A Prospective Payment System (PPS) is a Medicare reimbursement model where healthcare providers receive a predetermined, fixed payment for each service or patient case. Every procedure individually (as in the traditional fee-for-service model).
Retrospective authorization, often referred to as retroactive authorization, is a post-service approval process in medical billing where healthcare providers request insurance coverage for services that have already been rendered.
Medical billing denials are one of the biggest challenges in healthcare revenue cycle management. Every denied claim delays reimbursement and increases administrative workload. That’s why understanding denial codes in medical billing is essential for providers.
Billing for group therapy sessions can often confuse providers. Unlike individual therapy codes such as 97110 CPT, group therapy codes follow different rules, documentation requirements, and reimbursement guidelines.
The M25.50 diagnosis code is a billable ICD-10 code used for healthcare documentation and reimbursement. It represents pain in an unspecified joint, often referred to as arthralgia when the exact location is not specified.
Osteoporosis is one of the most common bone-related conditions in aging adults, especially women after menopause. The ICD-10-CM code M81.0 is used to describe age-related osteoporosis without current pathological fracture.
UNDERSTAND YOUR PRACTICE OVERALL HEALTH