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Speciality Medical Billing

Why Medical Billing Rules Change by Specialty | Documentation, ICD-Pairing & Denial Patterns

Medical billing uses one code system, but specialty medical billing applies that system in very different...

Why Medical Claims Get Denied: Understanding Payer Edit Systems

Medical claim denials look personal. Denials are not personal; they follow logic. A payer processes claims...

Pediatric Medical Billing

Pediatric Medical Billing: Claim Rules That Turn “Routine Visits” Into Denials

Pediatric schedules look predictable on the calendar, but claims do not. A single date of service...

ICD-10 Coding Guides That Support Medical Necessity and Clean Claims

Medical necessity is evaluated through multiple lenses: clinical documentation, payer coverage logic, and claim-edit automation. ICD-10-CM...

CPT Code Billing Guides With Modifiers, Documentation, and Denial Prevention

Medical billing performance relies on a consistent, repeatable discipline: each billed CPT code must correspond to...

What is Medical Billing and Coding: A Comprehensive Guide

Medical billing and medical coding work on three coordinated dimensions: clinical accuracy, payer requirements, and financial...

Macrocytic Anemia ICD-10 Coding: How to Avoid D53.9, D51.x, and D64.9 Mistakes

Macrocytic anemia ICD-10 coding fails in real practice for one simple reason: coders look at the...

Transaminitis ICD-10 Code (R74.01): Definition, Billing Rules, Documentation & Coding Guide

Elevated ALT and AST levels show up in routine panels for patients with no pain, no...

CPT 49320 billing guide for diagnostic laparoscopy showing a surgeon performing a laparoscopic abdominal procedure in an operating room.

CPT 49320 Billing Guide for Diagnostic Laparoscopy

Billing teams treat diagnostic laparoscopy as “simple.” Claim outcomes prove the opposite. CPT 49320 sits inside...

CO-16 denial code example showing missing claim data on ERA

CO-16 Denial Code Explained: Missing Info, RARCs, and Prevention

If you have ever opened a denial report and felt your stomach drop after seeing the...

OA-23 denial code example showing prior payer adjudication on ERA

OA-23 Denial Code (CARC 23): Prior Payer Authorization Explained

If you work in medical billing, the OA-23 denial code can feel like one of the...

CO-253 adjustment on Medicare ERA showing 2% sequestration reduction

CO-253 Denial Code (CARC 253): Medicare Sequestration, ERA Examples, and Correct Posting

I have personally seen this confusion play out in actual billing settings. The billing staff is...