Cervical orthosis HCPCS codes run from a soft foam collar that a patient can put on at home to a rigid multiple-post brace with chin and occipital supports, and the code that fits a given cervical collar depends far less on the brand on the box than on how the collar is built: how rigid…
Spinal orthosis HCPCS codes cover everything from a flexible elastic lumbar belt to a rigid thoracolumbar brace with shoulder straps, and the code that fits a given back brace depends far less on the brand on the box than on two things: how the brace is built, and how much work it took to fit…
Knee orthosis HCPCS codes run from a simple canvas immobilizer to a rigid double-upright OA brace, and the right code depends far less on the brand on the box than on two things: how the brace is built, and how much work it took to fit it to the patient. Most of the market will…
GA, GX, GY, and GZ are Medicare’s four liability modifiers. They are HCPCS Level II modifiers that you append to a line on a Medicare claim to tell the payer, before the claim is adjudicated, why a service may not be paid and who should be held responsible if it is denied. For an independent…
An in-office ankle-brachial index study billed under CPT 93923 is payable by Medicare when the record shows the test was ordered for a patient with documented signs or symptoms, a supporting ICD-10 diagnosis ties the study to that clinical picture, and a signed interpretive report explains what the result means for care. That, in one…
Modifier 76 vs 77 explained for repeat procedures: who performed the repeat, how to report it on the claim, and how to avoid duplicate denials.
A practical guide to the wrist and hand orthosis HCPCS codes an in-office practice uses, and the off-the-shelf versus custom-fit decision that picks the code.
The walking boot HCPCS codes are L4360, L4361, L4386, and L4387, and the one that fits a given boot depends on two things: whether the boot is pneumatic and whether it is dispensed off the shelf or custom fit. The Centers for Medicare and Medicaid Services (CMS) assigns L4360 and L4361 to pneumatic or vacuum…
Every diagnostic test that Medicare pays for in a physician office carries a required level of physician supervision, and a claim is only clean when that level is met. Diagnostic test supervision comes in three levels: general, direct, and personal. General means the physician directs the work but does not have to be present. Direct…
NCCI edits are the Medicare rules that decide which code combinations get paid and how many units of a test you can report in one day. They sit inside the claims system, run quietly, and reject anything that looks like unbundling or an impossible number of units. For an independent practice that performs its own…