Acuet Thanksgiving 2025

CPT Code Descriptions

100

Categorized by the following codes 64490,64491, 64493, and 64494

What are Facet Joint Injections?

200

These codes are associated with this type of procedure: 45380, 45385, 45381, 45388

Colonoscopy

Denial/Reason Codes

100

Defined by the following codes:
PR-1, PR-2, PR-3

Deductible, Co-insurance, and Copay

200

This is the code for missing authorization 

CO-197

300

This common EOB denial adjustment code means the cpt code was bundled into another cpt code on the same date of service.

CO-97

400

A mandatory, across-the-board 2% reduction in Medicare payments to providers, required by the Budget Control Act of 2011

Medicare Sequestration

500

This denial code may show up in the EOB, but should not be accepted at 100% accuracy. A call must be made to the insurance. 

CO-119 Maximum benefit reached

SOP

100

What website/portal is mostly commonly used for finding out claim status for these payers: BCBS, Aetna, Humana

Availity

200

After noting an account, this step must be completed before moving to the next account in HST.

Changing the Visit Category

300

When coming across this type of account in your regular work day, you need to skip the account regardless of which center you work on. 2 answers needed.

Zero and Credit Balance

400

This process must be completed when triggered by the following denial codes 

PR-22, PR-31, PR-27, PR-20

Coordination of Benefits

500

This process should be done in Waystar when receiving a claim worth more than $99,999.99 for Medicare

Split the Claim

Billing

100

This is how bilateral procedures are billed in an ASC. 

Billed on two lines, with modifiers RT and LT, and modifier 59 on one of those lines.

300

This is the revenue code for billing an implant under an institutional/UB payer.

0278

400

This payer requires an SG modifer as the primary modifer on every line. 2 payers

Department of Labor and Gallagher Bassett

500

The number of units billed for the implant code -  neuroelectrodes. 

16

Medical Policy

100

This is where you look for detailed Medical Necessity Requirements for Medicare. 

LCD - Local Determine Coverage Article

200

Covered once every 24 months if you’re at high risk. 

Colonoscopy

300

No more than two sessions will be reimbursed per rolling 12 months.

What is CPT 64633, 64634, 64635, 64636

Radiofrequency Denervation

400

Requires 50% or greater improvement in symptoms to be considered medically necessary

What is Permanent Implantation of Neurostimulator?

500

This code is not covered when billed with any of  the following codes: 29824, 29827, and 29828 due to Medicare NCCI edits.

What is CPT 29822

Limited Debridement of Shoulder