Mastering Medical Coding Modifiers: Unlocking Full Reimbursement Potential

As a medical coder, knowing when and how to use modifiers is crucial to ensuring you’re getting paid properly for services provided. One of the most powerful tools at your disposal, modifiers help you communicate that certain procedures, even within a global surgery period, are distinct and deserve separate payment. This is your secret weapon … Read more

Mastering Hip Replacement Coding: A Guide for Medical Coders

As a medical coder, mastering the language of orthopedics is essential for ensuring your coding is on point—especially when it comes to procedures like arthroplasty and joint replacement. While these terms are often used interchangeably, understanding their subtleties can make a huge difference in accurately translating clinical language into the precise codes used in medical … Read more

Update for Medical Coders: ICD-10-CM Code Changes Coming April 1, 2025

Get ready for some important ICD-10-CM updates that are sure to keep you on your toes! While CMS has announced there will be no brand-new ICD-10-CM codes introduced on April 1, 2025, don’t tune out just yet – they’ve released key diagnosis code update files for discharges and patient encounters from April 1 through September … Read more

Essential Updates to Vaccine Codes for 2025: What Medical Coders Need to Know

Vaccine codes, including those for immunizations and related procedures, are frequently updated, especially when new vaccines are introduced or billing requirements change. The American Medical Association (AMA) has updated the CPT code set to reflect these changes for the 2024-2025 period. In addition to updates for the influenza season, two new vaccine codes have been … Read more

Prolonged Service CPT Codes: A Guide for Medical Coders

Prolonged service codes provide a valuable opportunity for medical practices to earn additional revenue when a clinician spends extra time providing care to a patient. These codes are specifically designed to be used in conjunction with office-based Evaluation and Management (E/M) visits, allowing practices to report extended service time beyond the typical office visit. Here’s … Read more

Understanding Myocardial Injury, Ischemia, and Infarction: Key Concepts for Medical Coders

The conditions of myocardial injury, ischemia, and infarction are critical in cardiology as they greatly influence patient care and the healthcare system. It’s important for medical coders to understand these conditions, including their causes, symptoms, and how to document and code them accurately. This article explains these concepts, focusing on pathophysiology, diagnostic techniques, and coding … Read more

Clearing Up the ERCP and Cholangioscopy Coding Confusion

There is a common misconception that CPT® add-on code +43273 for cholangioscopy can only be reported when using a SpyGlass™ scope. After conducting research, I can confirm that this is not accurate, and here’s why. Focus on the Procedural Note Endoscopic retrograde cholangiopancreatography (ERCP) involves both diagnostic and therapeutic approaches, with distinct techniques covered under … Read more

Steps for Accurate Coding of Complex Surgical Procedures

Medical coders often face the challenge of decoding complex surgical reports filled with specialized terminology and detailed procedures. When confronted with a lengthy, intricate report, it can be overwhelming. However, breaking the process into manageable steps helps simplify and organize the task. The following six steps will guide you in transforming a complex surgical procedure … Read more

Clarifying the Difference Between Audio-Only and Telephone Codes for Medical Coders

It’s important for medical coders to understand the differences between audio-only visits and telephone visits, as they are not the same, despite both being types of telehealth services. Key Differences in the Codes: Audio-only codes are designed for both new and established patients. This means that these codes can be used whether it’s the first … Read more

Understanding HCPCS Level II Add-On Code G2211: Key Considerations for Medical Coders

HCPCS Level II add-on code G2211 recognizes the significant and ongoing relationship between a patient and their physician. It compensates for the additional time and effort involved in managing the complexities of long-term patient care. This includes activities such as patient conversations, development of comprehensive care plans, and collaborative decision-making. This article explores the billing … Read more

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