Medical Coding Guides

Expert CPT coding guides, modifier explanations, RVU optimization, and ICD-10 tips — written by a practicing surgeon for surgeons, residents, PAs, and coders.

Documentation

The Three Most Dangerous Words in an Operative Note: "Incidental Appendectomy Performed"

Why incidental appendectomy documentation needs rationale, findings, and surgical judgment instead of a three-word operative note.

Graydon Stallard, DO, FACOS, FACS · June 2026
RVU

How One Flap Can More Than Double the WRVUs of a Below-Knee Amputation

Why CPT 15738 lower extremity flap reconstruction can change a BKA from 14.99 to 33.55 wRVUs when the reconstructive work is real and documented.

Graydon Stallard, DO, FACOS, FACS · June 2026
Documentation

The Most Expensive Sentence in Surgery: "CT Reviewed"

Why independent image review belongs in the surgical consult note when it changes medical decision making, operative risk, and the plan.

Graydon Stallard, DO, FACOS, FACS · June 2026
RVU

How Surgeons Get Paid: RVU vs Salary Models

A practical surgeon-focused guide to salary, RVU productivity, base plus bonus, and collections-based compensation models.

Graydon Stallard, DO, FACOS, FACS · June 2026
Modifier

ALIF Coding Pearl: When Should the Exposure Surgeon Use Modifier 80?

When an ALIF exposure surgeon is commonly reported with modifier 80 instead of modifier 62, with CPT 22558 and 22585 examples.

Graydon Stallard, DO, FACOS, FACS · June 2026
Appeals

The $5,000 Letter Most Surgeons Never Write

How to appeal a downcoded or denied surgical claim with documentation, CPT guidance, payer policy, and a clear evidence-based argument.

Graydon Stallard, DO, FACOS, FACS · June 2026
RVU

The Surgeon vs. The Coder: Why You're Probably Losing RVUs and Don't Even Know It

Why incomplete operative notes make coders guess, weaken modifier support, create denials, and quietly leak surgical RVUs.

Graydon Stallard, DO, FACOS, FACS · June 2026
Documentation

How to Write a High-Value Consult Note That Supports Medical Decision Making

Why shorter, focused consult notes often support medical decision making better than long copied-forward notes filled with irrelevant information.

Graydon Stallard, DO, FACOS, FACS · June 2026
Documentation

The Most Important Sentence in Your Consult Note

Why every surgical consult note needs a clear sentence documenting what decision was made, why it was made, and how the patient was involved.

Graydon Stallard, DO, FACOS, FACS · June 2026
Documentation

Teaching Residents to Write Better Operative Notes

An attending surgeon's framework for teaching residents to write operative notes that are clinically useful, complete, and defensible.

Graydon Stallard, DO, FACOS, FACS · May 2026
Documentation

What a Better Surgeon Attestation Actually Looks Like

A practical surgeon attestation example that supports personal involvement, independent MDM, imaging review, operative planning, and risk discussion.

Graydon Stallard, DO, FACOS, FACS · May 2026
Modifier

Most Surgeons Under-Document Their Hard Cases

Why modifier 22 only works when the operative note documents substantially greater work, extra time, altered anatomy, and real technical complexity.

Graydon Stallard, DO, FACOS, FACS · May 2026
CPT Guide

The Global Period: One of the Most Confusing Parts of Surgical Billing

A surgeon-focused explanation of 0-day, 10-day, and 90-day global periods, what is bundled, and when modifiers 24, 58, 78, and 79 matter.

Graydon Stallard, DO, FACOS, FACS · May 2026
RVU

Why Surgeons Keep Losing wRVUs Without Realizing It

Where surgeons lose wRVUs through missed documentation, critical care underbilling, modifier mistakes, and multi-procedure coding problems.

Graydon Stallard, DO, FACOS, FACS · May 2026
Modifier

Modifier 25 vs Modifier 57: One of the Biggest Billing Mistakes in Medicine

Modifier 25 vs modifier 57 explained clearly: when to use each, where providers get it wrong, and why the wrong modifier can affect reimbursement.

Graydon Stallard, DO, FACOS, FACS · May 2026
Modifier

The Most Common Modifier Mistakes Surgeons Make

Modifier 57, 59, 25, and bilateral coding mistakes that cost surgeons real money.

