CPT Code 92250: Fundus Photography Billing Guide
Fundus photography is one of the most frequently performed procedures in ophthalmology and optometry offices across the country. Yet CPT code 92250 remains a persistent source of claim denials, modifier errors, and documentation gaps. Bilateral billing rules, NCCI edit conflicts with OCT codes, and payer-specific medical necessity criteria create enough complexity to trip up even […]
CPT Code 99460: Initial Hospital Newborn Care Billing Guide
Newborn billing errors cost pediatric practices thousands of dollars annually in denied or underpaid claims. The first 24 hours of a normal newborn’s life generate more coding decisions than most providers anticipate: which setting applies, which date of service rules govern the claim, and which diagnosis code pairs correctly. CPT code 99460 sits at the […]
CPT Code 95004: Allergy Skin Test Billing Guide (2026)
Allergy practices lose revenue every week on CPT code 95004, and the pattern is almost always the same: billing per session instead of per allergen, misapplying modifiers, or submitting claims without the ICD-10 codes payers require. The American College of Allergy, Asthma & Immunology (ACAAI) flags per-unit billing errors as one of the most consistent […]
CPT Code 11200: Skin Tag Removal Billing Guide (2026)
Skin tag removal is one of the most frequently miscoded minor procedures in outpatient dermatology and primary care. Claims get denied not because the procedure was wrong, but because the ICD-10 pairing was missing, the modifier was omitted, or the cosmetic vs. medically necessary distinction wasn’t documented before submission. According to CMS Medicare Coverage Article […]
CPT Code 83036: Hemoglobin; Glycosylated (A1c) Billing Guide
Diabetes affects over 38 million Americans, and the hemoglobin A1c test is the cornerstone of managing every one of those patients. Yet CPT code 83036 generates a disproportionate share of claim denials, precisely because billers conflate it with 83037, apply the wrong ICD-10 pairings, or misread the QW modifier rules. A single documentation gap on […]
CPT Code 91010: Esophageal Motility Study Billing Guide
GI motility studies are among the most documentation-sensitive procedures in gastroenterology billing. A missing interpretation report, wrong place-of-service code, or misapplied modifier can turn a covered esophageal manometry claim into a denial. CPT Code 91010 – the code for esophageal motility studies with interpretation and report – requires precise documentation, correct ICD-10 pairing, and an […]
CPT Code 70553: MRI Brain With and Without Contrast
CPT Code 70553: Official Description and Clinical Scope Radiology billing departments submit hundreds of MRI claims daily, yet a single missing field in the contrast documentation triggers denials that can take weeks to resolve. CPT code 70553 is one of the most frequently ordered brain imaging codes in the United States, covering magnetic resonance imaging […]
CPT Code 58558: Surgical Hysteroscopy Billing Guide
OB-GYN billing denials rarely announce themselves clearly. A claim for surgical hysteroscopy goes out, a payment never comes in, and the only explanation is a bundling edit no one flagged before submission. CPT code 58558 sits at the center of a dense web of coding relationships – with diagnostic codes, companion surgical codes, and modifier […]
CPT Code 99385: Preventive Visit Billing for New Patients 18-39
Primary care practices bill hundreds of preventive visits every month, yet CPT code 99385 is among the most frequently miscoded in this category. Apply it to an established patient, submit it without the right ICD-10 companion, or confuse it with Medicare’s annual wellness visit structure, and the claim comes back denied. This guide covers everything […]
CPT Code 17999: Unlisted Integumentary Procedure Billing Guide
When a procedure on the skin, mucous membrane, or subcutaneous tissue does not fit any existing code in the integumentary section of the CPT code set, the correct code is CPT code 17999. The American Medical Association (AMA), which maintains the CPT code set, classifies 17999 as an unlisted procedure code within the destruction and […]