Primary care is high volume, so small coding habits add up across thousands of claims.
Examples of frequently billed services, with billing notes from our coders.
| CPT code | Service | Billing note |
|---|---|---|
| 99213 | Established patient office visit, low-to-moderate | Level by medical decision-making or time |
| 99214 | Established patient office visit, moderate | Documentation must support the level |
| 99204 | New patient office visit, moderate | New vs established status matters |
| 99396 | Preventive visit, established patient, age 40 to 64 | Add -25 for a separate problem visit |
| G0439 | Medicare annual wellness visit, subsequent | Once per year |
| 99490 | Chronic care management, first 20 minutes per month | Consent and time documented |
| 90471 | Immunization administration | Vaccine product billed separately |
Codes shown are common examples and descriptions are simplified in our own words. CPT® is a registered trademark of the American Medical Association. Always confirm against the current AMA CPT codebook, ICD-10-CM and each payer’s policy.
Modifiers tell the payer how and why a service was performed. Missing or wrong ones are a leading cause of denials.
Eligibility, benefits and prior authorization verified before the visit.
Code, modifier and documentation review before claims are submitted.
Denials corrected and appealed, aging claims worked until resolved.
Diagnostic testing, procedures and E/M claims coded correctly for each payer.
View billing detailsBiopsy, lesion removal and Mohs billing, with medical and cosmetic claims kept separate.
View billing detailsColonoscopy, endoscopy and screening claims coded for the right site and payer.
View billing detailsTalk to our team about your practice, hospital or lab. We will review your current billing and show you where revenue is slipping away.