DenialMedical Billing & Coding Blog
Practical guides for billing teams — NCCI edits, modifiers, RVUs, MUE limits, and denial prevention.
Global Surgery Periods Explained: A Guide for Billing Teams
What global surgery periods cover, how the 0-, 10-, and 90-day packages work, and how to bill for unrelated services during a global period.
Pre-Submission Claim Scrubbing: Catch Errors Before They Cost You
How pre-submission claim scrubbing catches NCCI bundles, MUE violations, and modifier gaps before they reach the payer — and what to scrub for.
How to Appeal a Claim Denial: A Step-by-Step Guide
A step-by-step guide to appealing Medicare claim denials — from redetermination through ALJ hearings — with timelines and documentation tips.
Medicare Fee Schedule 2026: Key Changes Every Billing Team Needs to Know
Key changes in the 2026 Medicare Physician Fee Schedule: conversion factor update, RVU adjustments, and what your billing team needs to review now.
ICD-10 and CPT Code Pairing: Avoiding Diagnosis-Procedure Mismatches
How diagnosis-procedure mismatches cause CO-50 medical necessity denials — and how to align your ICD-10 and CPT codes before submission.
MUE Limits in Medicare: How Medically Unlikely Edits Affect Your Claims
How CMS Medically Unlikely Edits work: what MAI 1, 2, and 3 mean for your claims, and how to avoid MUE denials before you submit.
What Are RVUs? A Plain-English Guide to Relative Value Units
RVUs explained in plain English: how work, practice expense, and malpractice RVUs combine with GPCI and conversion factor to calculate Medicare payment.
CPT Modifier Guide: When to Use Modifier 25, 59, 91, and More
When to use CPT modifier 25, 59, 91, and other common modifiers. Clear rules, documentation requirements, and payer notes for each modifier.
Medical Billing Denials: 10 Most Common Reasons and How to Prevent Them
The 10 most common reasons medical claims get denied — and the specific steps your billing team can take before submission to prevent each one.
What Is NCCI? A Complete Guide to CMS Bundling Edits for Medical Billers
Learn how CMS NCCI edits work, what procedure-to-procedure bundling means for your claims, and how modifier indicator 0 vs. 1 affects reimbursement.