Orthopedic Surgery Billing Guide: Fracture Care, Arthroplasty, Arthroscopy CPT Codes, Global Periods, and Orthopedic RCM
Orthopedic surgery billing covers fracture care codes with 90-day global periods...
Medical Coding
74 articles: ICD-10, CPT, HCC coding guidance.
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Showing 1 to 24 of 74
Neonatology and Pediatrics Billing Guide: Newborn Care, NICU Codes, Well-Child Visits, and Pediatric RCM
Neonatology and pediatrics billing covers newborn hospital care codes 99460-99463, NICU neonatal critical care 99468-99469 and continuing intensive care 99477-99480 stratified by birth weight with common birth weight coding error explana...
Obstetrics and Gynecology Billing Guide: Global OB Package, GYN Procedures, and OB/GYN RCM
OB/GYN billing covers global obstetric package codes 59400 vaginal delivery and 59510 cesarean with bundled antepartum, delivery, and postpartum care, antepartum-only codes 59425-59426 and delivery-only codes 59409-59514 for split care a...
Nephrology and Dialysis Billing Guide: ESRD Monthly Capitation, Dialysis Procedure Codes, CKD Management, and Nephrology RCM
Nephrology and dialysis billing covers ESRD monthly capitation payment codes 90951-90970 by patient age and face-to-face visit frequency, hemodialysis procedure codes 90935-90937 for acute inpatient settings, peritoneal dialysis 90945-90...
Radiation Oncology Billing Guide: Treatment Planning, IMRT, SBRT, Brachytherapy, and Radiation Oncology RCM
Radiation oncology billing covers treatment planning CPT codes 77261-77295 by complexity level, IMRT planning 77301 and delivery codes 77385 simple vs. 77386 complex for VMAT, SBRT per-fraction delivery 77373 and per-course management 77...
Hematology and Oncology Billing Guide: Chemotherapy Administration, Oncology E&M, Drug Billing, and Heme-Onc RCM
Hematology oncology billing covers chemotherapy administration CPT hierarchy 96413-96417 with sequential add-on 96417 and concurrent 96416, cancer drug HCPCS J-code billing with NDC numbers and Modifier JW for single-dose vial wastage an...
Orthopedic Billing Guide: Joint Replacement, Arthroscopy, Fracture Care, Sports Medicine, and Orthopedic RCM
Orthopedic billing covers total joint replacement 90-day global period management for THA 27130 TKA 27447 and TSA 23472, arthroscopy CPT codes 29800-29999 with NCCI bundling rules and add-on code requirements, fracture care coding by ope...
Allergy and Immunology Billing Guide: Allergy Testing, Immunotherapy, IVIG, and Allergy RCM
Allergy and immunology billing covers percutaneous allergy testing CPT 95004 and intradermal testing 95024 billed per allergen test, allergen immunotherapy split billing between preparation 95165 per dose and injection administration 951...
Pediatric Billing Guide: Well-Child Visits, Vaccines, EPSDT, CHIP, and Pediatric Revenue Cycle
Pediatric billing involves well-child visit preventive care codes age-banded from infant through adolescent, vaccine administration CPT codes 90460 and 90471 with HCPCS product codes and VFC program billing, EPSDT mandatory Medicaid cove...
Dental Billing Guide: CDT Codes, Medical Necessity Cross-Billing, and Insurance Coordination
CDT code structure by category (diagnostic D0, preventive D1, restorative D2, endodontics D3, periodontics D4, oral surgery D7, orthodontics D8), ADA claim form requirements and dental clearinghouse ecosystem, dental insurance benefit ti...
Clinical Documentation Improvement Guide: CDI Programs, Physician Queries, and DRG Optimization
CDI program structure with concurrent and retrospective review, compliant physician query types and non-leading query methodology, DRG CC/MCC documentation for inpatient reimbursement optimization, HCC risk adjustment CDI for Medicare Ad...
