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A
Has anyone billed 95165 to United Healthcare and getting their claims denied? Our claims are being denied when we provide supporting documents. Does the notes have to reflect the breakdown of the vials? e.g. if you bill 20 units, does the notes have to reflect the breakdown of the vials 10 cc 1 unit, and 10 cc 1unit? Or do we bill 10 units on 2 lines. Eg. 95165 1 unit, 95165 mod 59 1 unit?
H
J3301 - Medicare keeps denying for "Frequency". We are billing 99213.25 20610.LT and J3301.JZ. What are we doing wrong?
A
Are we no longer allowed to bill out 87502, 87634 and 87635? We've never had any issues with the insurance companies paying but over the last 2 weeks the insurance companies have been declining to pay the codes we billed and instead they've been adding cpt code 87631 and paying that.
C
Can Audiology TECHNICIANS bill for their services OR should it bill under the Audiologist as Primary Provider/Biller unless it is a commercial that does not accept Audiologist?
M
Hello, I am new to medical coding. I have been doing vascular surgery coding for a year now. Our surgeons just started performing GAEs. I know I use code 37242 for the embolization, but I am unsure of catheter placement codes and if I can code for a diagnostic angiography. Access of SFA to genicular arteries(SLGA ILGA DGA) ?36247
A
Hello. I have a question about skilled nursing facilities and Ambulatory Surgery Center Medicare payments. Is it true that if a patient resides in a skilled nursing facility, medicare will not pay for a procedure done in an ASC?
P
Credentialing Specialist Course

Has anyone completed the Credentialing Specialist course via AAPC? If so, about how many questions are on the final assessment? Also, did it help you when you started looking for work? I know a lot of employers want someone with experience, and I do have my CPB so I am just curious.
A
I recently came across the Forensic Medical Coder (FMC) certification and I’m curious if it’s a legitimate field or more of a niche certification. I’d love to hear from anyone who has experience in this area—is there really a career path here, and what does the day-to-day work look like?
J
What are the coding guidelines for a patient seen in the office transferred to hospital and seen by a different provider from the same specialty?
C
The scenario is: A physician who speaks both English and Spanish. His patient only speaks Spanish and the physician communicates with the patient in Spanish. Can this physician claim the add-on code T1013 for interpreting along with his primary service?
jkyles
jkyles
Hi there, no he cannot.
V
Hello, Is there a good guideline, article or webinar explaining how profee coders code in an inpatient setting? Do they follow the outpatient guidelines because they're a profee coder, or do they follow the inpatient guidelines because it's an inpatient encounter. There is a debate on this at my work, so I'm trying get solid information.
V
Varicak
ICD-10-CM/PCS Coding clinic, First Quarter ICD-10 2014 Pages: 17-18;
Azucena1
Hi everyone! I'm not sure who to turn to for the answer to this question so I'm hoping someone here can help me out. How do I get the "A" removed from my title? iv been coding for at least 3 years now. Thank you so much I hope everyone's well:)
R
Hi. I recently passed my cpc exam. I am new to this field and I also live in Katy Tx. Good to see someone from the same city.
nmojave@gmail.com
New to the platform!
N
nataliiarusyn@hotmail.com
Hi, I couldn't passed my CPB exam. Do you have have any recommendations or maybe someone is interested to practice the exam preparation in order to pass CPB exam?
R
rwbates2014@gmail.com
Hello, I am still learning how to code. Can someone please share with me how to find the laterality modifiers on the CS website? I have selected just about every tab on the site and still seem not to be able to find the table. Thank you!
R
Hi Swarna. I am Reshma. I recently got my cpc A . I am looking for a friend to share and talk about the career opportunities, as I am new to this field. Are you interested? Please let me know.
L
I noticed your question, and our stories seem alike. 15+ years coding experience, raised my kids, and re-entered into the coding world with the apprentice attached. I work remotely for a company called MBMS llc. They have 2 sites one in Wyomissing, PA and one in Newark, Delaware. Check their website. Their training process, the people and the company have been nothing short of amazing. Best of luck!!
L
leki2328
Hi, thank you I will go ahead a search them!
S
Helitene injection on CVC line Due to Bleeding, Kindly confirm can we code 37799 Unlisted for this procedure
P
Hi Jenny,

I was reading your very old post about Maloney dilation and would love to get your insight on this situation.

My provider does an EGD biopsy, stepwise Balloon Dilation to 20mm and Maloney 56Fr.

How would you codes these.

