct ICD-10-CM code [...]

Diagnostic Radiology Coding:
Review the Documentation for Symptoms When X-rays Are Normal
Question: If there is no medical reason for the X-ray listed in the clinical documentation [...]

Primary Care Coding:
Use These New Codes for Genetic Susceptibility
Question: Is there a way to report a patient’s genetic predisposition to cancers and other [...]

Path/Lab Coding:
Mark This DOS Advice in Your Claim Calendar
Question: We received a saliva specimen for a genetic screening test that had been stored [...]

Pediatric Coding:
Code This Campfire Injury Correctly
Question: The physician had a 13-year-old patient come in with second-degree burns on their upper back [...]

Pulmonology Coding:
Examine This Comprehensive Guide on Sarcoidosis Treatment and Coding
Find out about the Siltzbach classification system. Sarcoidosis is a condition that develops when a [...]

Technology & Innovation:
Learn How New Treatments Reach Your Patients — Part 2
Examine the FDA’s role in medical device development. Revenue Cycle Insider explored different study types [...]

Gastroenterology Coding:
Understand the Intricacies of GERD Coding
Find out how to report testing procedures for GERD. Gastroesophageal reflux disease (GERD) is considered [...]

ICD-10-CM Coding:
Code Causal Dx, not Just the Context for Encounter
Question: A provider at my practice documented that a patient came in to receive hormone [...]

E/M Coding:
Bill an E/M for This Follow-Up Situation
Question: A provider saw a patient and performed a procedure, which had 0 global days, [...]

Podiatry Coding:
Apply KX Correctly on Your DME Claims
Question: I am relatively new to podiatry coding, and I am trying to determine if [...]

General Coding:
Stress Less About This New Patient Scenario
Question: Can a stress test and a new physical therapy office visit be billed together? [...]

Evaluation and Management:
Don’t Use Prolonged Services Codes for Calls
Question: I’m reading documentation notes and see that a provider had a 40-minute phone call [...]

Path/Lab Coding:
Match This Biopsy Lab With the Right Dx
Question: We are seeing denials when 88305 is billed with certain diagnosis codes, so I’m [...]

Neurology & Pain Management Coding:
Sleep Disorder Coding Requires Nimble ICD-10-CM Navigation
The various sections contain codes for a broad spectrum of conditions. Not all sleep disorders [...]

Medicare Regulations:
Know the Ins and Outs of Medicare Rules Regarding Disasters
Keep an eye out for blanket waivers, which can make associated paperwork less burdensome. It’s [...]

Cardiology Coding:
Navigate When to Code Standard Echocardiograms vs. Congenital With These Tips
Hint: Don’t make your coding selection based on age alone. Echocardiography , also known as [...]

Emergency Department Coding:
Breeze Through 3 Common Summer Presentations With Key Tips
Certain ED complaints are more common when the temperatures rise. The temperature is up, school [...]

Ob-Gyn Coding:
Post-Term Pregnancies Means This Many Weeks
Question: We are seeing patients with post-term pregnancies. What does that mean, and how should I [...]

Ob-Gyn Coding:
Hysterectomy Coding Decoded: Mastering CPT® Nuances for Maximum Reimbursement
Don’t miss common add-ons during hysterectomy procedures. With approximately 600,000 hysterectomies performed each year in [...]

Compliance:
Use This Website to Help Identify Fraud and Stay Compliant
Protect yourself by staying current on government-impersonating scammers. The Office of the Inspector General (OIG) [...]

Primary Care Coding:
Bring Your Measles Coding Up to Speed, Part 2
Here’s what to do when immunizations don’t go forward. In the first part of this [...]

Ob-Gyn Coding:
Gestational Hypertension no Longer Present: What to Do
Question: How do you code for a postpartum follow-up visit for a patient who had gestational [...]

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