IPPSpalooza Is Here!
Chuck Buck
July 14, 2025
Dear Colleague, Today’s news is a mixed bag—good and not-so-good. First, the not-so-good news: The Centers for Medicare & Medicaid Services (CMS) is poised to
Dear Colleague, Today’s news is a mixed bag—good and not-so-good. First, the not-so-good news: The Centers for Medicare & Medicaid Services (CMS) is poised to
What is duplicate billing, and how does it occur?
An interventional cardiologist performs a PTCA in the LAD artery. The physician also performed angioplasty in the diagonal side branch of the patient’s LAD at the same session. How would we bill this in a hospital setting?
What are the circumstances that will meet the requirements for assigning 93458?
We are a hospital-based laboratory. Can we charge Medicare for handling fees to send samples to a reference lab using code 99001?
Are there any code edits that we should be aware of when applying LT and RT modifiers?
If both low-risk and high-risk HPV types are performed in a single assay, how would we code?
When both tibial/peroneal arteries in both legs are treated for lower extremity revascularization, what modifiers would we report?
We are still confused about when to use or if to use the LT or RT modifier. Do you have a formula that we could apply based on a scenario?
Do you have any additional guidelines for modifiers LT and RT?
What is the procedure code when a specific antigen test is ordered as a diagnostic test based on a sign or symptom?
Can you provide more clarity for 37215?
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