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CPT code 75561: cardiac MRI billing, documentation, and reimbursement guide

CPT code 75561 cardiac MRI billing 2026 hero banner: without contrast followed by contrast and further sequences, 75557 noncontrast versus 75563 with stress, 75565 velocity flow mapping add-on at up to four units per day, Modifier 26 and TC component split, and authorization-to-protocol mismatch denials, from One O Seven RCM.

CPT 75561 at a glance CPT code 75561 reports a cardiac MRI that evaluates heart structure and function. The scan starts without contrast, then the team gives contrast and captures more sequences. It can show ventricular function and tissue findings like scar or fibrosis. CPT code 75561 does not include stress imaging. When the without-and-with-contrast […]

CPT 75574: 2026 CCTA Coding, Billing and Reimbursement Guide

CPT 75574 coronary CTA billing 2026 hero banner: coronary arteries and bypass grafts with contrast and 3D postprocessing included, 75572 non-coronary structural CT versus 75574 coronary-specific, 75571 calcium score bundled when performed same session, Modifier 26 for interpretation-only and TC for technical-only, and active CMS RAC nationwide outpatient hospital review approved August 2025, from One O Seven RCM.

Medical coding disclaimer: This article is general educational information for cardiology, radiology, and revenue-cycle professionals. It is not coding, billing, legal, or reimbursement advice for any specific claim, patient, or payer contract. CPT codes, descriptions, and related data are copyright the American Medical Association (AMA); CPT is a registered trademark of the AMA. Always verify current […]

CPT 93923: 2026 Billing, Documentation, Medicare Coverage and Denial Prevention

CPT code 93923 complete bilateral physiologic arterial study billing 2026 hero banner: three or more tested levels or a qualifying provocative maneuver required, 93922 for limited one-to-two-level studies, ABI as one component not the whole service, no automatic Modifier 50 since bilateral is built into the descriptor, and NCCI edits with same-day duplex imaging codes 93925 and 93926, from One O Seven RCM.

CPT 93923 reports a complete, bilateral physiologic study of the upper or lower extremity arteries. The study must cover three or more levels, or include a qualifying provocative maneuver, to count as complete. It measures blood flow and pressure through function, not through imaging of the vessel itself, and a routine ABI alone doesn’t meet […]

CPT Code 93925: 2026 Billing, Documentation and Reimbursement Guide

CPT code 93925 lower-extremity arterial duplex billing 2026 hero banner: complete bilateral study versus 93926 unilateral or limited, B-mode plus color-flow and spectral Doppler components required, ABI not included in the duplex code, Modifier 26 for interpretation-only and TC for technical-only, and same-day NCCI edits with physiologic testing codes 93922-93924, from One O Seven RCM.

The 93925 CPT code reports a complete bilateral duplex scan of the lower-extremity arteries or arterial bypass grafts. The study combines structural imaging with blood-flow analysis and covers both legs in the same session. CPT 93926 is the code you’ll see when the study only covers one leg or a limited portion of the vascular […]

CPT 93922: ABI Billing, Documentation and Reimbursement Guide

CPT code 93922 arterial physiologic study billing 2026 hero banner: limited bilateral ABI plus a qualifying method at one or two levels, prohibited Modifier 50 since bilateral is built into the descriptor, MUE of two reflecting upper and lower extremity same-day testing not two units per leg, 93923 for three or more levels, and the distinction from 93925 and 93926 duplex imaging, from One O Seven RCM.

CPT 93922 reports a limited, bilateral, noninvasive physiologic study of the arteries in the arms or legs, usually performed at one or two testing levels. A lower-extremity study commonly pairs ankle-brachial index measurements with a second qualifying test, such as Doppler waveform recording, volume plethysmography, or transcutaneous oxygen measurement. The code is not interchangeable with […]

93971 CPT Code: 2026 Billing, Documentation, Modifiers and Denial Prevention

CPT code 93971 unilateral or limited venous duplex billing 2026 hero banner: complete unilateral or limited bilateral study versus 93970 complete bilateral, prohibited Modifier 50 for a limited bilateral exam, Modifier 26 for interpretation-only and TC for technical-only, LCD-required ICD-10 pairings for DVT and venous insufficiency, and same-day NCCI edits with 93970 and 76536, from One O Seven RCM.

The 93971 CPT code looks like one of the simpler entries in a vascular ultrasound fee schedule. Payment problems start when study scope, documented laterality, medical necessity, and the diagnosis code on the claim tell different stories. Confusion with the neighboring bilateral code is the biggest source of code-selection risk on extremity venous duplex claims. […]

93970 CPT Code: Complete Billing and Documentation Guide

CPT code 93970 bilateral lower extremity duplex billing 2026 hero banner: complete bilateral venous study versus 93971 unilateral, prohibited Modifier 50 and laterality modifiers on 93970, NCCI bundling with 93971 on same claim, LCD-required ICD-10 pairings for DVT and venous insufficiency, and Modifier 26 for interpretation-only versus TC for acquisition, from One O Seven RCM.

CPT 93970 reports a complete bilateral duplex examination of the extremity veins, covering paired upper or lower extremities. The study combines structural imaging with blood-flow analysis, and compression or other documented maneuvers confirm the findings. Code selection has to match the examination performed and documented, not the exam that was originally ordered. Practices often search […]

Account Receivable in Medical Billing: The 2026 Guide for Healthcare Providers

Account receivable in medical billing 2026 guide hero banner: AR as earned but uncollected revenue from payers and patients, Days in AR calculation and 30-to-40-day benchmark, aging bucket prioritization by timely-filing risk and balance value, denial versus rejection distinction, underpayment detection from ERA reconciliation, and the five-step prevent-detect-prioritize-resolve-measure AR improvement framework, from One O Seven RCM.

Your practice earned the money weeks ago. The visit happened. The claim went out. The cash still isn’t in your account, and that gap between earned and collected is where revenue slips away. Account receivable in medical billing is the revenue a healthcare provider has earned for services already delivered but has not yet collected […]

99495 CPT Code: 2026 TCM Billing Rules, Documentation, and Denial Prevention

CPT code 99495 transitional care management billing 2026 hero banner: moderate MDM with 2-business-day patient contact and 14-calendar-day face-to-face visit over 30-day TCM period, 99495 versus 99496 comparison by MDM level and visit deadline, required visit bundled into TCM not separately billable as 99214, and denial prevention for missed timing and documentation gaps, from One O Seven RCM.

Your team saw the patient after a hospital discharge, documented the visit, and sent the claim. The denial came back anyway. Practices that treat the 99495 cpt code like a routine hospital follow-up see this denial repeat. The code pays for Transitional Care Management (TCM), a 30-day service that starts the day a patient leaves […]

CPT Code 78452: The 2026 Billing Guide to SPECT Myocardial Perfusion Imaging

CPT code 78452 nuclear stress test billing 2026 hero banner: SPECT multiple-study rest-and-stress protocol versus 78451 single phase, 78453 and 78454 for planar not SPECT, 78491 and 78492 for PET not 78452, MAC-specific LCD coverage under NGS A56743 and Novitas, Lexiscan J2785 and Cardiolite A9500 billed separately, and nuclear medicine certification required for the interpreting physician, from One O Seven RCM.

What Is CPT Code 78452, and Which Modality Does It Cover CPT code 78452 reports myocardial perfusion imaging using SPECT technology, performed as multiple studies, both rest and stress, to evaluate blood flow to the heart muscle and identify areas of reduced perfusion. Physicians order this study to diagnose coronary artery disease, evaluate damage after […]