Graydon Stallard, DO, FACOS, FACS · May 2026
CPT Guide

96365 vs 96374: IV Infusion vs IV Push Coding

The practical difference between IV infusion and IV push coding, including where 96366 fits and what documentation actually matters.

Graydon Stallard, DO, FACOS, FACS · May 2026
CPT Guide

Infusion Administration CPT Codes: 96365, 96366, and 96374

How to code IV infusion and IV push administration without overcoding, under-documenting, or inventing time that is not in the chart.

Graydon Stallard, DO, FACOS, FACS · May 2026
ICD-10

ICD-10 for Postoperative Complications: Stop Using Garbage Diagnoses

How to code postoperative complications in ICD-10 more accurately, including wound infection, hemorrhage, seroma, and device-related problems.

Graydon Stallard, DO, FACOS, FACS · May 2026
CPT Guide

Trauma Laparotomy CPT Coding: What Actually Gets Paid

A practical trauma laparotomy coding guide covering exploratory laparotomy, bowel resection, splenectomy, packing, and modifier pitfalls.

Graydon Stallard, DO, FACOS, FACS · May 2026
RVU

Why 90-Day Global Procedures Can Fool Your RVU Math

A surgeon-focused RVU guide explaining why 90-day global procedures look richer than they feel and where post-op work hides inside the value.

Graydon Stallard, DO, FACOS, FACS · May 2026
Modifier

Modifier 24: Unrelated E/M During the Postoperative Period

When to use modifier 24, when it fails, and how to document unrelated postoperative E/M visits without getting denied.

Graydon Stallard, DO, FACOS, FACS · May 2026
CPT Guide

How to Code a Laparoscopic Cholecystectomy: CPT 47562, 47563, 47564

Complete coding guide for lap chole — with/without cholangiography, CBD exploration, modifiers, and ICD-10 pairing.

Graydon Stallard, DO, FACOS, FACS · April 2026
CPT Guide

Appendectomy CPT Codes: Open vs Laparoscopic, Simple vs Complicated

44950, 44960, 44970 — when to use each, modifier -22 for complicated, ICD-10 K35 series pairing.

Graydon Stallard, DO, FACOS, FACS · April 2026
CPT Guide

Inguinal Hernia Repair CPT Codes: Complete Coding Guide

Open vs laparoscopic, initial vs recurrent, bilateral coding, and modifier usage for inguinal hernia repair.

Graydon Stallard, DO, FACOS, FACS · April 2026
CPT Guide

Wound Debridement CPT Codes: 11042-11047 Coding Guide

Depth-based coding, add-on codes, size calculation, and when to use the 97597/97598 vs 11042 series.

Graydon Stallard, DO, FACOS, FACS · April 2026
CPT Guide

Central Line and Vascular Access CPT Codes

PICC, IJ, subclavian, femoral — tunneled vs non-tunneled, age-based codes, and port placement coding.

Graydon Stallard, DO, FACOS, FACS · April 2026
CPT Guide

Breast Surgery CPT Codes: Biopsy, Lumpectomy, Mastectomy

19100-19307 series, sentinel lymph node, excisional vs incisional biopsy, partial vs total mastectomy coding.

Graydon Stallard, DO, FACOS, FACS · April 2026
CPT Guide

Abscess I&D CPT Codes: Simple vs Complicated

10060, 10061, 10080, 10081 — perirectal vs superficial, when to code separately vs bundle.

Graydon Stallard, DO, FACOS, FACS · April 2026
CPT Guide

The Global Surgical Package: 0, 10, and 90-Day Rules

What's included, pre-op E/M, post-op visits, return to OR modifiers, and how global periods affect billing.

Graydon Stallard, DO, FACOS, FACS · April 2026
CPT Guide

Small Bowel Surgery CPT Codes: Resection, Obstruction, Enterotomy

44120, 44121, 44130, 44615 — obstruction, adhesiolysis, Meckel's, trauma, and anastomosis coding.

Graydon Stallard, DO, FACOS, FACS · April 2026
CPT Guide

CPT Code for Colon Resection: Right vs Left Colectomy Complete Guide

Right colectomy (44140, 44204), left colectomy, sigmoid (44143, 44208), total colectomy (44150, 44210) with wRVU comparison table.

