Category: Medical Billing and Compliance
E/M Coding 2026 Guidelines: MDM vs Time-Based Level Selection Explained
E/M coding 2026 guidelines let practitioners select an office or outpatient visit level (99202-99215) using either medical decision making (MDM) or total practitioner time on the date of the encounter. MDM is the level met by 2 of 3 elements: problems, data and risk. Time-based coding requires the documented total minutes to meet the code’s […]
Read more
Incident-To Billing Rules for NPs and PAs: 2026 Medicare Guide
Incident-to billing rules for NPs and PAs are Medicare conditions that let a nurse practitioner’s or physician assistant’s office service be billed under a supervising physician’s NPI at 100% of the fee schedule. The service must follow a physician-initiated plan of care, occur in a non-institutional setting, and be performed under direct supervision. When any […]
Read more
10 Common Reasons for Claim Denials and Fixes
Healthcare organizations experience revenue loss when claims are denied or delayed. Evidence shows that nearly 15 to 20 percent of all medical claims are denied on the first submission, and of those, more than half could have been prevented through stronger documentation, coding accuracy, and administrative controls. Understanding the Common Reasons for Claim Denials is […]
Read more