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Author: Claim Max RCM

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CPT code 99205 billing guide showing high complexity MDM requirements and 60 minute time threshold for new patient visits

CPT Code 99205: Billing Compliance and Audit Defense Guide [2026]

Fact Detail Code 99205 Short Description New patient office or other outpatient E/M visit Patient Type New patient; no professional services from the same provider, same specialty, or same group within the prior three years MDM

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CPT Code 99204 billing for new patient visits with moderate medical decision making and 45-59 minutes documentation requirements

CPT Code 99204: Complete Billing, Audit Defense and Claim Compliance Guide [2026]

CPT code 99204 is an evaluation and management code used for new patient office or other outpatient visits requiring moderate medical decision making or 45 to 59 minutes of total time on the date of the

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CPT Code 99203 billing guide for new patient visits with low MDM, 30–44 minutes time requirement, documentation tips, audit risks, and reimbursement optimization

CPT Code 99203: Complete Billing, Audit Defense and Claim Compliance Guide [2026]

What Is CPT Code 99203? CPT code 99203 is an evaluation and management (E/M) code used for new patient office or outpatient visits requiring a medically appropriate history and/or examination and low medical decision making complexity,

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CPT code 99202 billing guide highlighting reimbursement accuracy, compliance risks, and denial prevention strategies

CPT Code 99202: Complete Billing, Audit Defense and Claim Compliance Guide [2026]

The HHS Office of Inspector General has flagged evaluation and management coding as a persistent payment integrity concern for years. Recovery Audit Contractors recovered more than $900 million in improper E/M payments across the most recent

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CPT code 97140 medical billing guide showing reimbursement, compliance, and denial risks for manual therapy services

CPT Code 97140: The Audit Defense, Denial Recovery, and Revenue Recapture Guide for 2026

CPT code 97140 is the billing code for manual therapy techniques, including mobilization, manipulation, manual lymphatic drainage, and manual traction, performed for one or more regions, each 15 minutes, as defined by the American Medical Association

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POS 22 in medical billing infographic showing on-campus outpatient hospital billing, facility rate reimbursement, and compliance impact

POS 22 in Medical Billing: The 2026 Complete Guide for Healthcare Providers

Table of Contents POS 22 in medical billing is the official CMS designation for On Campus-Outpatient Hospital. It identifies that a patient received care within the hospital’s main campus in an outpatient department without being formally

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Occupational therapy CPT codes billing concept showing common codes and claim accuracy importance

Occupational Therapy CPT Codes 2026: Complete Billing Guide, Reimbursement Rates and Denial Prevention

Written by the Claimmax RCM Billing Specialists Team. Reviewed by a Certified Professional Coder (CPC). Last Updated: [April 2026]. Occupational therapy CPT codes are five-digit numeric codes used by occupational therapists and billing specialists to report

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Entity code errors in medical billing causing claim denials, documentation issues, and lost healthcare revenue

What Is an Entity Code in Medical Billing? Types, Errors and Fixes

You submitted a clean claim. Everything looked right: the diagnosis codes, the procedure codes, the patient information. Then it came back rejected with a message that said “this code requires use of an entity code.” No

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93306 CPT code billing errors leading to claim denials, audit risks, and revenue loss in echocardiogram services with compliance solutions for 2026

CPT Code 93306: Payer-Specific Compliance, Audit Defense and Denial Recovery Playbook [2026]

The average cardiology practice bills CPT code 93306 between 40 and 80 times per week. At roughly $220 per claim, that’s $450,000 to $900,000 in annual echocardiogram revenue from a single CPT code. Yet CMS Recovery

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Eligibility verification vs prior authorization errors causing claim denials and revenue loss in medical billing

Eligibility Verification & Prior Authorization: Key Differences Every Healthcare Practice Must Know [2026]

A billing coordinator at a busy orthopedic practice picks up the phone and calls the insurance company. “I need to verify the patient’s eligibility for an MRI,” she says. The rep on the other end pauses,

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