If your practice bills Evaluation and Management (E/M) services, you need to pay close attention to changes coming October 1, 2025. Cigna’s new Evaluation and Management Coding Accuracy (R49) policy will affect how claims are reviewed, how much they may be reimbursed, and how much pressure there is on documentation quality. At Medatron, we know […]
One of the most common CPT codes associated with medical billing about E/M services is 99213. This can sometimes be tricky to describe as an office or outpatient visit, as the physician must evaluate and manage the patient. Healthcare professionals often use 99213 for problems that are only slightly complex and will require minimal decisions. […]
Accurate coding is essential for proper billing, reimbursement, and documentation in healthcare. The 97161 CPT code holds particular importance among the many used for therapy services. This code is associated with Physical Therapy (PT) specifically for evaluating a patient’s condition. In this blog, we will dive deep into what the CPT code 97161 represents, how […]
Denials in healthcare claims and billing are among the most common headaches for providers and medical practices. Of all the denial codes that could appear, CO 226 frequently creates confusion. So, what does CO-226 denial code description mean, and how can you effectively address it? Let’s break it down and explore the intricacies of CO […]
Modifier 78 is an absolute must in medical billing. It indicates that the patient returned to the operating/procedure room for a procedure directly related to the same procedure during the global period of the initial surgery. Thus, one can easily see that using the modifier will accurately reflect claims and proper remittance. Let’s discuss its […]
Genetic testing has grown exponentially over the past few decades. Today, with the help of PGx testing of RPh Labs, it’s possible to explore genetic contributions to health, disease, and drug response. One of the several tests available is the 81408 test, which is known to screen for thousands of genes. Let’s see how many […]
Proper billing is key in mental health practice to ensure practitioners receive fair reimbursement for their services while remaining compliant with insurance regulations. One of the most frequently utilized billing codes is CPT Code 90837, specific to a particular psychotherapy service. This blog will discuss CPT Code 90837 in detail, including its practical application and […]
The art of medical billing and coding can be confusing. Modifiers like Modifier 22 will help health professionals clarify scenarios where they did something much more challenging than they normally would have to. It should be used when a surprise challenge increases the procedure’s usual amount of time, resources, or effort. Let me simplify it […]
The CPT code 99214 is part of the Current Procedural Terminology (CPT) system, which healthcare professionals use to report medical services for billing and insurance purposes. Specifically, 99214 is used for a Level 4 Established Patient Office Visit in the outpatient setting. Understanding this code is crucial for medical professionals, coders, and billers, as it […]
Knowledge of specific CPT codes is essential in medical coding, especially in physical therapy, rehabilitation, and wound care. These codes ensure proper billing and reimbursement for medical services. One such code that is critical in the management of wound care is the 97597 CPT code. What is the 97597 CPT Code? The 97597 CPT Code […]
