Claim denials can significantly impact revenue for healthcare practices. Understanding common denial categories and how to prevent them can streamline billing operations and improve cash flow. This article breaks down the most frequent claim denial types and provides actionable solutions. Coverage and Eligibility Denials These denials occur when a patient’s insurance is inactive, expired, or […]
Denied claims are a significant issue in healthcare revenue cycle management. In 2024 alone, over 48 million healthcare claims were denied, creating financial and administrative burdens for practices. While completely eliminating denials is unrealistic, understanding common denial codes and implementing prevention strategies can drastically reduce their occurrence. One of the most frequent denial codes is […]
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 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 […]
