Modifier SA: Understanding Its Role in Medical Billing
Just when you think you’ve figured out the right codes, a small detail like Modifier SA shows up and throws everything into question. Maybe you’ve seen it on a claim. Maybe someone on your team brought it up during an audit. Or maybe you’ve avoided it completely, hoping it doesn’t apply to your practice. But […]
Inside the APAPP Conference With Cadence Collaborative
When a client calls, we show up. When that client is someone like Marathon Medical Associates, and the invite comes from Erin MacNeill, you can bet we packed our bags fast. Earlier this year, Ryan Benjamin, our Founder, Arielle Bergmann, our Project Manager, and Jennifer Pientka, our Vice President of Client Relations, headed to the […]
96130 CPT Code: Definition and Billing Tips
If you work in behavioral health billing, you’ve probably seen 96130 on a claim or superbill and wondered exactly when (and how) to use it. You’re not alone. Psychological and neuropsychological testing codes can feel like alphabet soup, overlapping with other cognitive assessments, extended evaluations, and multiple providers touching the same patient record. It’s one […]
What Does IPA Stand For in Healthcare?
If someone mentioned “IPA” in a healthcare meeting and your first thought was craft beer… you’re definitely not alone. But in this world, IPA doesn’t mean India Pale Ale, it stands for something far more operational (and yes, a bit more complicated): Independent Practice Association. Whether you’re new to healthcare administration, managing provider contracts, or […]
EGD vs Endoscopy: What’s the Difference?
If you’ve ever heard someone use “EGD” and “endoscopy” like they’re the exact same thing… well, technically, they’re not wrong. But they’re also not giving you the full picture. This is one of those moments where providers can get tripped up. Because while every EGD is an endoscopy, not every endoscopy is an EGD. And […]
How to Code Multifocal Pneumonia ICD-10
If you’ve ever stared at a chest X-ray report that says “multifocal opacities” and thought, “Okay… but what code do I use for this?” — you’re not alone. Multifocal pneumonia can sound vague at first. It’s not a specific bug like pneumococcal pneumonia, and it’s not clearly tied to a single lobe like lobar pneumonia. […]
ICD-10 Coding for CPAP in Sleep Apnea
Sleep apnea often gets brushed off as just snoring or tossing and turning at night. But if you’ve ever tried billing for it or getting a CPAP machine covered, you know it’s not that simple. Behind the scenes, it takes more than a diagnosis. You need solid documentation, the right ICD-10 code, and a clear […]
EKG CPT Code: What You Need to Know
You’d think an EKG would be simple, right? Heart test done, code it, bill it, move on. But here’s the thing — it’s not that simple. There isn’t just one EKG code floating around out there. Depending on what part of the process your team handles, there are different codes that tell different parts of […]
Why Is It Useful to Ask for Billing Codes on a Medical Bill?
Ever feel like your billing reports are telling you… almost nothing? The totals are there. The percentages look fine. But something’s off, maybe collections are slower than expected, or your team is chasing denials more than usual. And when you ask what’s going on, you get vague answers or a spreadsheet that somehow makes things […]
POS 11 in Medical Billing: What You Should Know
You know that feeling when something seems so simple, you stop questioning it? Like, “Of course this is an office visit—why overthink it?” Welcome to POS 11. It’s the place of service code that flies under the radar because it’s so common. So assumed. So… obvious. But here’s the twist: when you treat it like […]
