Medical coders work with many different code sets including CPT, HCPCS, ICD-10-PCS, and ICD-10-CM. This means coders need to be well-versed in medical terminology. One terminology not often talked about in coding circles is the Systematized Nomenclature of Medicine Clinical Terms—despite the system being around for more than 20 years.
Take three steps when an assistant surgeon helps during a procedure. First, make sure an assistant-at-surgery modifier is appropriate for the procedure. Second, make sure the primary surgeon’s note explains why they needed the help of a qualified healthcare professional (QHP) or another physician for the procedure. Third, make sure you select the correct modifier, based on the assistant’s credentials and role.
Our experts answer questions about the multiple sclerosis medication administration, coding a crack cocaine overdose, and Medicare administrative contractors.
A neonatal intensive care unit offers very specialized medical services and treatments to premature and critically ill neonates (i.e., babies 28 days old or younger). Review which ICD-10-CM and CPT codes may be used for providers assisting in this type of care.
Accurate provider documentation is the foundation of compliant coding, appropriate reimbursement, and defensible claims. Yet, in a rapidly changing healthcare landscape, even highly skilled clinicians can find it difficult to stay current.
Our experts answer questions about the 2026 Medicare Physician Fee Schedule final rule, coding an excision of a ganglion cyst, and coding first-degree burns.
As denials rise, watch for E/M scrutiny with diagnostic X-rays. Billing experts advise that practices should be watchful for these and challenge them when they occur.
With the start of a new year, take a moment to refresh yourself on the ins and outs of the primary code sets an outpatient coder needs to understand and use in their role. This article provides a brief overview of three code sets that will serve as a review for veteran coders or a solid base of information for new coders.
Beginning January 1, 2026, the AMA will add a number of changes to CPT codes for two related sections: Digitally Stored Data Services/Remote Physiologic Monitoring; and Remote Physiologic Monitoring Treatment Management Services.
Our experts answer questions about emergency transport services, the medical necessity requirements for epidurals to treat chronic pain, and medication noncompliance vs. underdosing.
