PayerReady Medical Coding Team
The certified coders, billers, and RCM specialists who curate, validate, and review every coding page you read on PayerReady. We work as one named entity rather than individual bylines because what matters is institutional consistency, not personal brands.
coding@payerready.comOrg-level authorship, not individual bylines.
Most coding sites publish "by [single coder name]" as a vanity signal. We don't, for three reasons:
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1Consistency over time. A coder leaves, a page goes stale. Org-level authorship means every page is owned by the team that's still here next quarter.
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2Multiple eyes on every page. A specialist coder writes the draft, a senior reviewer validates it, the rules engine cross-checks it. No single byline could honestly capture that.
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3Accountability is institutional. If a page has an error, you email a team that responds in 5 days, not an individual who may not even be at the company.
What our coders cover
Every coding domain that drives a denial, an audit, or a missed revenue opportunity. We don't cover everything in healthcare. We cover everything that lands on a CMS-1500 or UB-04.
Evaluation & Management
2021 office E/M revision, MDM-driven coding, time-based selection, prolonged service add-ons, split-shared rules, telehealth POS 02 vs 10.
Surgical Coding
Global surgical packages 0/10/90 day, modifier 24/57/58/78/79, co-surgeon (62), assistant (80/82/AS), bilateral (50), unbundling discipline.
NCCI & Bundling
4.5M Procedure-to-Procedure edits, MUE per-day quantity limits, modifier indicator 0 vs 1, X{EPSU} subset modifier preference.
Risk Adjustment
CMS-HCC v28, MEAT documentation, RAF score capture, RADV audit defense, problem-list-only diagnoses that fail audit standards.
Modifier Discipline
422 modifiers including 25, 59, X{EPSU}, GA/GZ/GY, KX, JW, telehealth 95/93. Audit triggers, payer policy variations, OIG Work Plan exposure.
Denial Management
1,506 CARC + RARC codes with curated root-cause analysis. Appeal letter templates for top 9 denials. Overturn-rate benchmarks from CERT and RAC reports.
ICD-10-CM Diagnoses
98K codes with full Excludes1/Excludes2 hierarchy, Includes annotations, billable flags, parent/child navigation, HCC mapping, LCD coverage flags.
Medicare Fee Schedule
PFS rates across all 55 MAC jurisdictions, facility vs non-facility, conversion factor application, geographic practice cost index (GPCI) effects.
Specialty Billing
54 specialty playbooks with common CPTs, bundling traps, modifier discipline, payer-specific rules, revenue opportunities, and compliance risks.
Compliance & Audit
OIG Work Plan annual targets, RAC pattern detection, CERT improper payment trends, modifier 25/59 audit defense, ABN and GA/GZ/GY workflow.
Inpatient Coding
MS-DRG assignment, CC and MCC capture, ICD-10-PCS procedure coding, hospital UB-04 billing, present-on-admission indicators.
Outpatient Facility
OPPS APC payment, status indicators, packaging flags, HCPCS C-codes for pass-through devices, ASC payment system.
When each dataset is re-verified
No "AI-generated, never updated" pages on PayerReady. Every code page is on a documented review cycle synced to the upstream publisher's release schedule.
Three checks every page passes before publish
If any gate fails, the page is marked noindex and excluded from sitemaps. We refuse to ship thin pages just to pad URL counts.
Data completeness
Page must have a short descriptor, MPFS rate (where applicable), and at least one cross-reference (NCCI partner, linked ICD-10, or modifier). Pages failing this are marked noindex.
Automated validation
Our internal rules engine runs 163 accuracy tests on every code page before publish (current pass rate: 163/163 as of 2026-04-13). Cross-references CPT-to-NCCI, CPT-to-MUE, ICD-to-HCC, denial-to-CPT.
Specialist spot-review
Rolling sample of 500 pages per month gets human review by the PayerReady Medical Coding Team. Top-traffic codes (E/M, top denials, top modifiers) get full prose authorship rather than spot-check.
Email the team. We respond in 5 business days.
Wrong code references cause real claim denials and patient billing errors. We treat error reports as high-priority. Confirmed errors get corrected and republished within 10 business days, and the page's "Last verified" timestamp updates accordingly.
coding@payerready.comBuilt to the standard a working coder expects on the job.
Wrong code references cause real claim denials and real patient billing errors. We don't optimize PayerReady's reference content for marketing or for thin-content SEO. We optimize it for the working coder who's about to bill a claim and needs the answer right.
The reference is here whether you sign up or not.
PayerReady credentialing customers get the full coding toolkit, denial library, specialty playbooks, NPI lookup, fee comparator, and claim audit at no extra cost.
Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team