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Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
Coding Joint Injections 20610, Trigger Points 20552 and the Drug Line
In-office injections are short procedures with long coding rules: joint size, laterality, ultrasound guidance, muscle counts for trigger points, and a drug line that has to carry the right J code, units and wastage modifier. Here is how we code 20610, 20611, 20552 and 20553 so they pay the first time.
NCCI Edits Version 32.1 Took Effect April 1, 2026: What Changed, What to Check
The April 2026 NCCI update added more than 3,750 procedure-to-procedure pairs, deleted more than 4,800, and changed 121 medically unlikely edits, including cutting G0447 to one unit per day. Here is how to read the files, which specialties are touched and how to reconcile the edits against your own top code pairs.
Coding Diabetes With Complications: E11 Combination Codes, Z79.4 and Z79.84
Most practices code type 2 diabetes as E11.9 and stop, even when the chart shows kidney disease, neuropathy and insulin. Here is how coding diabetes with complications actually works: the E11 subcategories, the "with" convention, the Z79 medication codes, a worked example and the errors auditors flag.
Time-Based E/M Coding: What Counts in Total Time on the Date of the Encounter
Time-based E/M coding lets you level an office visit on total time instead of medical decision making, but only certain minutes count. Here is the 2026 threshold table, the activities that count and the ones that do not, a worked 99214 example and the documentation auditors look for.
The April 1, 2026 ICD-10-CM Update Has No New Codes, but It Changes Sequencing
The mid-year ICD-10-CM update effective April 1, 2026 adds no diagnosis codes. It converts 16 Excludes1 notes to Excludes2, turns the I16.1 and H40.84 instructions into "code also" notes, and moves Parkinson's disease indexing to G20.A1. Here is what coders and claim scrubbers need to change today.
Prolonged Services Coding: 99417 vs G2212, Time Thresholds and Documentation
A 62-minute follow-up visit is worth more than a 99215, but only if you know which prolonged code the payer accepts and at what minute it starts. We explain 99417 and Medicare's G2212, the 55, 69, 75 and 89 minute thresholds, the time statement that survives an audit, and the mistakes that get these add-ons denied.
Unspecified Diagnosis Codes, Laterality and Seventh Characters: Avoiding Denials
The diagnosis code is the part of the claim physicians control most and check least. When an unspecified code is acceptable and when it will deny, how laterality and the seventh character work, the codes office practices get wrong most often, and the documentation phrases that let a coder pick the specific code.
UnitedHealthcare Medicare Advantage Enforces Excludes1 Edits From March 1, 2026
UnitedHealthcare told its network that Medicare Advantage claims of every type, including professional claims, are subject to ICD-10-CM Excludes1 edits for dates of service on or after March 1, 2026. What Excludes1 means, the diagnosis pairs that trip it most in office practice, and how to keep clean claims clean.
Global Surgical Package Rules: 0, 10 and 90-Day Periods and the Four Modifiers
Office practices lose money on both sides of the global surgical package: billing visits that are bundled and writing off visits that are payable. We explain the 0, 10 and 90-day periods, what is inside the package, and when modifiers 24, 58, 78 and 79 apply, with a worked split-care example.
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