Author: One o Seven RCM

Learning how to fill out a CMS 1500 form correctly is one of the most practical skills in medical billing. Every box you complete determines whether you get paid, how fast you get paid, and whether the claim survives payer adjudication. The form has 33 items, each with specific rules.…

CPT code 90834 is the most commonly billed psychotherapy code in outpatient behavioral health, and it’s also one of the most frequently denied. Incorrect time documentation, wrong modifier usage, same-day billing violations, and insufficient clinical notes account for the majority of 90834 claim rejections, costing practices thousands in lost revenue…

G2211, commonly searched as the G2211 CPT code, is technically a HCPCS Level II code, not a CPT code. CMS created this add-on code specifically to capture the inherent complexity of evaluation and management visits involving longitudinal care. It recognizes the extra cognitive work that goes into managing patients you…

CPT code 99205 is the highest-level evaluation and management (E/M) code for new patient office or outpatient visits. To bill it, you need either high complexity medical decision making (MDM) or a minimum of 60 minutes of total provider time on the date of service. The 2026 Medicare reimbursement rate…

CPT Code 99204: Quick Reference Field Value Code CPT 99204 Description New patient office/outpatient E/M visit MDM Level Moderate complexity Time Range 45 to 59 minutes total on date of encounter Patient Type New patient (no services in prior 3 years) Work RVU (2026) 2.60 Total RVU (2026) 3.56 Est.…

Quick Facts: CPT Code 99203 Field Value Code 99203 Short Description New patient office/outpatient E/M visit MDM Level Low complexity Time 30 to 44 minutes total time on date of encounter Patient Type New patient (not seen in past 3 years) Work RVU 1.60 Total RVU (Non-Facility) ~3.13 2026 Medicare…

Mental health practices lose an estimated $30,000 to $50,000 every year to preventable claim denials. CPT code 90837 sits at the center of more billing disputes than any other psychotherapy code, according to industry analysis of behavioral health denial patterns. The problem isn’t that providers don’t understand the code. It’s…

2026 QUICK STATUS FOR EXPERIENCED CODERS: Incorrect modifier 26 usage costs radiology and pathology practices thousands in preventable denials every year. Wrong PC/TC indicator. Missing documentation. Wrong place of service. Any of these triggers a rejection from CMS or commercial payers, and your revenue sits in limbo. The pattern is…

The CO-45 denial code appears on more remittance advices than almost any other adjustment code in medical billing. It’s not a denial in the way most people think. Your claim was processed and paid; CO-45 just documents the gap between what you billed and what your payer contract allows. According…