Thanks
S
The physician is applying Afrin and gentle nose pressure to control the nose bleed. Would this be enough to code for CPT code 30901
R
If cyst or lesion not mentioned in medical record then can we add MIPS code G9551 (Measure 405), please advise.
G
Can code G0348 and code 99397 be coded together with a modifier as separately identifiable services to Medicare Advantage Plans, since one is hands on and the other no hands on.
M
Hello,
I am trying to find clarification for telehealth. Looks like pos 02 or 10 have to be placed on the claim. Our Patients reside in assisted living and memory care facilities which is not a nursing home. But it is where they reside. So is POS 02 or 10 the correct one to use. Any guidance is greatly appreciated.
L
This has bothered me for years!! If 75635 is for a CTA arterial runoff, can we use this for a CTV, like the MRA/MRV, or do we really have to break it down into 73706/74174(5) ??
M
Medicare institutional complex billing specialist here specialized in claims investigator audit, research, improper payment validation, return-to-provider, payment validation, CWF and centralized database proficient looking for CMS Medicare specific roles.
A
Hi folks...i have a concern over reporting of RPM code 99454. Is it possible to report 99454 on January 30th and then again on February 28th? this falls within 30 days period but not in the same month...please advise!
J
Good morning, we are going to start having a Respiratory Therapist doing the breathing treatments for our patients and I was wondering if anyone knew how we would go about coding and billing when a RT does it vs a Nurse doing it? Thank you!
F
Hi, I may be in the wrong place. I am taking the Certified Billing course self-study I am finding it to be more challenging than I thought it would be. I am looking for tutoring or guidance on this class. Can you please offer advice on where I can go for help and if there are any tutors willing to help with my billing course
L
Finish Practicode !!! last week, waiting for my A to be removed. It was part of my package deal through my class, do I need to call or will it get done automatically? it says 4 to 6 weeks anyone know if that's true?
L
Hello, has anyone had any luck billing the new AMA/CPT telemedicine codes so far? We are receiving denials from Highmark and UHC so far and had no response from other commercial insurances. Any advice would be appreciated. Thanks!
A
Hello, my name is Autumn. I did see your post about hiring in Arkansas for CPC-A 's and you provide training as well. I am interested in a position. Is there contact information on how I can apply?
T
I have a patient that presented to clinic for a Preventive Wellness visit. During which she had an acute problem that the provider addressed in HPI, ROS and PE, and for the plan she done a referral. Is this enough to qualify for a significantly separate E/M?
C
chantal777
Good morning Treman,
Yes. If during an AWV the physician addressed a new or existing problem and well documented in the A/P therefore, the encounter is eligible for an office visit with -25 modifier.
Michele
E
Hello, I have 2 questions.

Q1- Where do I find the updates/changes CPT 2025 Mental Health codes? Such as the E/M codes and therapy.


Q2 - Is Adult Day treatment cpt H2012. What are the requirements that must be met to bill that service? Current practice is billing 3 units per day if requirements are met. (1 unit =60mins). Recently I heard, the 3 units must be met within a 7 day period, not sure how true that is.
D
I am presently seeking some advice from fellow cardiology coders regarding EKG documentation.
Sample: the EKG is performed prior to MD seeing the patient by office nurse, does the MD confirm, sign and date the EKG prior to adding to the patient's electronic chart?
Also, is the EKG findings documented in the patient's progress note. Thank You!
T
TThivierge
Yes the radiologist reads the EKG or doctor then give dx code on outcomes. All this data should be on the EKG final report and provider will mention confirmed results of EKG in treating documenting for the day.
B
Hello members
I am trying to code for 22802:-Arthrodesis posterior for spinal deformity with or without cast 7 to 12 vertebral segments. The Medicare is kicking this code back for LCD/diagnosis reason. Does anyone know an appropriate diagnosis code to use for Medicare payment or which goes with LCD. Also there is no LCD article for the 22802 code. Thank You
Pam Warren
Pam Warren
That LCD was retired in March of 2024. When's your date of service? A draft article is in process. DA59664.
B
Binitharamesh
Thank You
H
clarification: a covid shot was given the same day as a flu shot. the covid administration is 90480. Will the flu shot administration be coded with a 90471 or a 90472 (because it is the 2nd shot given today)?
S
Looking for clarification. I coded 1-M47.26, 2-M48.061, 3- M99.73. Is this correct? If not why? History- Disc degeneration of the lumbar spine. Impression- 1- lumbar spondylosis, including advanced lumber facet arthrosis. 2- L3-L4 mod to severe central canal stenosis. Mild/mod bilat foraminal stenosis. 3- L4-L5 Mod central canal stenosis. Mild/mod rt foraminal stenosis.
C
We recently starting doing Peripheral Nerve Stimulation trials, CPT 64555 billed twice, and now they are wanting to do the permanent placement. This would be CPT 645902, 64555 & 64555 but it is within 365 days of the trial and I am unsure if they will pay the 64555 code more than twice in that 365 day period. Does anyone have any experience with this?
B
How would you code history of tobacco use, currently on nicotine patch? I have had this question come up on an exam, but not sure if I answered correctly. Thank you in advance.
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