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Procedure: Ultrasound-guided core needle biopsy right breast at 2 sites, ultrasound-guided core needle biopsy left axillary lymph node, right diagnostic mammogram HISTORY: 33-year-old woman presents with history of a 25 mm mass of the right breast 10 o’clock position, 7 cm from nipple (site A), 5 mm mass of the right breast 9 o’clock position, … Read more
Basics of CPT code 93886 CPT Code 93886 is Transcranial Doppler study of Intracranial arteries; complete study. It requires bilateral insonation and waveforms from all major vessels with the cranium through the Temporal acoustic window. These vessels include the Middle Cerebral Artery (MCA), Anterior Cerebral Artery (ACA), and Posterior Cerebral Artery (PCA). The Posterior window … Read more
The 2025 expansion of CPT (Current Procedural Terminology) codes is poised to bring significant changes to primary care practices, with the introduction of 270 new codes, 38 revisions, and 112 deletions. These updates, effective January 1, 2025, are crucial for providers to review in advance to ensure timely reimbursement. On September 1, the American Medical … Read more
In January 2024, the Centers for Medicare & Medicaid Services (CMS) issued guidance regarding the implementation of HCPCS add-on code G2211. This code is designed for office and outpatient (O/O) evaluation and management (E/M) visits that are inherently complex due to the medical care required. G2211 applies when care involves continuous collaboration for a patient’s … Read more
As modifier -FS approaches its third year of active status, it’s important to understand the correct application of this modifier, which dictates payment for split/shared E/M visits. Since its introduction by CMS in January 2022, the modifier has become crucial for accurate billing, helping to prevent overpayments, underpayments, and compliance issues. Here are key tips … Read more
The Centers for Medicare & Medicaid Services (CMS) has finalized several changes that significantly expand the scope of behavioral health services, incorporating new coverage for digital treatments and crisis intervention codes. These updates aim to enhance access to behavioral health care, especially in digital and remote settings, and address evolving patient needs. Key Updates to … Read more
Since January 2021, healthcare providers have had the flexibility to select the level of evaluation and management (E/M) service based on either the complexity of medical decision-making (MDM) or the total time spent on the date of the encounter. This flexibility allows providers to choose the method that best reflects the care provided during a … Read more
What is Moderate Sedation? Moderate sedation, also known as conscious sedation, is a medical procedure where medication is used to relax a patient, but they remain awake and responsive. The patient can respond to verbal commands or light touch, and they do not need assistance with their airway or breathing. Heart function is generally stable … Read more
Newborns born before they reach full term can be categorized based on their birth weight and gestational age. These are classified under the code category P07, which includes: Extremely Low Birth Weight (P07.0-): Babies weighing 500-999 grams. Low Birth Weight (P07.1-): Babies weighing 1,000-2,499 grams. Extreme Immaturity (P07.2-): Babies born before 28 weeks of pregnancy … Read more
In the world of healthcare claims, proper coding is essential for ensuring that providers receive timely payments for their services. One important aspect of this process is understanding remark codes, which communicate specific issues related to claims processing. Among these, Remark Code MA04 serves a crucial role in indicating problems with secondary payer claims due … Read more