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 […]
J Codes are critical for billing injectable drugs and biologicals in medical claims. Used primarily in outpatient and physician office settings, they cover a wide range of injectable treatments. However, billing with J Codes comes with specific challenges that can lead to claim denials or underpayment if not handled correctly. Let’s look at these challenges […]
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 […]
Billing and coding are essential components of medical practice management. Proper billing practices not only ensure that physicians are paid correctly but also help maintain compliance with healthcare regulations. This article explores key aspects of billing and coding, focusing on recent changes, common challenges, and strategies for effective management. Importance of Accurate Billing Practices Accurate […]
Accurate medical coding is crucial for effective revenue cycle management (RCM) in healthcare practices, especially in the field of obstetrics and gynecology (OB/GYN). This article explores the specific ICD-10-CM coding guidelines for pregnancy-related conditions, providing valuable insights and best practices to enhance coding accuracy and efficiency. Understanding Chapter 15: Pregnancy, Childbirth, and the Puerperium Chapter […]
Billing for newborn office visits can be a complex process for healthcare practices, particularly when navigating the intricate rules of insurance carriers. Understanding the nuances of newborn billing, from initial coding to ensuring proper insurance enrollment, is crucial for minimizing denials and ensuring timely reimbursements. Coding for Newborn Office Visits When a newborn is discharged […]
Diabetes is a widespread diagnosis in the United States, with over 10% of the population affected by this condition. Given its prevalence, healthcare practices need to be well-versed in the coding guidelines for diabetes to ensure accurate documentation, proper patient care, and correct reimbursement. Types of Diabetes When coding for diabetes, the first thing to […]
Chronic pain is a significant health problem in the United States, affecting between 11 and 40 percent of adults. Pain management specialists are tasked with providing patient-centered care while navigating the complexities of insurance scrutiny, changing codes, prior authorization requirements, fee schedule cuts, and increased patient financial responsibility. Partnering with a medical coding company that […]
Nerve blocks are a challenging aspect of same-day surgery coding, and many coders find themselves unsure about when to code nerve blocks separately. This article aims to clarify the guidelines for coding nerve blocks in the context of anesthesia and pain management. What is a Nerve Block? A nerve block is the injection of numbing […]
