Medical billing Archives - One O Seven RCM

CO 226 Denial Code: Description, RARC Pairings, and How to Fix It

CO-226 denial code 2026 hero banner: information requested from the billing or rendering provider not provided or incomplete, CO-226 versus PR-227 provider-side versus patient-side confusion, N706 and M127 remark code pairings, the 45-day Medicare ADR response window, and state Medicaid enrollment-based 226 edits in Ohio and Louisiana, from One O Seven RCM.

CO 226 means the payer asked the billing or rendering provider for information and did not receive it, did not receive it in time, or found what arrived incomplete. The CO prefix stands for Contractual Obligation, so the provider absorbs the adjustment and cannot bill the patient for it. Key Takeaways This guide covers CARC […]

CO-8 Denial Code: The Procedure Code Is Inconsistent With the Provider Type or Specialty (Taxonomy)

CO-8 denial code 2026 hero banner: procedure code inconsistent with provider type or specialty taxonomy, NUCC's self-selected taxonomy code correction, group code CO provider write-off, the three-record mismatch between claim, NPPES, and payer enrollment file, and the corrected claim versus enrollment correction versus appeal decision path, from One O Seven RCM.

A CO-8 denial code fires when the procedure you billed doesn’t match the provider type or specialty, the taxonomy, that the payer has on file for that NPI. Because the adjustment carries group code CO, Contractual Obligation, the balance becomes your write-off and you can’t bill the patient for it. The mismatch usually sits in […]

POS 31 in Medical Billing: The Complete 2026 Guide to Skilled Nursing Facility Claims

POS 31 in medical billing 2026 hero banner: skilled nursing facility coded by active Medicare Part A status not care type, POS 32 paying more than POS 31 under the CY2026 practice expense split, CARC 58 rejections under the July 2025 CR 13767 system edit, SNF consolidated billing carve-outs, and the mixed-facility POS 31 default presumption, from One O Seven RCM.

POS 31 is the Place of Service code for a Skilled Nursing Facility. It’s a two-digit code you report on professional claims, including the CMS-1500, to show that care was delivered to a patient during a covered Medicare Part A stay. Place of service 31 applies when the patient has an active Part A benefit […]

Cryotherapy CPT Codes: The Complete 2026 Billing Guide for Every Code Family

Cryotherapy CPT codes 2026 hero banner: premalignant lesion codes 17000-17004 billed per lesion, benign lesion codes 17110-17111 billed per session, skin tag codes 11200-11201, acne code 17340, PT modality 97010, cryoneurolysis 0440T-0442T, and body-site codes for gynecologic, ophthalmic, and pulmonary cryotherapy, from One O Seven RCM.

There Is No Single Cryotherapy CPT Code Cryotherapy describes a technique. The cryotherapy CPT code you report follows the tissue you destroyed. Liquid nitrogen, CO2 slush, and argon gas all route through the same code families, so the cold agent never picks the code for you. Five families cover most skin cases: premalignant lesions, benign […]

Account Receivable in Medical Billing: The 2026 Guide for Healthcare Providers

Account receivable in medical billing 2026 guide hero banner: AR as earned but uncollected revenue from payers and patients, Days in AR calculation and 30-to-40-day benchmark, aging bucket prioritization by timely-filing risk and balance value, denial versus rejection distinction, underpayment detection from ERA reconciliation, and the five-step prevent-detect-prioritize-resolve-measure AR improvement framework, from One O Seven RCM.

Your practice earned the money weeks ago. The visit happened. The claim went out. The cash still isn’t in your account, and that gap between earned and collected is where revenue slips away. Account receivable in medical billing is the revenue a healthcare provider has earned for services already delivered but has not yet collected […]

CPT Code 78452: The 2026 Billing Guide to SPECT Myocardial Perfusion Imaging

CPT code 78452 nuclear stress test billing 2026 hero banner: SPECT multiple-study rest-and-stress protocol versus 78451 single phase, 78453 and 78454 for planar not SPECT, 78491 and 78492 for PET not 78452, MAC-specific LCD coverage under NGS A56743 and Novitas, Lexiscan J2785 and Cardiolite A9500 billed separately, and nuclear medicine certification required for the interpreting physician, from One O Seven RCM.

What Is CPT Code 78452, and Which Modality Does It Cover CPT code 78452 reports myocardial perfusion imaging using SPECT technology, performed as multiple studies, both rest and stress, to evaluate blood flow to the heart muscle and identify areas of reduced perfusion. Physicians order this study to diagnose coronary artery disease, evaluate damage after […]

CPT Code 99401 Billing Guide: Documentation, Medicare Rules, Modifiers, and Denials

CPT code 99401 preventive counseling billing 2026 hero banner: 15-minute individual risk-factor counseling with 8-minute midpoint threshold, Medicare benefit-specific code paths G0447 for obesity and G0443 for alcohol over general 99401, time and behavior-change plan documentation required, Modifier 25 on the E/M not on 99401, and bundling risk when billed with annual preventive visit codes, from One O Seven RCM.

Why CPT 99401 Is Harder to Bill Than It Looks A provider who orders preventive counseling usually knows the visit involved risk factor reduction, not treatment of an active illness. The 99401 cpt code itself is not the hard part. What is hard is whether the payer accepts it, whether the note proves a separate […]

Stress Test CPT Codes: The 2026 Billing Guide for Exercise, Echo, and Nuclear Cardiac Testing

Stress test CPT codes 2026 hero banner: 93015 global exercise ECG versus 93016, 93017, 93018 split components, 93351 stress echo with continuous ECG monitoring versus 93350 without, 78452 nuclear rest-and-stress SPECT, virtual direct supervision permanent January 2026, and LCD L38396 replacing the retired A57184, from One O Seven RCM.

What Is a Cardiac Stress Test, and Which CPT Code Applies to Each Type Stress test CPT codes fall into three distinct families, depending on how the heart is stressed and what the team measures: exercise or pharmacologic ECG monitoring under 93015 through 93018, stress echocardiography under 93350 through 93352, and nuclear myocardial perfusion imaging […]

How the Best Medical Claims Virtual Assistant Can Transform Your Practice’s Revenue Cycle

In today’s fast-paced healthcare industry, managing medical claims with speed and precision is more important than ever. Healthcare providers face an increasing load of administrative work that often takes time away from patient care. This is where the best medical claims virtual assistant becomes not just a helpful addition, but a strategic advantage. One O’Seven […]

Why AR Follow-Up Is the Backbone of Your Medical Billing Services?

In the world of healthcare administration, there’s a silent engine that keeps your revenue cycle moving forward—AR Follow Up. It’s not glamorous. It’s not always visible. But it’s absolutely critical to the success of your medical billing services. Without a strong AR strategy in place, practices face increased denials, delayed payments, and declining cash flow. […]

Category: Medical billing