Research | Medical Billing and RCM Guides

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Practical content for practices that want to collect more of what they bill.

October 3, 2026

When can you bill 99464 for attendance at delivery alongside newborn care?

The NCCI edit table decides whether 99464 can ride alongside a newborn care code, and the six pairings behave differently. Here is the matrix, the twins rule, and what each construction pays.

Shivam Pujara, Founder

Infusion and Chemotherapy Coding

October 3, 2026

What is the correct hierarchy for chemo administration codes when infusions run concurrently?

Chemotherapy is primary to therapeutic and prophylactic services, which are primary to hydration, and infusions are primary to pushes. The rule most teams get wrong is that 96368 is still reportable when a non-chemo drug runs alongside chemotherapy.

Shivam Pujara, Founder

340B drug billing

October 3, 2026

When does the 340B JG modifier apply, and how does it change payment?

Modifier JG stopped reducing 340B drug payment in September 2022 and was discontinued entirely on January 1, 2025. Here is what replaced it, what it used to cost, and what belongs on a 340B drug line now.

Shivam Pujara, Founder

Hospital Status Determination

October 3, 2026

How does the two-midnight rule decide observation vs inpatient status?

The rule is about what the admitting practitioner expected, not how long the patient stayed. This page separates the benchmark from the presumption, shows which hours count, and covers how to fix a status that was already wrong.

Shivam Pujara, Founder

Neonatal Intensive Care Coding

October 3, 2026

How does NICU billing change when the baby is no longer critically ill?

The step down out of neonatal critical care is decided by present body weight, not by code family, and 99477 is not available to fall back on. This page gives the decision tree, the per-day amounts and the rules that make these claims deny.

Shivam Pujara, Founder

Drug Waste Billing

October 3, 2026

How do the JW and JZ modifiers work for drug waste, and what happens if you skip them?

The pair rule, the rounding trap that turns a JW line into a JZ line, what an unprocessable return really costs, and the federal refund program your JW units quietly feed.

Shivam Pujara, Founder

Pathology IHC Coding

October 3, 2026

How do you bill 88342 immunohistochemistry units without unbundling denials?

Most 88342 denials are a unit cap or a per-specimen rule rather than unbundling, and the three have different fixes. This page separates them, gives the current caps, and shows what an appeal needs.

Shivam Pujara, Founder

Neonatal Billing

October 3, 2026

How do the neonatal critical care per diem codes 99468 to 99472 work?

The neonatal and pediatric critical care per diems are global day codes with no time threshold, and almost every published page stops before the questions a NICU biller actually hits. This covers day 29, bundling, non-admission days and concurrent physicians.

Shivam Pujara, Founder

Laboratory Date of Service

October 3, 2026

What is the 14-day rule for lab date of service, and when does it change who bills?

The 14-day rule decides whether a laboratory test belongs to the hospital or to the lab. This page separates the three date of service exceptions, shows which one carries the 14-day clock, and sets out who bills in each case.

Shivam Pujara, Founder

Concurrent Care Billing

October 3, 2026

How is concurrent care billed when a hospitalist and a specialist both see the patient?

Both physicians can bill, but the claim is decided by the Medicare enrollment specialty code rather than by the notes. This page gives the three conditions, the claim field that stops the denial, and what a denied pair is worth.

Shivam Pujara, Founder

PRACTICAL GUIDES FOR PRACTICE OWNERS AND ADMINISTRATORS

Latest posts

When can you bill 99464 for attendance at delivery alongside newborn care?

What is the correct hierarchy for chemo administration codes when infusions run concurrently?

When does the 340B JG modifier apply, and how does it change payment?

How does the two-midnight rule decide observation vs inpatient status?

How does NICU billing change when the baby is no longer critically ill?

How do the JW and JZ modifiers work for drug waste, and what happens if you skip them?

How do you bill 88342 immunohistochemistry units without unbundling denials?

How do the neonatal critical care per diem codes 99468 to 99472 work?

What is the 14-day rule for lab date of service, and when does it change who bills?

How is concurrent care billed when a hospitalist and a specialist both see the patient?