Changes to the Medicare provider-based billing requirements for off-campus outpatient departments are coming with the passage of the Consolidated Appropriations Act last month.
Radiation oncology is a specialty utilizing radioelements either externally or internally to treat medical conditions such as cancer. This article serves as a primer for coding radiation oncology services.
Modifiers -50, -RT, and -LT are laterality modifiers that clarify a CPT code by defining which side of the body the service was performed on. But knowing when to use them is not always immediately clear. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Copy-and-paste functionality is a documentation integrity issue with clinical, financial, legal, and quality implications. Maria Anaizza Aurora Reyna, MD, explores how collaboration between CDI teams and physician advisors can ensure the medical record evolves with the patient, supports accurate coding and clinical validation, withstands external scrutiny, and ultimately tells the patient’s true story across the continuum of care.
Our experts answer questions on clinical recognition of pediatric malnutrition, query opportunities for unclear drug documentation, and clinical validation of tumor lysis syndrome.
Our experts answer questions about behavioral health coding, internal coding audits, and coding non-emergency services provided in the emergency department.
In December 2023, the Office of the Inspector General published a toolkit for Medicare Advantage organizations who submit high-risk diagnoses, and it announced in January 2026 that an audit will be conducted on high-risk codes that the organizations submitted for 2024. Nancy Reading, BS, CPC, CPC-P, CPC-I, reviews the high-risk codes and emphasizes what to look for in the documentation to support coding practices.
The CPT manual includes many types of biopsies: fine needle aspiration (FNA), core needle, and skin (tangential, punch, and incisional). This article focuses mainly on FNA biopsies and its complicated guidelines, while also touching on core needle biopsies.
