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The requirement of medical coders is increasing day by day. If you are visiting AAPC website, you can check in their monthly newsletters, the number of CPC-A, CPC. COC, CIRCC etc. newly certified coders with their names. The number of certified coder increasing every month. Majority of coders are clearing CPC Certification exam. So, the demand … Read more
Basics for G codes & CPT code 90471, 90472, 90473, +90474 For Medicare, the use G codes is very common for billing specific procedures. For example, the Vaccine administration codes used for flu, is reported with G code G0008. Similarly there are many G codes used for Medicare patients.Also, there are diagnosis codes like Z23 … Read more
Basics about Pelvic Ultrasound CPT code 76856 In Radiology, diagnosis related to pelvic region are very common to code. For example, for ovary cyst, pelvic pain, abdominal pain etc. are the common diagnosis for Pelvic exam in females. Mostly the ultrasound CPT code 76856 is used for pelvic region. This is the most frequently used … Read more
Basics of Mounjaro (Tirzepatide) Mounjaro, also known as Tirzepatide, is a novel treatment for Type 2 diabetes that has been generating a lot of buzz in the pharmaceutical industry. Mounjaro is similar to others medications and has both useful effects and possible side effects. Mounjaro has potential side effects that patients should be aware of … Read more
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
What is Denial Code 119 Denial code 119 signifies that the highest benefit permitted for a certain time frame or event has been attained. This suggests that the insurance coverage or policy typically has a cap on the funds it will disburse for a particular service or treatment within a specified period. Once this cap is hit, any further … 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