Cigna’s CO-197 denials for pediatric MMR vaccine code 90707 often stem from missing prior authorization or documentation gaps, despite CMS’s no-cost-share mandate for ACIP vaccines. To resolve, appeal with CDC-aligned records and verify eligibility upfront. Athelas tools streamline verification and appeals to boost reimbursement and reduce denials.

Keep up with CMS telehealth changes in our quick guide to the July 2025 proposed rule for the CY 2026 Medicare Physician Fee Schedule, tailored for orthopedics. Discover key updates like permanent virtual supervision, extended waivers for rural clinics, and a new payment model for low back pain.

Discover how to master telehealth documentation for virtual foot exams under CPT 73620 in 2025, ensuring smooth reimbursement and quality podiatric care. This guide simplifies logging image reviews, tracking patient progress, and avoiding claim denials with clear, cautious billing practices.

Telehealth is revolutionizing radiology, but strict payer rules can trigger denials for codes like CPT 72100 if documentation falters. This guide offers practical tips to fix and prevent claim errors, ensuring accurate billing and uninterrupted care in 2025.

Anesthesiology practices are embracing telehealth in 2025, but state-specific billing rules can lead to costly denials if mishandled. This guide simplifies navigating regional regulations, POS codes, and documentation to ensure accurate claims and seamless care.

In 2025, telehealth is crucial for rural healthcare, but accurate billing is essential to avoid costly errors. This guide breaks down CPT codes, modifiers, and documentation tips to ensure compliance and seamless care delivery in remote communities.

In July 2025, CMS updated telehealth policies for orthopedics, extending virtual care options and refining surgical follow-up billing through September 30, 2025. Learn how to use Modifier -54 and new code G0559 to streamline claims and avoid denials while keeping patient care seamless.

Confused about CPT codes 99202–99205 for new patient visits? This guide breaks down how Medical Decision Making (MDM)—not time—determines the right code. Learn why 99204 is most commonly used, how to document correctly, and what changes from insurers like Cigna could mean for your practice. Stay compliant, accurate, and audit-ready.

This post explains RARC M51 as a remark code indicating missing, incomplete, or invalid procedure codes like CPT or HCPCS, often paired with CARC 16, causing claim denials. It provides CMS-guided steps to fix denials by validating and resubmitting codes, alongside preventive tips like using updated HCPCS lists and billing software to ensure clean claims.

Medicare’s 2025 rules extend key telehealth flexibilities for pediatric care—allowing home-based and audio-only visits, caregiver training, and virtual supervision through December 31. These updates improve access for eligible children, but many benefits may end in 2026 without further action.

The blog explains CARC 16 as a denial code for claims missing key details like codes or provider info, often paired with RARCs like N265. It offers CMS-guided steps to correct and resubmit claims, plus prevention tips like pre-submission checks to minimize denials.