CPT codes are five-character codes from the American Medical Association’s Current Procedural Terminology code set, meaning a standard shorthand that providers put on claims to report the services and procedures they performed. On a claim, the diagnosis code says why the patient was seen. The CPT code says what was done. This guide covers who … Read more
Medical billing is the process of turning a patient visit into a paid claim, meaning the provider’s services and diagnoses are coded, sent to the insurer in a standard format, tracked, and matched against what the insurer pays. Medical billing looks like one task, but it is a chain of steps. A mistake early on, … Read more
CPT 87798 is being denied for 13 units because payers have moved this code into active enforcement in 2026, and 13 units billed on a single date of service trips every automated edit that enforcement triggers.
When Connecticut Medicaid denies CPT 90839 and 90840 with the reason “coverage/program guidelines were not met”, it is not saying the crisis session did not happen.
If you are billing CPT 15771 and 15772 and receiving the denial message “The primary service code was not submitted therefore the secondary code is not allowed”, you are not alone. It is one of the most common fat grafting add-on code denials.
A coder posted this question in a billing community forum: what CPT code is everyone using for injections of Juvederm Ultra XC to bilateral breasts?
CO-96 is one of the denial codes that shows up across every specialty, every payer, and every billing department regardless of how experienced the team is.
Z41.1 is the ICD-10-CM diagnosis code for Encounter for Cosmetic Surgery. It is a Z code, which means it represents a reason for an encounter rather than a disease or injury.
Medicare billers working in cosmetic, aesthetic, and plastic surgery practices encounter the GY modifier regularly. It is one of the most specific and unambiguous modifiers in the Medicare billing system, and using it correctly protects the practice, clarifies patient financial…
Claim denials don’t just slow down your revenue. They erase it. In 2025, Experian Health’s 3rd Annual State of Claims Survey found that 41% of healthcare providers had at least 1 in 10 claims denied, marking the third consecutive year…