Research | Medical Billing and RCM Guides

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

October 16, 2026

What is the difference between CPT 92610, 92611 and 92612?

The three swallowing evaluation codes cover different exams, pay between $84.84 and $199.74, and carry different same-day edits. Plus who bills 74230 on a modified barium swallow.

Shivam Pujara, Founder

Spine Surgery Coding

October 11, 2026

How do spinal instrumentation add-on codes stack on a multi-level fusion?

Posterior and anterior instrumentation are reported once per construct, not once per level, because each code carries an MUE of one. The codes that do stack are the arthrodesis add-ons and the interbody device codes.

Shivam Pujara, Founder

ESRD Partial-Month Billing

October 11, 2026

What happens to billing when a dialysis patient is hospitalized mid-month?

A hospitalization does not automatically convert an ESRD month to the per diem codes, and the admission and discharge days are usually still payable. Here is the decision, the day count and the arithmetic on both claims.

Shivam Pujara, Founder

Ophthalmology Drug Billing

October 11, 2026

How do you bill intravitreal injections plus the drug without losing the J-code?

The injection code and the drug code fail for different reasons and take each other down. Unit arithmetic per agent, the bevacizumab code conflict between two current CMS articles, and what the 2026 site-of-service gap costs.

Shivam Pujara, Founder

Newborn Coding

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

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

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

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

FQHC Behavioral Health Billing

September 29, 2026

Can an FQHC bill behavioral health integration and a medical visit on the same day?

Behavioral health integration is not an FQHC visit, so it never competes with a medical encounter for the one visit a day the PPS pays. This page separates the three services health centers call behavioral health, gives the 2026 code set, and shows what a same-day date is worth.

Shivam Pujara, Founder

GI Anesthesia Billing

September 29, 2026

How is anesthesia for a screening colonoscopy billed (00812 vs 00813)?

00812 is the screening colonoscopy anesthesia code and 00813 covers a same-session upper and lower endoscopy. This page sets out which code carries the case, what each pays at CY2026 rates, and where the patient cost-share lands when a screening turns diagnostic.

Shivam Pujara, Founder

PRACTICAL GUIDES FOR PRACTICE OWNERS AND ADMINISTRATORS

Latest posts

What is the difference between CPT 92610, 92611 and 92612?

How do spinal instrumentation add-on codes stack on a multi-level fusion?

What happens to billing when a dialysis patient is hospitalized mid-month?

How do you bill intravitreal injections plus the drug without losing the J-code?

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

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

How do you bill 88342 immunohistochemistry units without unbundling denials?

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

Can an FQHC bill behavioral health integration and a medical visit on the same day?

How is anesthesia for a screening colonoscopy billed (00812 vs 00813)?