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At an annual visit, the physician notes that the 15-year-old patient has obesity, with a BMI of 35. How is this coded? A. Z68.53 B. Z68.54 C. Z68.55 D. Z68.56 Rationale: The code changes in the ICD-10-CM Tabular List for fiscal year 2025 include one revised code (Z68.54) and two new codes (Z68.55, Z68.56). Z68.55 … Read more
In the case of a hip revision surgery, which CPT® code should be used if both the complete acetabular and complete femoral components are revised? A. 27137 B. 27134 C. 27138 D. 27091 Rationale: In cases where the femoral head and acetabular liner are exchanged, but not the femoral stem and acetabular cup, it is … Read more
A patient is documented as having hypertension, end-stage renal disease, and diastolic congestive heart failure. The patient receives dialysis. How is this coded? A. I13.2, N18.6, I50.30, Z99.2 B. I13.2, N18.6, I50.30 C. I13.2, N18.5, I50.30 D. I13.2, N18.9, I50.30Rationale:ICD-10-CM Official Guidelines for Coding and Reporting direct coders to use a hypertension code from category … Read more
Which ICD-10-CM code would you use to document trichiasis of the upper right eyelid without entropion? A. H02.051 B. H02.052 C. H02.054 D. H02.055 2. A 10-year-old patient presents with symptoms of fatigue, frequent infections, and abnormal bleeding. After a series of diagnostic tests, the patient is diagnosed with Fanconi anemia. Which ICD-10-CM code should … Read more
The American Medical Association (AMA) released its quarterly update to the CPT Proprietary Laboratory Analyses (PLA) codes within the Pathology and Laboratory section on October 1st. These crucial modifications, though effective January 1, 2026, will be formally published in the CPT 2027 codebook due to the timing of the release cycle. Summary of Revisions The … Read more
The Fundamentals: CPT Codes vs. CMS Regulations CPT (Current Procedural Terminology) Codes are the foundation of our billing language. Developed and maintained by the AMA (American Medical Association), these proprietary codes (Level I of the HCPCS system) describe the medical, surgical, and diagnostic services furnished by providers. Our job is to select the most precise … Read more
Introduction on FY 2026 ICD-10-PCS Updates This document details recent modifications to the procedural codes, primarily affecting the cardiovascular system, musculoskeletal system (specifically joints and bones), and nervous system. These changes are incorporated within both the Medical and Surgical and the New Technology and Extracorporeal or Systemic Assistance and Performance sections. The revisions to these … Read more
Each year, the American Medical Association (AMA) updates CPT (Current Procedural Terminology) codes to reflect changes in technology, care delivery, and policy. These updates aren’t just administrative—they directly impact how services are coded and reimbursed. Missing CPT updates can result in: Claim denials Compliance risks Lost revenue Who Should Pay Attention? Everyone involved in medical … Read more
CPT 2026 Update: New Audiology Coding for Hearing Aid Services The American Medical Association (AMA) has issued CPT 2026, introducing a major revision to coding for professional hearing aid and hearing device-related services. This annual update replaces the legacy CPT codes 92590–92595 with a new suite of 12 codes designed to more accurately capture the … Read more
Dealing with bundling denials is a common challenge in healthcare revenue cycle management, but they’re absolutely preventable. As a medical coder, understanding these denials and how to avoid them is key to ensuring your provider gets paid correctly and on time. This guide breaks down bundling denials, their causes, and the best strategies for prevention … Read more