CPT Code 45380: Colonoscopy with Biopsy Billing Guide
Colonoscopy denials pile up fast when the wrong code is submitted. A patient goes in for a routine screening, a biopsy is taken, and suddenly the claim crosses into diagnostic territory – with different cost-sharing implications, different modifiers, and different payer rules. CPT Code 45380 sits at the center of this transition. Getting it right […]
CPT Code 75574: Cardiac CT Angiography Billing Guide
Cardiac CT claim denials for CPT code 75574 often come down to the same handful of avoidable problems: wrong modifier, missing documentation of 3D postprocessing, or a non-covered ICD-10 pairing. For radiology coders and cardiology billing staff managing high-volume coronary CTA workflows, getting these details right on the first submission is the difference between clean […]
CPT Code 93356: Myocardial Strain Imaging Billing Guide
Cardiology billing teams consistently report that add-on codes generate a disproportionate share of claim denials. When a service requires a primary procedure code plus a supplemental code, each with its own documentation standard, the margin for error doubles. CPT Code 93356 sits squarely in that category. Introduced as a Category I code on January 1, […]
CPT Code 76857: Limited Pelvic Ultrasound Billing Guide
Radiology claims auditors flag limited pelvic ultrasounds more often than most coders expect. The confusion between CPT Code 76857 and its close relatives, 76856 and 76830, accounts for a significant share of denied claims in OB/GYN, urology, and fertility billing. Selecting the wrong code, or billing post-void residual measurement separately, can trigger both recoupment demands […]
CPT Code 99255: Inpatient Consultation, Level 5 Billing Guide
Most consultation denials are not caused by incorrect code selection. They happen because the supporting documentation fails to justify the level billed. For CPT Code 99255, the highest-level inpatient or observation consultation in the active range, the gap between what a consulting physician actually did and what the medical record proves can cost thousands in […]
CPT Code 99395: Preventive Visit Billing Guide for Ages 18-39
Preventive visits are among the most audited and most denied claim types in outpatient primary care. CPT Code 99395 is the correct code for a comprehensive preventive medicine reevaluation of an established patient between 18 and 39 years old, but incorrect modifier usage, missing ICD-10 pairing, and age-range errors cause a disproportionate share of rejections. […]
CPT Code 33285: Insertion, Subcutaneous Cardiac Rhythm Monitor
CPT Code 33285: Definition and Clinical Description Cardiology billing specialists see CPT Code 33285 denied more often than almost any other device implantation code, and the root cause is nearly always the same: missing or incomplete documentation of medical necessity. The code was added to the American Medical Association’s CPT code set in 2019 as […]
CPT Code 76604: Chest Ultrasound Billing Guide
CPT Code 76604: Definition and Clinical Description Chest ultrasound denials are rarely about the procedure itself. They are almost always about what the documentation says – or fails to say. CPT code 76604 is the designated billing code for an ultrasound examination of the chest including the mediastinum, performed in real time with image documentation. […]
CPT Code 92015: Determination of Refractive State
Refraction claims are among the most commonly denied in eye care billing. Practices bill CPT Code 92015, assume standard coverage applies, and then receive zero reimbursement from Medicare and a flat bundling rejection from Humana. This happens not because the service was undocumented, but because the coverage rules for refraction differ dramatically from payer to […]
CPT Code 27599: Unlisted Procedure, Femur or Knee
Unlisted procedure codes trip up orthopedic billing teams more often than any other code category. When a surgeon performs a novel or rarely codified knee procedure, there is no default CPT code to reach for, and submitting without the right documentation almost guarantees a denial. CPT Code 27599 exists precisely for this gap, but using […]