CO-45 Denial Code: Meaning, Causes, and How to Fix It
Receiving a CO-45 denial code on an Explanation of Benefits (EOB) can be frustrating and confusing for healthcare providers and medical billing professionals. This code indicates that the insurance company has adjusted the billed amount because it exceeds the contracted rate agreed upon between the provider and the payer. If not handled correctly, it can […]
POS 11 vs. POS 22 in Medical Billing – Key Differences & Best Practices
When billing for healthcare services, understanding POS 11 vs. POS 22 is crucial for accurate claims and proper reimbursements. These Place of Service (POS) codes determine whether a service is billed under a physician’s office (POS 11) or an outpatient hospital setting (POS 22), impacting reimbursement rates, facility fees, and compliance. Misusing these codes can […]
CPT Codes for Labs: A Complete Guide to Laboratory Billing & Coding (2025)
CPT (Current Procedural Terminology) codes are essential for billing laboratory tests in the healthcare industry. These standardized codes allow laboratories, hospitals, and healthcare providers to document and bill for diagnostic tests accurately. Without the correct CPT codes, insurance claims may be delayed, denied, or reimbursed incorrectly. Understanding these codes ensures that both providers and patients […]
Guide to Laboratory Billing and Coding Process for Healthcare Professionals
Efficient and accurate Laboratory Billing and Coding Process are essential for maintaining a smooth revenue cycle in healthcare facilities of all sizes. These processes ensure that laboratories receive timely reimbursements, adhere to strict regulations, and minimize costly claim denials. A streamlined billing workflow not only improves financial outcomes but also enhances operational efficiency, contributing to […]
What Is Down Coding in Medical Billing? Understanding Its Impact
In medical billing, accuracy is absolutely critical for efficient operations. Mistakes like down coding can lead to significant financial losses, compliance issues, and reduced efficiency for healthcare providers. By identifying these errors early and addressing their root causes, healthcare organizations can improve their revenue cycle and ensure that their billing practices align with regulatory standards. […]