1. K

    Wiki E/M Service Rendered at Non-medical Community Center

    I have a provider who works for an Indian Health Service that will go to the reserve and render services at their local Activity Community Center. There are no permanent medical facilities and it's not a residence. What E/M CPT code would you recommend? I'm struggling to find the code as this is...
  2. A

    Wiki Unlisted Procedures

    Does anyone have experience billing frequent Unlisted Procedure codes? Do you follow the guidance to send a cover letter with the claim?
  3. E

    Wiki Why was I marked wrong? (Practicode Case ID: OPD7390)

    The documentation: How am I supposed to know that the code for the operating microscope (69990) is bundled into codes 63051 and 63001? I didn't see this specified in the guidelines for either of these codes, or in the guidelines at the beginning of the section.
  4. E

    Wiki Why was I marked wrong? (Practicode Case ID: OPD7188)

    The documentation: How do I know that I should report 63020 instead of 63045?
  5. F

    Wiki CPC-A Earned December 2023

    I am a highly motivated and detail-oriented individual with a strong passion for Medical Coding and Billing. I completed the Outpatient Medical Coding and Billing program at CareerStep.com in November 2023 allowing me to earn my CPC-A in December 2023. I gained a comprehensive knowledge and...
  6. E

    Wiki Why was I marked wrong? (Practicode Case ID: OPD7205)

    The documentation: Why is 96372 reported in addition to J0696, which already specifies that the drug was injected?
  7. C

    Wiki Medical vs. Dental Codes

    I'm having a hard time with Highmark claims when it comes to billing wisdom teeth extractions to medical insurance using medical codes. The first code always pays, but all of the subsequent codes on the claim deny as duplicates. I make sure that the teeth numbers are on the claim too. Am I...
  8. I

    Wiki Shoulder RFA CPT code

    Does anyone have idea about shoulder RFA cpt code? Please refer below notes. Thanks! Does anyone have idea about Shoulder RFA CPT code?
  9. C

    Wiki Can an Audiologist Bill 92633?

    Hoping someone can help me with this... One of my company's clients is a Speech-Language-Hearing Clinic in Pennsylvania. They have speech-language pathologists and an audiologist. I was asked to look into whether the audiologist can bill CPT 92633 (auditory rehabilitation; post-lingual hearing...
  10. M

    Wiki BILLING 37231 AND 37225 TOGETHER

    Hello, I need help! Hopefully someone can help me here. When billing for 37231 + 37225 is a modifier required? If so, which one.
  11. C

    Wiki Diagnostic and Procedure coding

    If a diagnostic knee arthroscopy procedure was completed but the provider, then also completed a arthroscopy meniscus repair. Would you code both the diagnostic arthroscopy and the repair?
  12. K

    Wiki CPC-A with strong data entry skills ready to work full-time | Remote | CRC Exam next month

    Hi! I am a newly certified CPC-A that is seeking full-time remote employment. I scored 89% on the CPC exam two weeks ago and am currently scheduled to take the CRC certification exam on July 23. I have exceptional data entry skills from a computer programming degree and strong analytical skills...
  13. L

    Wiki CPT code for H0015

    I am having some issues with Humana Commercial line of business wanting all claims on the 1500 form. H0015 will deny on a commercial line of business, but I don't know what to use as the CPT code instead? Or any of the Hcodes for that matter. They will all deny on 1500 form for a commercial...
  14. dgarri


    We have a Provider who has a referring physician ordering CT Scanograms of various Extremity Joints (I.e. Hip, Knee, Shoulder, etc.). From a procedural standpoint it is performed on the CT, but they only run a high resolution Scout (AP View), with NO Axial images obtained. In essence, it’s...
  15. KStaten

    Wiki CPT: Distal Coplaning with Subacromial Decompression

    "Distal Coplaning and with Subacromial Decompression" for treatment of Impingement Syndrome Summary of Procedures: Soft tissue was used to skeletonize the undersurface of the acromion 4.5 mm barrel was then used to remove 5 to 7 mm of the bone off the anterior and lateral border from the...
  16. J

    Wiki Blood Pressure Monitoring Coding for Events/Home Visits

    Hello All, My question pertains to coding blood pressure monitoring on remote devices (non-digitally transmitting) for patients at health care events/in-home services. Since the health events are one time only I was thinking 99453 or 99454 would suffice. I see that the service must be ordered...
  17. J

    Wiki Modifier 27 help

    Hi all! I'm looking for resource material regarding the use of Mod-27. I code for an ED with affiliated Primary and Specialty Care offices and Walk-In's. At some point, someone in my organization advised we could not use Mod-27 with ED E/M's when a patient has an additional outpatient visit that...
  18. C

    Wiki CPC 5 yr experience

    CPC certified, looking for a remote coding opportunity overseas, 5 years experience with ICD 10 and CPT coding. Looking for a position where my coding, technology, and organizational skills can be used to help a company to reach their goals. Willing to relocate: Anywhere Authorized to work in...
  19. KStaten

    Wiki Are all 20610 Injections considered "Intra-articular"?

