Guides
ICD-10 coding guides
How the code sets actually work - the rules that decide whether a claim is accepted, explained with the codes they apply to.
Excludes1 vs Excludes2 in ICD-10-CM: the difference that gets claims denied
Excludes1 means never code together. Excludes2 means both may be coded. Confusing them is one of the most common causes of a rejected claim.
How to read an ICD-10-PCS code, character by character
Every ICD-10-PCS code is seven characters and each position means something specific. Learn to read a PCS code as a sentence rather than look it up.
Billable vs non-billable ICD-10-CM codes, and why billable is not the same as paid
What makes an ICD-10-CM code billable, why submitting a header code gets rejected, and why a billable code still may not be reimbursed.
The seventh character in ICD-10-CM: A, D and S explained
Initial encounter, subsequent encounter and sequela. What the seventh character means, when a placeholder X is required, and the mistakes that follow.
Laterality in ICD-10-CM: right, left, bilateral and unspecified
Many ICD-10-CM codes require a side. Which codes need laterality, what documentation supports it, and why unspecified is a last resort.
When unspecified ICD-10 codes are acceptable - and when they are not
Unspecified codes are valid and sometimes correct. The official guidelines are clearer on this than their reputation suggests.
Code first, use additional code: getting ICD-10 sequencing right
Etiology and manifestation pairs must be sequenced in a specific order. How to read the instructional notes that tell you which code comes first.
How MS-DRGs work: from diagnosis codes to an inpatient payment
An inpatient stay is paid by DRG, not by individual diagnosis code. How codes group into a DRG and why CC and MCC severity matters so much.
HCPCS modifiers explained: what they change and when to append them
Modifiers alter the meaning of a procedure code without changing the code. What the common ones do and the errors that trigger denials.
The annual ICD-10 update cycle: what changes every October 1
ICD-10-CM and ICD-10-PCS are revised once a year, effective October 1. What actually changes, and how to prepare without scrambling.