Have you had your claims rejected by insurance due to an old or non-specific diagnosis code? Then you understand the importance of getting it right. In medical billing, whether or not your claims get paid can come down to a single line on your superbill. But when dealing with one
As soon as a new patient enters the clinic, an assessment procedure takes place, which starts with an appropriate billing decision. This may seem like an obvious step, but choosing the wrong CPT code will mean losing money on either side. In a high-deny industry like physical therapy, where the
Back in October, I looked into denial reports for a clinic in Paramus, NJ. Two clinicians, good patient flow, and experienced biller with five years of experience. What’s their denial rate? 22 percent! One in five claims was being denied. The owner didn’t have any clue about it since they
March 2024, third week. I’m reviewing claims data for a PT clinic in Woodbridge, New Jersey and something doesn’t smell right. On Tuesday afternoon, their therapist recorded 22 minutes of therapeutic exercise (97110) and 20 minutes of manual therapy (97140) for a patient. Total treatment time: 42 min. The biller
If you run a physical therapy clinic or handle PT billing, you’ve probably dealt with M62.81 more times than you can count. It’s one of the most used diagnosis codes in outpatient rehab — and one of the easiest to get wrong. Here’s the straight talk on how to use
Are you finding that your claims are being denied regularly when they should be paid? Are your reimbursements taking longer to process even though you submitted the claim accurately? In 2026, the challenges associated with billing for behavioral health are increasing in complexity. Billing for behavioral health services now requires
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