Graydon Stallard, DO, FACOS, FACS · April 2026
CPT Guide

Colorectal Surgery CPT Codes: Colectomy, Colostomy, Proctectomy

44140-44160 series, laparoscopic codes, Hartmann's, total colectomy, ostomy creation and reversal.

Graydon Stallard, DO, FACOS, FACS · April 2026
CPT Guide

GI Endoscopy CPT Codes: EGD, Colonoscopy, and Interventions

43235-43259 EGD, 45378-45398 colonoscopy — diagnostic vs therapeutic, biopsy, polypectomy techniques.

Graydon Stallard, DO, FACOS, FACS · April 2026
CPT Guide

Trauma Surgery CPT Codes: Exploratory Lap, Damage Control, Critical Care

49000-49002, organ repair, critical care time coding, trauma activation, and multiple procedure rules.

Graydon Stallard, DO, FACOS, FACS · April 2026
CPT Guide

Thyroidectomy CPT Codes: Partial, Total, and Completion

60220-60260 series, with/without neck dissection, parathyroid exploration, and nerve monitoring coding.

Graydon Stallard, DO, FACOS, FACS · April 2026
CPT Guide

Skin and Soft Tissue Excision CPT Codes

11400-11446 benign, 11600-11646 malignant — excision vs shave, margin measurement, and closure codes.

Graydon Stallard, DO, FACOS, FACS · April 2026
Modifier

Modifier 25 Explained: When and How to Use It Correctly

Significant, separately identifiable E/M on same day as procedure — documentation requirements and denial prevention.

Graydon Stallard, DO, FACOS, FACS · April 2026
Modifier

Modifier 59 vs XE, XS, XP, XU: Distinct Procedural Service

NCCI edits, when -59 is appropriate, the X{EPSU} modifiers, real examples, and bundling solutions.

Graydon Stallard, DO, FACOS, FACS · April 2026
Modifier

Modifier 57: Decision for Surgery — When It Matters Most

E/M visit where decision for major surgery is made, 90-day global, vs modifier 25, documentation tips.

Graydon Stallard, DO, FACOS, FACS · April 2026
Modifier

Modifier 22: Getting Paid for Difficult Cases

When to use increased procedural services, documentation requirements, operative note language, RVU impact.

Graydon Stallard, DO, FACOS, FACS · April 2026
Modifier

Modifier 51: Multiple Procedures — Understanding Payment Reduction

MPPR rules, how payment is calculated, primary vs secondary, when NOT to use -51, exempt procedures.

Graydon Stallard, DO, FACOS, FACS · April 2026
ICD-10

ICD-10 Coding for Acute Appendicitis: K35 Series Guide

K35.2, K35.3, K35.80, K35.89 — with/without abscess, perforation, peritonitis, documentation tips.

Graydon Stallard, DO, FACOS, FACS · April 2026
ICD-10

ICD-10 Coding for Gallbladder Disease

K80 cholelithiasis, K81 cholecystitis — acute vs chronic, with/without obstruction, documentation gaps.

Graydon Stallard, DO, FACOS, FACS · April 2026
ICD-10

ICD-10 Coding for Hernias: Complete Guide

K40-K46 series — inguinal, ventral, umbilical, femoral with laterality, recurrence, obstruction, gangrene.

Graydon Stallard, DO, FACOS, FACS · April 2026
RVU

Understanding Work RVUs: What Every Surgeon Needs to Know

How wRVUs are calculated, conversion factor, PE and MP components, compensation benchmarking.

Graydon Stallard, DO, FACOS, FACS · April 2026
RVU

Highest RVU General Surgery Procedures

Top 20 procedures by wRVU, time-to-RVU ratio, and coding tips to maximize your productivity.

Graydon Stallard, DO, FACOS, FACS · April 2026
RVU

RVU Optimization for Surgical Practices

Common missed charges, documentation tips, same-day E/M, critical care billing, teaching physician rules.

Graydon Stallard, DO, FACOS, FACS · April 2026

Find CPT Codes Instantly

Use our free interactive decision tree to find the exact CPT code for your procedure — with modifiers, ICD-10 codes, and RVU values.

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