Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
CPT 2027 Is Out: 299 New Codes, a Maternity Overhaul and a Plan for January
The AMA released the CPT 2027 code set on September 9, 2026, with 299 new codes, 74 revisions and 80 deletions effective January 1, 2027. Here is what changed, who it affects most, and the twelve-week plan we use to get charge masters, templates and payer contracts ready.
Modifier 22 and Modifier 51: Unusual Services, Multiple Procedure Reductions
One modifier asks for more money and one tells the payer to pay less, and practices get both wrong in the same ways. Here is how modifier 22 and modifier 51 actually work: the multiple procedure reduction math, the codes that never take 51, and the documentation payers want before they pay extra for 22.
The October 1, 2026 NCCI and HCPCS Quarterly Updates: What to Load Beside ICD-10
Everyone is watching the 190 new diagnosis codes arriving October 1. Fewer practices notice that the NCCI edits, the MUE table, the HCPCS Level II file and the Part B drug pricing file change the same day. Here is what CMS posted in September and how we load all four without breaking October claims.
OB Global Package Billing and Well-Woman Visits: What Is Included, What Is Not
The obstetric global package pays one fee for months of care, which is exactly why it gets billed wrong. Here is what 59400 and its siblings include, when the antepartum-only codes 59425 and 59426 apply, how to split a pregnancy across two payers or two practices, and how well-woman visits differ from a problem visit.
Psychotherapy Time Thresholds: 90832, 90834, 90837 and Add-On Codes Done Right
The 50-minute session is the most common billing error in behavioral health because it is not a 90837. We lay out the minute ranges for every timed psychotherapy code, how the E/M add-ons and crisis codes work, what the note must show about time, and how to spot an outlier pattern before a payer does.
Fracture Care Coding: Global Care vs E/M Plus Casting, and When Each Is Right
A closed fracture treated in the office can be coded two legitimate ways, and the choice changes what you bill for the next 90 days. We explain the global fracture care codes, the E/M plus casting alternative, the modifiers each needs, a distal radius example, and the mistakes that produce denials.
A 90-Day Plan for the October 1, 2026 ICD-10-CM Update: 190 New Codes
CMS and the CDC posted the FY 2027 ICD-10-CM files on June 5, 2026: 190 new codes, 30 deletions and four revised titles, effective for dates of service on or after October 1, 2026. It is a quieter year than FY 2026, which is exactly when practices get sloppy. Here is a week-by-week plan from July 7 to October 1.
Wound Care and Debridement Coding: 97597, 11042 to 11047, Depth and Surface Area
Debridement claims fail on two questions: how deep did you go, and how many square centimeters did you debride? We explain the difference between 97597 and the 11042 to 11047 series, how to add up surface area across wounds, what the note must record, and a worked example with three wounds at two depths.
Injection and Infusion Coding Hierarchy: 96360 to 96379, Initial vs Subsequent
Office infusions are small dollars per visit and large dollars per year, and they are coded wrong more often than any other office procedure we audit. We walk through the 96360 to 96379 family, the one-initial-code rule, the hydration time rules and a worked example with start and stop times.
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