Learn How to Code
Burn injuries are among the most complex conditions to code accurately in ICD-10-CM medical coding. One critical concept every medical coder must understand is the extent of burn, which determines how much of the body surface is affected and how severe the injury is. Correctly reporting the extent of burn using ICD-10 codes T31 and … Read more
Understanding ICD-10 seventh character values is essential for accurate burn and corrosion coding. Many medical coders struggle with when to use A (Initial Encounter), D (Subsequent Encounter), and S (Sequela). Applying the wrong seventh character can lead to claim denials, coding errors, and compliance issues. In ICD-10-CM, burn and corrosion codes from T20–T28 require a … Read more
Accurate ICD-10 burn coding is essential for medical coders, healthcare providers, and billing professionals. Proper sequencing of burn and corrosion codes ensures correct claim submission, proper reimbursement, and compliance with ICD-10-CM guidelines. Burn injuries often involve multiple anatomical sites and different degrees of severity, making coding complex. Understanding the correct sequencing rules for burns and … Read more
Cardiac CT codes 75571–75574 cover non-invasive imaging for coronary calcium scoring, structural evaluation, congenital heart disease, and coronary CTA. Per AMA guidelines, these include pre-contrast axial images, arterial/venous phase sequences (if performed), 2D/3D reformatted images, and quantitative assessments (e.g., coronary stenosis, ventricular volumes, ejection fraction, stroke volume). Function studies and ECG monitoring are bundled—no separate … Read more
Low-Dose CT Thorax Codes for Lung Cancer Screening 71271: Computed tomography, thorax; low dose for lung cancer screening, without contrast material(s) G0296: Initial or subsequent low-dose CT scan for lung cancer screening (Medicare-specific) Updated Coverage per NCD 210.14 (Effective February 10, 2022) Eligibility expanded to: Age 50-77 years (lowered from 55-77) ≥20 pack-years smoking history … Read more
In the 2026 CPT update, Category III code 0042T for cerebral perfusion analysis has been deleted and replaced by two new Category I codes: 70472 and 70473. These codes support critical applications like acute stroke evaluation, occlusive carotid disease assessment, post-aneurysm vasospasm detection, brain tumor grading, stereotactic biopsy guidance, and treatment response monitoring. Perfusion analysis typically follows a … Read more
Medical coders must accurately report hydration therapy and injection administration using specific CPT codes, ensuring compliance with time-based rules and documentation standards. Hydration Services 96360: Intravenous infusion, hydration; initial, 31 minutes to 1 hour 96361: Each additional hour (list separately in addition to code for primary procedure) Therapeutic, Prophylactic, and Diagnostic Injections 96372: Therapeutic, prophylactic, … Read more
Definition of “With Contrast” The phrase “with contrast” applies only to contrast material administered intravascularly, intra-articularly, or intrathecally. Oral or rectal contrast administration alone does not qualify as a “with contrast” study. CMS Policy on Low Osmolar Contrast Material (LOCM) CMS has eliminated prior payment restrictions for LOCM, making it available to all Medicare beneficiaries. LOCM use is now standard … Read more
Medicare Claims Processing Manual (Chapter 17, §40) mandates JW and JZ modifiers for separately payable Part B drugs/biologicals from single-use vials/packages to track administered vs. discarded amounts. Modifier Definitions Modifier Usage Requirement JW Discarded/not administered portion from single-use vial Separate line; full documentation of discard process JZ Entire single-use vial administered (no discard); effective 1/1/2023, … Read more
Unlock the power of minimally invasive vascular imaging with CPT 73706: Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing. This code captures a sophisticated CT angiography (CTA) study that visualizes arterial and venous anatomy in the lower extremities with remarkable precision. CTA typically begins with a noncontrast scan for … Read more