CPT 93000 With an E/M: Why EKG Claims Deny and What 2027 May Change
The 93000 CPT code vs. 93005 and 93010, why an EKG with a same-day E/M denies, and what the proposed 2027 same-day E/M reduction would and would not touch.
CPT 45378 vs. 45380: Screening, Diagnostic and Modifiers 33 and PT
CPT 45378 vs. 45380: when a screening colonoscopy becomes diagnostic, which Medicare G-code or modifier 33 or PT applies, and the 2027 coinsurance change.
Medical Billing Services vs. Revenue Cycle Management Services: What’s Actually Different
Medical billing vs revenue cycle management: where HFMA draws the line, which MAP Keys each service touches, and how to tell which one a vendor sells.
2027 Coding Changes: What to Fix Before January
Before January 1, 2027, practices need to fix three things: maternity billing, where 17 CPT codes including the global packages are deleted in favor of…
The No Surprises Act in 2026: What Practices Need to Know About IDR, QPA & Compliance
IDR volume has doubled, providers win ~88% of disputes, and a 2026 final rule just cut the filing fee to $15. What the No Surprises Act means for your practice now.
Family Practice Medical Billing Services: Stop Leaving Revenue on the Table
Modifier 25, the G2211 add-on, and Chronic Care Management are where family practices quietly lose — and recover — thousands each month. Here’s how.
CARC and RARC Codes Explained: How to Read a Remittance Advice
CARC codes (Claim Adjustment Reason Codes) explain why a payer paid a claim differently than you billed it; RARC codes (Remittance Advice Remark Codes)…
Physician Credentialing Services: What’s Included and When to Outsource
Physician credentialing services handle the verification and paperwork that let a physician see patients and get paid: primary-source verification of…
Texas Provider Credentialing and Enrollment: TSCA, TMHP and Payer Rules
Quick answer In Texas, physician credentialing by hospitals, HMOs and PPOs runs on the Texas Standardized Credentialing Application (TDI form LHL234); Medicaid enrollment goes through TMHP, with separate contracting for each Medicaid managed-care plan; and a physician joining an established group can be paid as in-network while credentialing under Texas Insurance Code chapter 1452, subchapter […]
Why CPT 59400 Global OB Claims Deny — and What Changes in 2027
Quick answer CPT 59400 is the global vaginal-delivery obstetric package — antepartum care, delivery and postpartum care by the same physician or group. Most denials happen when the global package is billed for a pregnancy the practice did not manage end to end. From 1/1/2027 the global packages are deleted entirely. When care is split, […]
Why CPT 76801 and 76817 OB Ultrasound Claims Deny
Quick answer CPT 76801 is the first-trimester (before 14 weeks 0 days) transabdominal obstetric ultrasound and 76817 is the transvaginal obstetric ultrasound. Most denials come from stacking the two without documentation, missing the additional-gestation add-ons, or billing 76811 without a high-risk indication. 76817 may be reported with a transabdominal exam only when both approaches are […]
Why CPT 75574 CCTA Claims Deny
Quick answer CPT 75574 is coronary CT angiography — CT of the heart, coronary arteries and bypass grafts with contrast, including image post-processing and quantitative evaluation of coronary calcium when performed. Most denials are coverage and documentation failures, not coding errors. Because 75574 already includes calcium evaluation when performed, 75571 is not separately reported for […]