Articles

Billing for Lab Tests: P-Code HCPCS Reference

P-codes are HCPCS Level II codes for clinical pathology and lab tests. They are used alongside CPT lab codes in independent lab billing.

Aug 1, 2026

Reading a HCPCS Explanation of Benefits (EOB)

The EOB or remittance advice shows how a payer processed each service line. Knowing which HCPCS codes were paid, denied, or reduced and why is essential for billing follow-up.

Jul 25, 2026

HCPCS Annual vs Quarterly Updates: What Changes

HCPCS codes are updated four times per year. The January update is the largest, but interim quarters can carry significant changes for drug codes and temporary codes.

Jul 18, 2026

How Payers Use NCCI Edits to Deny Claims

Medicare and many commercial payers use NCCI edits as automated claim scrubbers. Understanding how the denial logic works helps billers respond effectively.

Jul 11, 2026

Compliance Risks in HCPCS Billing

HCPCS billing errors can cross into compliance territory when they are systematic or appear intentional. Understanding the line between billing mistakes and fraud is essential.

Jul 4, 2026

Vision, Hearing, and Speech Codes: V-Code Reference

V-codes are HCPCS Level II codes for vision, hearing, and speech services and devices, including eyeglasses, contact lenses, and hearing aids.

Jun 27, 2026

HCPCS Codes for Orthotics and Prosthetics (L-Codes)

L-codes are HCPCS Level II codes used by orthotists and prosthetists to bill Medicare for braces, orthotic devices, and prosthetic limbs.

Jun 20, 2026

Medicare Part B Outpatient Drug Coverage and J-Codes

Medicare Part B covers drugs that are not typically self-administered. J-codes are used to bill Part B for injectable and infused drugs in a clinical setting.

Jun 13, 2026

How to Look Up Active vs Deleted HCPCS Codes

CMS marks HCPCS codes as active, deleted, or changed each quarter. Billing a deleted code is a common reason for automatic claim denial.

Jun 6, 2026

Understanding NCCI Modifier Indicators

NCCI modifier indicators tell billers whether a modifier can override an edit. A "0" means no modifier can bypass it; a "1" means modifier 59 or an X modifier may apply.

May 30, 2026

J-Code Billing Fundamentals — How HCPCS Drug Codes Work

A practical guide to billing HCPCS J-codes for injectable, infused, and inhaled drugs under Medicare Part B — units, ASP pricing, NDC crosswalks, and the most common denial reasons.

May 27, 2026

DME Billing Fundamentals — Modifiers, MUEs, and the Forms You Need

A field guide to billing Durable Medical Equipment (DME) under Medicare — the NU/RR/UE/KX/KH-KI-KJ modifier system, the Standard Written Order, capped rental rules, and the DMEPOS fee schedule.

May 27, 2026