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Basic of Medicare Condition Codes National Uniform Billing Committee (NUBC) in its Official UB-04Data Specifications Manual 2007 defines condition codes as codes used to identify conditions or events relating to this bill that may affect processing. Condition codes refer to specific form locators in the UB-04 form that demand to describe the conditions applicable to … Read more
Basics about Emergency department (ED) CPT code 99283 An Emergency Department (ED) is defined as an organized hospital-based facility for the provision of unscheduled episodic services to patients who present for immediate medical attention. The facility must be available 24 hours a day. The common reasons for ED visits are chest pain, abdominal pain, open wounds, … Read more
Procedure performed for CPT code 97802, 97803 & 97804 A dietetic professional provides medical nutrition therapy assessment or re-assessment and intervention in a face-to-face or group patient setting. After nutritional screening identifies patients at risk, preventive or therapeutic dietary therapy is initiated to induce a positive result in the role nutrition plays in improving health … Read more
Basics about Initial observation Care E/M CPT codes Significant changes were made to the Evaluation and Management (E/M) Hospital Inpatient and Observation Care Services subsection of the Current Procedural Terminology (CPT®) 2023 code set. Other E/M subsection revisions were discussed in previous CPT Assistant issues. In this issue, the newly combined subsection of hospital inpatient and observation … Read more
Understanding Denial Code 109 Denial code 109 indicates that the claim or service you submitted falls outside the coverage provisions of the specific payer or contractor to whom you sent it. To resolve this, you must redirect the claim or service to the appropriate payer or contractor that provides coverage. Frequent Reasons for CARC 109 (denial code 109) The prevalent factors leading to code 109 include: 1.Wrong payer or contractor details: A frequently encountered reason for denial code 109 is the submission of the claim or service to an incorrect payer or contractor. This often stems from inaccuracies in the patient’s insurance details or uncertainty regarding the correct payer for … Read more
Understanding Denial Code 97 Denial code 97 signifies that the benefit for a specific service has already been encompassed within the payment or allowance for another service or procedure that has been processed previously. In essence, the insurance provider has already factored in the expense of this service within the payments made for another associated … Read more
Basics of Vasectomy CPT code A vasectomy is a surgical procedure used as a method of male contraception. During the procedure, the vas deferens—the tubes that carry sperm from the testicles to the urethra—are cut, sealed, or otherwise blocked. This prevents sperm from mixing with semen that is ejaculated from the penis, effectively preventing pregnancy. … Read more
Accurate coding for colonoscopies in outpatient settings hinges on a clear understanding of the different procedure types. Coders must differentiate between screening and therapeutic colonoscopies to ensure correct code selection and compliance with coding guidelines. Types of Colonoscopies 1. Diagnostic Colonoscopy Definition: Often referred to as a screening colonoscopy, a diagnostic colonoscopy is a preventative … Read more
Basics of Pulmonary tissue ventilation analysis code 0807T, 0808T For the CPT 2024 code set, two new Category III codes (0807T, 0808T) were established to report pulmonary tissue ventilation analysis. This article provides an overview of the intent and use of these new codes. The provider uses software to analyze data that measures the patient’s … Read more
In 2025, their are many new ICD 10 codes in Chapter 2 neoplasm. Yes, their will be separate ICD-10 CM codes for neoplasm in remission phase. Remission means that the signs and symptoms of your cancer are reduced. Remission can be partial or complete. In a complete remission, all signs and symptoms of cancer have disappeared. … Read more