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Guides & Articles
Step-by-step instructions, actionable line-item breakdowns, and up-to-date coverage of Texas-specific regulations to protect you from surprise medical bills.
5 articles in 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
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
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
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
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