CPT Codes

Physical therapy (PT) evaluations are among the hardest to bill. Why? They require comprehensive documentation and are bound by numerous limitations. Keeping track of these limitations and requirements can be confusing, which leads to claims denials.  A frequently used PT code for face-to-face evaluation is CPT code 97161. In this guide, we have discussed everything […]

Prostate cancer ranks as the most frequently diagnosed cancer among men in the U.S. Approximately 1 in 8 men will be diagnosed with prostate cancer at some point in their lives. It is also the second most common cause of cancer-related fatalities. However, the death rate can be controlled with early diagnosis. There are various

Billing for chest X-rays, such as CPT code 71045, may seem straightforward. However, there are several factors to consider. Proper billing and documentation are integral to preventing payment delays and denials. This procedural code is vital for diagnosing and monitoring a wide range of conditions, from suspected pneumonia to post-trauma evaluations. Thus, radiologists need to

Precision is everything in the intricate world of medical billing. But have you ever wondered why it is so complex? Because every diagnosis, every procedure, and every piece of equipment has a specific code.  These codes help you tell a story to insurance payers: what you rendered, why you performed it, and how it was

As a medical practitioner, you aim to provide healthcare services and generate income from them. However, earning this income can be challenging, as medical billing relies on complex coding systems that are necessary for reimbursement. Insurance payers obligate healthcare professionals to report their services using specific CPT codes. To make medical billing easier for you,

Do you know how to bill CT scans of the abdomen and pelvic area that require imaging with and without contrast? You might think to simply bill them separately using the distinct codes. But no, doing this will result in denials.  Such comprehensive CT scanning is billed with CPT code 74178. However, many billers don’t

Did you know that nursing homes provide care services to approximately 1.2 million individuals in the USA? This highlights the need for attentive, high-quality care. However, for physicians, this attention extends beyond the patient’s bedside to the complex process of medical billing. How? Since each visit to a nursing facility represents a vital part of

Seeking the correct code to bill for a unilateral diagnostic mammogram? CPT code 77065 is the right choice. But do you really know its billing requirements?  Approximately 43 million mammography procedures are performed annually in the U.S. However, only 10% of patients are recalled for further evaluation, that is, a diagnostic mammogram. So, while this

Ultrasound scans can be tricky to bill. Complex documentation and confusing modifier usage make the billing of these procedures challenging. On top of this, clear billing instructions and guidelines are also scarce for ultrasound procedures.  A frequently used imaging code is CPT code 76536. Despite its frequent use, many billers struggle to file it correctly.

Medical billing for nursing homes can be really challenging if you are not updated with the latest guidelines and requirements. Why? Mainly due to the complex documentation and the multi-level coding structures of the patient visits. Just the evaluation and management (E/M) visits are divided into three categories, i.e., initial visits, subsequent visits, and discharge