Stark Law Explained: Rules, Exceptions, Violations, and Updates
A hospital wants to give a cardiologist medical-director duties. The cardiologist already refers patients to that hospital for imaging and inpatient care. Everyone agrees…
Topic archive
Category: Compliance
Verification checklists and responsible workflow guidance.
CPT Code 96127 Explained: Behavioral Health Assessment, Billing Rules, Units, Modifiers, and G0444 Comparison
A patient may complete a depression questionnaire in the waiting room, answer an anxiety scale in the patient portal, or have a parent and…
MRI Abdomen With and Without Contrast CPT Code 74183: Billing Guide
An MRI order says “abdomen with and without contrast.” The scheduling team selects one protocol, the technologist records several image sequences, and the radiologist…
Prosper Beyond VBC Inc Payer Contracting: Services, Pricing, and Strategy (2026)
A medical group can see steady patient volume, bill accurately, and still wonder why payments from one health plan lag far behind those from…
History of Stroke ICD-10: Z86.73 vs. I69 Codes Explained
A chart may say “stroke in 2019” and leave the coder with a deceptively simple question: does that history belong under Z86.73, or is…
Modifier 79 Explained: When to Use It, Billing Rules, and Examples
A patient undergoes a knee procedure, then returns to the same surgeon three weeks later for treatment of a new hand injury. The billing…
ASCs vs. HOPDs: Differences in Costs, Care, and Medicare Billing
A surgeon may offer the same outpatient procedure at two different locations: a freestanding surgery center and a hospital outpatient department. The appointment may…
ICD-10 Code for Pre-Op Clearance: Z01.818 and Related Codes
A surgeon requests “medical clearance” before a patient’s scheduled operation. The primary care office completes the visit, reviews the medication list, discusses anesthesia-related risks,…
Abdominal Pain ICD-10 Codes: R10.9, Pain by Location, and 2027 Coding Guidelines
A patient comes in with abdominal discomfort, but the examination and initial workup do not establish a cause. The clinician writes “abdominal pain” in…
ICD-10 Code for Type 2 Diabetes Mellitus: E11.9, Complications, and 2027 Updates
A patient returns for a diabetes follow-up. The chart says “type 2 diabetes,” lists metformin, and includes a recent A1c result. Which ICD-10-CM code…