    Question: Are all injections that fall under the CPT code 20610 considered "intra-articular," or does that term not apply to ALL injections that can be performed under the 20610 CPT code, such as injections into the bursa? THANKS!
  20. C

    Wiki greater and lesser occipital block CPT

    Hello, I am trying to correctly code for Px greater AND lesser occipital nerve blocks bilateral. Would the correct coding be 64405 AND 64450? Or would one be inclusive to the other? Please advise, thank you!
  21. C

    Wiki RFA code for Greater trochanter nerves

    Hello, Dr. notes procedure as Right RFA of "Peripheral Nerve sensory supply to the greater trochanter." Can someone please help confirm correct CPT coding is 64640 (other peripheral nerve or branch) thank you!
  22. V

    Wiki Therapeutic Wound Exploration and lysis of lumbar adhesions.

    Our pain management doctor performed a procedure which was authorized under CPT code 11043 - Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less. This is what the doctor documented: The patient was brought back into the...
  23. C

    Wiki 97164

    Hi, This is my post in the forum and newly certified. I’m currently work in a physical therapy office. We were discussing utilizing the re-eval. code 97164. I understand that there are some guidelines when it’s appropriate to use this code. In addition that the modifier 59 would need to be...
  24. S

    Wiki New procedure code for COVID-19 POC Rapid test?

    Is there a new CPT code for COVID-19 POC Rapid Test?
  25. K

    Wiki IV billing in an Office setting

    Hi all! My office does surgeries from POS 11, we are not surgery center. Can we bill for the IV for fluids and/or drugs that are being adminstered? Thanks in advance! Kim
  26. Z


    We are an Infectious Disease group. The doctors see patients at the hospital. Due to the supply shortages (protective equipment and testing kits) at the hospitals in NYS at the moment some visits with the patients being seen for COVID-19 r/o are not able to undergo a proper physical. The doctors...
  27. N

    Wiki Pre-Procedure Psychiatric Clearance Questions

    I work for a pain management doctor who is now performing procedures in office and also in an ASC that payers are beginning to require pre-procedure psych evaluation and clearance for. The physician would like to contract a LCSW to work in the office part time, under our group NPI, to perform...
  28. M

    Wiki Guiaic done in office for colon cancer screening

    There does not seem to be a code for a guiaic test done in the office for colon cancer screen. 82270 sounds like the patient is sent home with cards, and 82272 states "performed for other than colorectal neoplasm screening" When the sample is collected by the physician and test performed in the...
  29. stephanieannec

    Wiki Reliable Coding Resources for FFS???

    Hi! I'm primarily a risk adjustment educator and recently I was asked by my organization to reach out to a provider who also has a large FFS panel to provide general CPT "cheat sheets." I'm really rusty on this aside from E/M and Category II and I'm wondering if there's any reliable material I...
  30. D

    Wiki BCBS Cross Coding Oral/Maxiollofacial Surgery (CPT to CDT)

    Hello everyone! My name is Mallory and I work as a coder/biller for an oral/maxiollofacial surgeon in Lee's Summit, MO. While the majority of our practice is dental related (wisdom teeth, jaw bone grafting, etc.) my physician also does trauma rounds at the hospital, sees patient's for oral...
  31. C

    Wiki 2019 CPT Code Electronic Check-in

    Hello! With the start of the New Year we can no longer bill our patient electronic check-in pad with 96103 (computer administered, computer graded, psychologic assessment). If anyone else was billing 96103, have you found any appropriate alternatives? Thinking of 96146 OR 96136. Greatly...
  32. K

    Wiki Oral biospy cpt code

    Hi, I am new to Oral & Maxillofacial Surgery. I gave codes for the vestibule of the mouth and was told it is not the vestibule of mouth it's an oral biopsy Right retromolar area excision. So I found CPT 41826, Under Excision and Destruction Procedures on the Dentoalveolar Structures under...
  33. A

    Wiki 90696 for patients outside of 4-6 years old

    Hello, The nurse at our clinic who administers vaccines sometimes admins a 90696 for kids outside of the 4-6 age rage. She says it's due to patients being behind on their vaccines and circumstances like that. Can I code this a a DTaP 90700 and IPV 90713 separately? Or do I have to use the...
  34. KatieBrownCPC

    Wiki HELP Well woman Prev Visit vs Office Visit coding

    Need to understand when to code for Prev Visit and When to stick to new patient, all the ICD vs CPT feel backwards from primary diagnosis to visit billed ...TIA New Pt 36 Here for well woman with pap, STI and HIV ICD consists of Z11.3 STI screen Z11.4 HIV screen Z01.419 GYN routine exam...
  35. T

