MedMaxRCM

  In today’s evolving medical billing environment, understanding the difference between   CPT codes 99213 vs 99214   is essential for accurate reimbursement and compliance. These two Evaluation and Management codes are commonly used for established patient office visits, yet they are often misapplied. Selecting the wrong code can result in claim denials, audits, or lost revenue. Although time plays a role in choosing between these codes, it is not the only factor. Medical decision making, documentation depth, and visit complexity must all align with the selected CPT code. Key Takeaways CPT code 99213 is generally used for shorter visits with moderate complexity CPT code 99214 applies to longer visits involving higher clinical complexity Proper documentation is critical for both codes Incorrect coding can lead to reimbursement issues and compliance risks Understanding CMS guidelines helps reduce claim denials Introduction to CPT Codes 99213 and 99214 CPT codes serve as a s...

CPT code 96372 is one of the most frequently reported injection administration codes in outpatient and office-based settings. While it is widely used by healthcare providers, billing professionals, and insurance carriers, incorrect application of CPT code 96372 remains a common reason for claim denials and lost revenue. Many medical coders and practices struggle with understanding when CPT code 96372 is separately billable, how it interacts with Evaluation and Management services, and what documentation is required to support reimbursement. A clear understanding of  CPT code 96372  is essential for accurate billing and compliance. This guide explains the description, appropriate use, reimbursement rules, and common denial reasons associated with CPT code 96372. What Is CPT Code 96372? According to the American Medical Association Current Procedural Terminology guidelines, CPT code 96372 is classified under therapeutic, prophylactic, or diagnostic injections. It applies to non-...