ClaimsProcessing

Denial Code 151

Denial Code 151: Avoid Claim Rejections with Accurate Frequency Justification

Denial code 151 is a common reason for claim rejections, indicating that the payer believes the submitted information doesn’t justify the frequency or quantity of services billed. This can significantly impact your practice’s revenue. Understanding the causes and implementing effective strategies to address these denials is crucial. Common Causes of Denial Code 151 Several factors […]

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Reason Code N370

Reason Code N370: Avoid Denials by Managing Equipment Rental Periods

Reason code N370, “Billing exceeds the rental months covered/approved by the payer,” is a common stumbling block for healthcare providers. This denial often arises when medical equipment rentals surpass the authorized rental period. For instance, oxygen equipment might be billed for more months than initially approved. Common Causes of N370 Denials Several factors can lead

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Reason Code N22

Reason Code N22: Avoid Denials with Accurate Procedure Coding

Reason code N22, This procedure code was added/changed because it more accurately describes the services rendered, is a common denial encountered in healthcare billing. It indicates that the billed procedure code doesn’t accurately reflect the services provided. Understanding the reasons behind N22 denials and implementing effective solutions is essential for improving your practice’s revenue cycle.

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Reason Code N20

Reason Code N20: Avoid Denials with Effective Billing Practices

Reason code N20, “Service not payable with other service rendered on the same date,” is a common stumbling block in healthcare billing. It often occurs when multiple services are billed on a single day but aren’t considered separate by the payer. Understanding the reasons behind N20 denials and implementing effective solutions is essential for improving

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Reason Code M97

Reason Code M97: Understanding and Preventing Billing Errors

Are you facing a surge in denials due to Reason Code M97? This common billing error can significantly impact your practice’s revenue. Understanding the root causes of M97 denials and implementing effective solutions is crucial. Let’s delve into the reasons behind M97 denials and provide actionable steps to improve your billing practices. Understanding Reason Code

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Remark Code N123

Remark Code N123: Navigating Split Service Denials

Are you facing recurring claim denials due to Remark code N123? This code signals a split service, indicating that only a portion of the units from the originally submitted service are being billed. Navigating these denials can be challenging, but with a clear understanding of the underlying issues and effective strategies, you can significantly improve

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Denial Code 24

Code 24: Avoid Denials by Understanding Capitation Agreements and Medicare Advantage

Denial code 24, Charges are covered under a capitation agreement/managed care plan, often arises when healthcare providers submit claims to Original Medicare for services that should be billed to a Medicare Advantage plan. This typically occurs when a patient’s healthcare coverage is primarily through a Medicare Advantage plan, which is administered by a private insurance

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Remark Code M123

Remark Code M123: Avoid Denials with Accurate Drug Information

One of the most common reasons for claim denials in healthcare is the presence of remark code M123, which indicates missing, incomplete, or invalid drug information. This blog post will delve into the reasons behind these denials, provide practical solutions, and discuss the importance of accurate drug information for successful claim reimbursement. Understanding Remark Code

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Denial Code B9 Hospice billing

Prevent Denial Code B9: Align Hospice Billing and Documentation

Denial code B9 indicates that a patient is enrolled in a Hospice program, meaning Medicare Part B will not cover services related to the terminal condition. Hospice programs provide palliative care, focusing on comfort and quality of life rather than curative treatment. Common Reasons for B9 Denials Strategies to Prevent B9 Denials Claims Med: Your

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CO12 denial RCM solutions

Address CO12 Denials: Ensure Diagnosis Matches Provider Type

Denial code CO12, indicating a diagnosis inconsistent with the provider type, is a common challenge for healthcare providers. This denial arises when there’s a discrepancy between the documented diagnosis and the services provided by the healthcare professional. Let’s explore the reasons behind CO12 denials, potential solutions, and how Claims Med can assist in mitigating these

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