CPT Code 11423: Benign lesion excision billing guide [year]
CPT Code 11423 is the procedure code for excising a benign lesion, including margins, from the scalp, neck, hands, feet, or genitalia when the excised diameter measures 2.1 to 3.0 cm. The 2026 Medicare non-facility rate is approximately $208.76 per excision. Most claims for this code get denied for one of three reasons: the size […]
CPT code 01850: Anesthesia for forearm, wrist, and hand procedures
Anesthesia claims are denied more often than almost any other specialty billing category, and the reasons are rarely about the procedure itself. They are about missing modifiers, miscalculated time units, and incomplete documentation that auditors flag on the back end. CPT code 01850 covers anesthesia for procedures on the veins of the forearm, wrist, and […]
CPT Code 11004: Necrotizing fasciitis debridement billing guide
CPT Code 11004 describes debridement of skin, subcutaneous tissue, muscle, and fascia for necrotizing soft tissue infection of the external genitalia and perineum — the code billed for Fournier gangrene and similar necrotizing fasciitis presentations. Medicare classifies it as inpatient-only, so submitting it on an outpatient claim triggers an automatic denial, regardless of documentation quality. […]
CPT code 01400: Anesthesia for knee joint procedures
CPT code 01400 describes anesthesia administered for open or surgical arthroscopic procedures on the knee joint that aren’t otherwise specified elsewhere in the CPT knee-and-popliteal-area series. The American Medical Association (AMA) maintains this code within the anesthesia section of CPT (range 00100-01999). It covers general anesthesia, regional anesthesia, and monitored anesthesia care (MAC) provided during […]
CPT Code 00560: Anesthesia for intrathoracic procedures
CPT Code 00560 is the anesthesia code for procedures on the heart, pericardial sac, and great vessels of the chest performed without a pump oxygenator (cardiopulmonary bypass). It carries 15 base units under the ASA Relative Value Guide. The single clinical factor that separates it from adjacent code 00561 is whether cardiopulmonary bypass was used […]
CPT Code 97799: Unlisted physical medicine and rehabilitation service
CPT Code 97799 is the unlisted physical medicine and rehabilitation service code defined by the American Medical Association (AMA). Coders use it only when no specific code in the 97010-97799 range describes the treatment performed. Every claim submitted with 97799 goes to manual payer review, which means slower payment and closer documentation scrutiny than a […]
CPT Code 91200: Liver elastography billing guide
Claim denials for CPT Code 91200 almost always come down to the same handful of mistakes: wrong modifier, missing ICD-10 linkage, or documentation that payers flag as lacking medical necessity. For gastroenterology and hepatology practices billing liver elastography, these errors add up fast. The 2026 Medicare national average reimbursement for CPT Code 91200 is approximately […]
CPT Code 00170: Anesthesia for intraoral procedures
CPT Code 00170 covers anesthesia for intraoral procedures, including biopsy of the mouth, and carries a base unit value of 5. An anesthesiologist or CRNA bills it when providing general, regional, or monitored anesthesia care for an oral surgical procedure such as a tooth extraction, wisdom tooth removal, or oral biopsy. This reference covers base […]
CPT 01462: Closed lower leg, ankle and foot anesthesia
CPT code 01462 is the anesthesia billing code for closed procedures on the lower leg, ankle, and foot. Its official descriptor, as maintained by the American Medical Association (AMA), reads: Anesthesia for all closed procedures on lower leg, ankle, and foot. Notice what’s missing compared to its neighbors: 01462 doesn’t carry a “not otherwise specified” […]
CPT Code 01260: Anesthesia for upper leg procedures
According to the American Medical Association (AMA), which maintains the CPT code set, CPT Code 01260 is defined as: Anesthesia for all procedures involving veins of upper leg, including exploration. Specifically, the code sits within the anesthesia section of the CPT manual, which spans codes 00100 through 01999. The code covers the femoral vein, saphenous […]