An EGD, or esophagogastroduodenoscopy, is billed using CPT codes in the 43235 to 43270 range. The exact code depends on what the physician actually did during the procedure, not just the fact that an EGD took place. A simple diagnostic look uses 43235, a biopsy uses 43239, and therapeutic work like dilation, hemostasis, or stent […]
If you administer an injectable drug and can’t find a matching HCPCS code for it, you’ll almost certainly end up billing HCPCS code J3490, Unclassified Drugs. It’s one of the most misunderstood codes in medical billing, not because the definition is complicated, but because everything around it, the documentation, the modifiers, the pricing, and the […]
A new provider starts seeing patients on their first Monday. The schedule fills fast because that’s what a good practice manager does. Six weeks later, someone in billing flags a stack of claims sitting in a “hold” bucket, and the reason is the same for every single one of them: the provider isn’t enrolled with […]
If you bill Medicare Part B for physical therapy, occupational therapy, or speech-language pathology, one small miscalculation in the 8-minute rule can cost a practice thousands of dollars a year, either in units left on the table or in units that trigger a post-payment audit. After spending decades inside revenue cycle operations for rehab and […]
Denial management is the ongoing process of identifying why insurance claims get denied, correcting and appealing the ones that can be recovered, and using that data to stop the same denial from happening again. It’s not a one-time fix. It’s a continuous cycle that sits at the center of a healthy revenue cycle, and practices […]
I have sat across the table from practice owners who were certain their billing was fine right up until the audit report landed on their desk. The claims were going out. The payments were coming in. Nothing looked broken from the front office. Then the audit traced eighteen months of quietly denied claims that nobody […]
Quick answer: Revenue cycle management automation uses software, rules engines, and AI to handle the repetitive parts of medical billing, eligibility checks, charge review, claim scrubbing, payment posting, and denial routing, so claims move from the front desk to final payment with fewer manual touches and fewer preventable errors. It doesn’t replace billing judgment. It […]
Payment posting is the step in medical billing where every dollar received from a payer or a patient gets recorded against the right claim, in the right amount, with the right adjustment code attached. Get it right and your accounts receivable tells you the truth. Get it wrong and you’re chasing balances that were never […]
Quick answer: An AR aging report in medical billing is a snapshot of every unpaid insurance claim and patient balance, sorted by how many days it has sat unpaid since the date of service. It groups those balances into time buckets, usually 0-30, 31-60, 61-90, and 90+ days, so a billing team can see at […]
Money that a practice has earned but hasn’t collected yet doesn’t just sit quietly on a balance sheet. It sits in limbo, aging by the day, and every day it stays there is a day your practice is financing someone else’s cash flow instead of your own. That’s what the accounts receivable process in medical […]
