Coding

ICD-10, CPT, HCPCS, modifiers and E/M levels, written for people who have to get them right.

All posts Billing & Claims Coding Denials & Appeals Credentialing Compliance & HIPAA Practice Management Payer Updates Specialty Billing

3 posts, newest first.

Coding

Modifier 25: when it's correct and when it triggers an audit

Modifier 25 is the most useful modifier in outpatient coding and the most scrutinised. The line between correct use and audit exposure is documentation, not intent.

[CLIENT INPUT — coding lead], [CLIENT INPUT — CPC, CPMA or CCS] Published 30 June 2026

Coding

Modifier 59 and the X modifiers, explained

Modifier 59 unbundles services that a payer would otherwise consider included. The X modifiers say why — and choosing the specific one is increasingly not optional.

[CLIENT INPUT — coding lead], [CLIENT INPUT — CPC, CPMA or CCS] Published 23 June 2026

Coding

The annual code update calendar: ICD-10 in October, CPT in January

Two code sets change on two different dates, and both changeovers produce the same avoidable denials. Here is the calendar and the preparation that prevents them.

[CLIENT INPUT — coding lead], [CLIENT INPUT — CPC, CPMA or CCS] Published 16 June 2026

Coding

Modifier 25: when it's correct and when it triggers an audit

Modifier 59 and the X modifiers, explained

The annual code update calendar: ICD-10 in October, CPT in January

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