Medical claim denials are a major challenge for healthcare practices. Understanding common denial codes can help mitigate claim rejections and improve reimbursement rates. One such code is Denial Code PR 272, which indicates that a service is not covered by the patient’s insurance policy. This article explores the causes of PR 272, strategies to prevent […]
Understanding Denial Code CO 273: A Comprehensive Guide for Healthcare Practices Claim denials are a common challenge in the medical billing world, with up to 30% of claims facing denial for various reasons. Among these, denial codes serve as essential messages from insurance companies, explaining why a claim cannot be processed. A particularly notable example […]
2025 CPT Updates for Dermatology and Surgery: Key Changes and Practice Impact As the healthcare landscape shifts, dermatology and surgical practices must adapt to new coding and guideline updates to maintain operational efficiency and compliance. The 2025 CPT updates bring targeted changes that directly affect these specialties. Here’s a detailed breakdown of the updates and […]
As we approach 2025, the latest CPT (Current Procedural Terminology) updates are set to reshape coding and billing processes for healthcare practices. Understanding these changes is crucial to maintaining compliance, streamlining workflows, and maximizing revenue. Here, we break down the key updates and their potential impact on your practice. Overview of the 2025 CPT Changes […]
Accurate Documentation and Coding for Effective Risk Adjustment Accurate documentation and coding are essential for effective risk adjustment, ensuring that healthcare providers are reimbursed appropriately and that patient care aligns with their clinical needs. In this guide, we’ll highlight common documentation errors and share tips for improving the accuracy of Hierarchical Condition Category coding. Cancer and Metastases […]
Handling claim denials effectively is crucial for maintaining a healthy revenue cycle in any healthcare practice. One of the more common issues faced by billing teams is Denial Code PR 27. This denial code signifies patient responsibility, usually due to the patient’s insurance coverage ending. Let’s take a deeper look into what Denial Code PR […]
Billing in pain management is complex, requiring pain physicians to navigate unique coding challenges, payer requirements, and compliance standards. From proper documentation of single-use vials to understanding Evaluation and Management (E/M) code changes, staying informed on billing practices can directly impact a practice’s revenue and reduce risks of audits and penalties. Here are some critical […]
Infusion services are a critical revenue stream for many healthcare practices. By optimizing billing practices, practices have the opportunity to significantly boost their revenue. Even a slight improvement in reimbursement rates for each infusion can add up to substantial gains over time. Without proper attention to billing, practices may be missing out on additional revenue […]
According to Worldmetrics.org medical billing errors account for an estimated $68 billion in unnecessary healthcare revenue loss. Given this staggering figure, understanding the ins and outs of medical coding and billing becomes crucial for healthcare practices. Accurate documentation of services and procedures during patient visits can make the difference between receiving timely revenue or facing […]
In New Mexico, Behavioral Health (BH) agencies play a vital role in delivering specialized treatment and training to providers seeking independent licensure. These agencies provide an array of services, from comprehensive community support to opioid treatment programs. To effectively manage the complexities of Revenue Cycle Management (RCM) and credentialing, healthcare practices must stay compliant with […]