    Wiki Care Management codes

    Recently the care managers in my office have started team conferences (G9007). They want to know if they can bill G9007 with a telephone call (98966) on the same day. I can't find a lot of information regarding this, so I'm hoping someone here can help. Basically; can G9007 and 98966 be billed...
  36. I

    Wiki Total Time allotments for CPT Codes (Pre, Intra, Post - Service time allotments)

    Hello everyone, I'm looking for an excel spreadsheet I can download with all the breakdowns for CPT services (i.e. pre/intra/post minutes for each CPT code). I believe this information came from CMS...? My brain is fried today...I know I have downloaded this information previously, but can't...
  37. T

    Wiki Pathology Coding

    Hi fellow CODERS! I hope this message finds you well. I am in need of some clarification around lab billing. I am not very familiar and would like to get some feedback. our office is billing multiple CPT codes in the Microbiome area. One being 87798, as we know this is an unlisted code...
  38. A

    Wiki Resection of carpal trapezium w/internal brace stabilization for thumb base arthritis

    Hi all, I would like an expert opinion on which CPT code is most appropriate for what looks like a "suspension version" of a CMC arthroplasty. Per op report: "...A marked amount of arthritis at the trapezial carpometacarpal joint was identified. The trapezium was osteotomized in 3 places...
  39. K

    Wiki EEG coding in hospital setting

    I work for an outpatient neurological clinic, where the doctors will interpret EEG's done at the local hospital. My question is, one doctor always states in the report "Recording time consists of 30 minutes over an hour." While also stating "patient was recorded while awake and asleep." Now...
  40. R

    Wiki CPT Checklist

    Hi all, I've been looking for some sort of coding checklist that I might be able to give to my Physicians. For example a document that nudges them to use the correct verbage when dictating i.e. if we do a fistulagram with PTA what CPT codes does this entail, so they can go through their...
  41. C

    Wiki CPT Online

    Is the CPT published online? If not, how can I get the code descriptions online, guidelines, etc? I always cite my sources when I give providers advice on documentation and I'm getting tired of typing everything. I wanna copy and paste. I didn't see a link in the manual.
  42. A

    Wiki Jejunal tube conversion to a Gastrojejunostomy tube

    I am having a hard time finding the correct CPT for this procedure. Coder has coded 49446 which I see how they got this by going through our encoder. But I see that it isn't correct. I keep getting an unlisted CPT. needing a little help as to which CPT to use. Here is the note: The existing...
  43. M

    Wiki Residential Program Billing

    Does anyone know the appropriate CPT code for a Residential Program, per diem (supportive living) for TBI patients, billed to a no-fault auto insurance company?
  44. L

    Wiki Debridement and Unna/Compression CPTs for different wound conditions

    I'm hoping you all can help me find some documentation that I've lost. My research found that if I have a Venous Insufficiency ulcer, I can code Debridement AND Unna/Compression with a -59 modifier because the Debridement is for the ulcer and the Unna is for the separation condition for the...
  45. S

    Wiki Seeking an Outpatient Coding Position

    I am looking for a secure position where I can use everything I have learned. I am so ready to go :o Will re-locate.
  46. A

    Wiki I want to apprentice under hospital coder

    Hi! I live in Orange County, CA. I've really been wanting to become a stronger coder and I would love to sit and learn from a hospital coder. I'd love to work for a hospital but they require so many years under the belt. I'm willing to pick up the workload for free in exchange for an extended...
  47. K

    Wiki Revenue Codes that require a CPT or HCPCS

    I am auditing Revenue Codes to ensure that there is CPT or HCPCS correlating to charge. Is there a list that says what Revenue Codes require a CPT or a HCPCS. I have a good idea but just wonder if there is a master list. I have read that these types of Revenue Codes referred to as non-exempt...
  48. K

    Wiki An independent and self-motivated CPC-A with accurate and efficient coding skills

    15+ years of experience coordinating projects, administrative duties and processing large volumes of data in diverse office environments. • Certified Professional Coder-AAPC • CPT, HCPCS Level II and ICD-10-CM. • Knowledge of anatomy, physiology, and medical terminology. • Electronic health...
  49. C

    Wiki Prolonged Services

    Hello I have a patient who after his E/M visit was admitted to hospital by Dr. but stayed in office for 4 hours under supervision until an open room was available at hospital. Would I use prolonged visit codes? Or not include at all. Any advise would be helpful. thank you
  50. S

    Wiki Revenue code crosswalk

    Does anyone here have access to Revenue Code crosswalk tools like Uniform Billing Editor or Revenue Cycle Pro? I need a help with 6 codes.