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Insurance Guides (12)Billing Defense (7)Medical Billing (5)Medicare (1)Texas Laws (1)
Card summarizing lab modifiers 91, 90, QW and 59
Medical Billing

Lab Billing Modifiers Explained: 90, 91, 59, QW, and More

When to use lab modifiers 91, 90, QW, 59 and the X modifiers, 26 and TC, and ABN modifiers, plus the common mistakes that cause duplicate and bundling denials.

·4 min read

Card showing NCD and LCD coverage rules and ABN modifiers GA and GZ
Medical Billing

Lab Medical Necessity: NCDs, LCDs, and ABNs Explained

How Medicare decides if a lab test is covered: lab NCDs, Novitas LCDs, frequency limits, and when to use an ABN with modifiers GA, GZ, GX and GY.

·5 min read

Card listing CLIA certificate types and the QW modifier for waived tests
Medical Billing

CLIA Certificates and Modifier QW: Billing Waived Lab Tests

CLIA certificate types, where the CLIA number goes on the CMS-1500 and 837P, and when Medicare requires modifier QW for waived lab tests.

·4 min read

Lab claim checklist card showing CLIA number, QW modifier, diagnosis support and modifier 91
Medical Billing

Common Lab Billing Denials and How to Fix Them

The 10 most common lab claim denials, from missing CLIA numbers and QW modifiers to medical necessity, frequency limits and panel unbundling, with fixes for each.

·6 min read

Card summarizing remote patient monitoring CPT codes 99453, 99454 and 99457
Medical Billing

RPM Billing Guidelines for Medicare and Commercial Insurance

Remote Patient Monitoring billing explained: CPT codes 99453, 99454, 99457 and 99458, Medicare rules, commercial payer differences, documentation and common denials.

·7 min read

Illustrated medical claim showing CPT and ICD-10 codes with a duplicate charge flagged
Billing Defense

CPT and ICD-10 Codes on Your Medical Bill, Explained

What CPT, HCPCS and ICD-10 codes on your medical bill mean, the most common coding errors, and how to check and dispute them.

·4 min read

Card showing primary and secondary health plan order
Billing Defense

Coordination of Benefits: Who Pays First When You Have Two Health Plans

Have two health insurance plans? Learn the coordination of benefits rules, including the birthday rule and Medicare, and how to fix COB claim denials.

·4 min read

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