CPT Code 96372: Billing guide, modifiers, and reimbursement
CPT code 96372 is the billing code for a therapeutic, prophylactic, or diagnostic injection administered subcutaneously or intramuscularly. It covers the administration service only, and the drug itself is billed separately using a HCPCS J-code. Documentation errors, missing modifiers, and unlinked J-codes cause more 96372 denials than using the wrong code itself. This guide covers […]
CPT Code 28760: Jones-Type Arthrodesis Billing Guide
CPT Code 28760 is a billable code for arthrodesis of the great toe interphalangeal (IP) joint combined with an extensor hallucis longus (EHL) tendon transfer to the first metatarsal neck, the Jones-type procedure. Payers auditing these claims routinely find operative reports that confirm the joint fusion but omit the tendon transfer, the defining element of […]
CPT code 01638: Total shoulder replacement billing guide
CPT code 01638 is the anesthesia code for a total shoulder replacement: anesthesia for open or surgical arthroscopic procedures on the humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint, when the procedure performed is a total shoulder arthroplasty. It carries 10 base units, not the 8 an outdated reference table might still […]
CPT Code 00147: Anesthesia for iridectomy billing guide 2026
CPT Code 00147 covers anesthesia for iridectomy: base units, 2026 Medicare rates, modifiers AA/QX/QZ, ICD-10 pairings and denials.
CPT code 15101: Split-thickness autograft billing guide
CPT code 15101: Split-thickness autograft billing guide CPT 15101 is an add-on code for split-thickness autograft (STSG) applied to the trunk, arms, or legs, billed for each additional 100 sq cm beyond the first 100 sq cm covered by primary code 15100. According to the American Medical Association, add-on codes like 15101 must always appear […]
CPT Codes 11770-11772: Pilonidal cyst excision billing guide
Most pilonidal cyst denials come down to picking the wrong tier — or missing that a flap closure changes the code entirely. CPT codes 11770, 11771, and 11772 report excision of a pilonidal cyst or sinus, differentiated by how much tissue and dissection the procedure requires: simple (11770), extensive (11771), and complicated (11772). Looking for […]
CPT Code 11471: Hidradenitis excision, complex repair billing guide
CPT Code 11471 covers excision of skin and subcutaneous tissue for hidradenitis suppurativa in the perianal, perineal, or umbilical region, with complex repair. It’s the complex-repair counterpart to CPT 11470, which covers the same sites with simple or intermediate closure. The distinction that trips up more claims than repair type is reporting frequency. CPT Assistant […]
CPT code 12056: Intermediate repair of facial wounds, 20.1-30.0 cm
CPT code 12056 covers intermediate repair of wounds on the face, ears, eyelids, nose, lips, and mucous membranes measuring 20.1 to 30.0 cm in total length. Coders frequently mislabel it, either downcoding to 12055 or upcoding to 12057, because the boundary between codes comes down to a single measurement threshold rather than any change in […]
CPT Code 11640: Excision of malignant lesion, face, 0.5 cm or less
CPT Code 11640 covers excision of a malignant lesion, including margins, on the face, ears, eyelids, nose, or lips when the excised diameter is 0.5 cm or less. Dermatologists, plastic surgeons, and otolaryngologists are the primary billers for this code. Each specialty brings slightly different documentation habits, and those differences show up clearly in Medicare […]
CPT code 13153: Complex repair add-on for eyelids, nose, ears, and lips
CPT code 13153: Definition, add-on rules, and billing overview CPT code 13153 is an add-on code for complex repair of the eyelids, nose, ears, and/or lips, covering each additional 5 cm or less beyond the wound length covered by the primary code, CPT 13152. The American Medical Association publishes the official descriptor as: “Repair, complex, […]