NCCI Edits Guide: Understanding Medicare's National Correct Coding Initiative and Modifier Overrides
NCCI Procedure-to-Procedure (PTP) edit pairs and modifier indicator 0 vs. 1, correct use of Modifier 59 and X-modifiers (XE, XS, XP, XU) with documentation requirements, Medically Unlikely Edits (MUEs) and MAI adjudication indicators, co...
Medical Coding Certification Guide: CPC, CCS, CPMA, CRC, and Other AAPC/AHIMA Credentials
AAPC credentials including CPC, COC, CIC, and CRC for coding settings and risk adjustment, CPMA and CPCO for audit and compliance roles, AHIMA credentials including CCS and RHIA for inpatient and HIM, exam preparation strategies, special...
Outpatient Coding Guidelines: ICD-10-CM Rules, First-Listed Diagnosis, and Uncertain Diagnoses
First-listed diagnosis selection rules, coding uncertain diagnoses as signs and symptoms in outpatient settings, chronic condition coding at every applicable visit, Z code applications for preventive and screening encounters, and ICD-10-...
Value-Based Care Coding: Quality Measures, Care Management Codes, and Shared Savings Documentation
CCM and TCM billing documentation requirements, AWV as a quality measure and HCC capture vehicle, MIPS CPT II quality measure coding, ACO patient attribution and cost-of-care documentation, and behavioral health integration (BHI) codes.
HCC Risk Adjustment Coding: RAF Scoring, Annual Wellness Visits, and Hierarchical Condition Categories
How the CMS-HCC model calculates RAF scores, high-value HCC coefficients, AWV-based annual HCC capture workflow, ICD-10 coding specificity for diabetes and CKD risk adjustment, and RADV audit compliance requirements.
ENT Billing Guide: Otolaryngology CPT Codes for Sinus Surgery, Tonsillectomy, Audiology, and Laryngoscopy
FESS endoscopic sinus surgery codes by sinus type, tonsillectomy age-specific codes, flexible laryngoscopy billing, hearing evaluation and audiology codes, and in-office ENT procedure capture best practices.
Psychiatry and Behavioral Health Billing Guide: E&M vs. Psychotherapy, Add-On Codes, and Parity Laws
Psychiatric evaluation codes 90791/90792, psychotherapy time-based codes, E&M plus psychotherapy add-on billing (90833/90836/90838), interactive complexity add-on 90785, and mental health parity law compliance.
Global Surgery Period Guide: What's Included, What's Separately Billable, and Modifier Rules
The surgical global period (0-day, 10-day, 90-day) defines what services are included in the surgical fee. Learn what is and isn't covered, and the modifiers for separately billable services.
Medical Coding for Radiology: Professional vs. Technical Components and Imaging CPT Codes
TC/26 split billing rules, global code billing requirements, CT and MRI coding by contrast status, ultrasound complete vs. limited distinctions, nuclear medicine coding, and imaging supervision levels.
Orthopedic and Spine Billing Guide: Joint Replacement, Fracture Care, and Spinal Procedure Codes
90-day global period management, fracture care code rules, joint replacement bundled payments, spinal surgery component coding, and arthroscopy bundling rules in orthopedic billing.
Oncology and Infusion Billing Guide: Chemotherapy, Drug Administration, and HCPCS J-Codes
Drug administration CPT hierarchy rules, HCPCS J-codes for drug billing, chemotherapy vs. non-chemotherapy administration code distinctions, and drug waste billing with JW modifier.
Anesthesia Billing Guide: Base Units, Time Units, Qualifying Circumstances, CRNA Billing, and Anesthesia RCM
Anesthesia billing uses the base units plus time units times conversion factor formula. This guide covers anesthesia CPT code base unit values, qualifying circumstances 99100-99140, anesthesia modifiers AA QZ QX QK and AD, medical direct...
Emergency Medicine Billing Guide: ED E&M Levels, Critical Care, EMTALA, and Emergency Department RCM
Emergency medicine billing uses ED-specific E&M codes 99281-99285 based solely on Medical Decision Making with no new vs. established distinction, critical care time billing with 99291 for first 30-74 minutes and 99292 add-on for each ad...