Tag: Healthcare Reimbursement

HCPCS Coding Errors

Common HCPCS Coding Errors That Lead to Claim Denials

Healthcare organizations rely heavily on accurate coding to ensure timely reimbursement. While CPT and ICD-10 codes often receive most of the attention, HCPCS Level II codes play an equally critical role in billing for supplies, medications, durable medical equipment (DME), ambulance services, and other non-physician services. Even small HCPCS mistakes can trigger claim rejections, payment […]
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Coding and Billing Alignment Strategies

2026 Coding and Billing Alignment Strategies for Cleaner Claims

Here’s your rephrased, expanded, and more natural (human-written style) version with smoother flow, stronger transitions, and added depth. I kept your structure but enriched the narrative, added examples, and improved readability while keeping it newsletter/blog-friendly. In 2026, healthcare organizations are dealing with a challenge that feels familiar—but far more intense than before. Claims are becoming […]
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Direct Member Reimbursement form

Direct Member Reimbursement Form: A Complete Guide for Healthcare Providers

In today’s complex healthcare billing environment, patients are increasingly paying out-of-pocket for medical services and later seeking reimbursement from their insurance plans. This shift has made the Direct Member Reimbursement (DMR) form an essential component of the revenue cycle for both patients and healthcare providers. A Direct Member Reimbursement form allows insured members to request […]
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HCPCS B Codes

Understanding HCPCS B Codes for Enteral and Parenteral Therapy: A Guide

Enteral and parenteral therapies play a critical role in the treatment of patients who cannot meet their nutritional or medication needs through normal oral intake. From patients with gastrointestinal disorders to those requiring long-term intravenous nutrition, these therapies are essential for sustaining life and improving clinical outcomes. However, billing for these services can be complex, […]
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Modifier 81

Modifier 81 Complete Guide: Accurate Usage for Assistant Surgeon Billing

Accurate modifier usage is one of the most important elements in achieving clean claim submissions and full reimbursement in surgical billing. Among the lesser-used but extremely important surgical modifiers is Modifier 81 – Minimum Assistant Surgeon. Many practices overlook or misuse this modifier, leading to preventable denials, delayed payments, and compliance issues. This comprehensive guide […]
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Right Hip Pain

ICD-10 Code for Right Hip Pain (M25.551) | Billing & RCM Guide

In the complex world of healthcare, accuracy in medical coding is not just about compliance—it’s the foundation of timely reimbursements and a healthy revenue cycle. Among the most common patient complaints is hip pain, which often leads to diagnostic evaluations and treatment claims. Properly using the ICD-10 code for right hip pain (M25.551) is crucial […]
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CPT Code 27447

CPT Code 27447: A Complete Guide to Total Knee Arthroplasty (TKA)

Total knee arthroplasty (TKA), also known as total knee replacement, is one of the most commonly performed orthopedic procedures in the United States. With the rising number of patients suffering from osteoarthritis, rheumatoid arthritis, and other degenerative joint diseases, the demand for accurate coding and billing for knee replacement surgeries has never been greater. For […]
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CO-97 Denial Code

Understanding CO-97 Denial Code: Common Causes, Impact, and Best Practices

In the complex world of medical billing, claim denials are one of the biggest challenges healthcare providers face. Among them, CO-97 denial code is one of the most frequent and confusing denials providers encounter. A denied claim not only disrupts cash flow but also leads to additional administrative costs and potential compliance risks. To minimize […]
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