Research | Medical Billing and RCM Guides

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Practical content for practices that want to collect more of what they bill.

October 22, 2026

How to set up automated medical billing for a private practice

An eight-step setup guide to automated medical billing for private practices, with published software prices, a worked cost example and the denials automation can and cannot prevent.

Shivam Pujara, Founder

CGM Billing

October 22, 2026

How do you bill continuous glucose monitoring codes 95249, 95250 and 95251?

The equipment decides between 95249 and 95250, the 72-hour minimum applies to all three codes, and 95251 is a separate decision most practices never bill. This page sets out the rules, the frequency limits and what a CGM book is actually worth.

Shivam Pujara, Founder

Patient billing disputes

October 22, 2026

How do revenue cycle management services handle patient billing disputes?

How billing teams take in, hold, investigate and resolve patient billing disputes, which federal rules pause collections, and what a dispute costs a practice.

Shivam Pujara, Founder

Skin Biopsy Coding

October 22, 2026

How do you use the biopsy add-on codes 11102 to 11107 correctly?

The skin biopsy family allows one primary code per date of service and an add-on for every other lesion. This page sets out the ranking rule, the units rule, the CMS bundling language and what a four-lesion encounter is actually worth.

Shivam Pujara, Founder

Pharmacist MTM billing

October 22, 2026

How do pharmacists bill MTM codes 99605 to 99607?

How pharmacists bill CPT 99605, 99606 and 99607 across Medicaid, commercial plans and Part D, with state rates, unit rules and a worked Minnesota example.

Shivam Pujara, Founder

Insulin Pump Billing

October 22, 2026

How do you bill insulin pump training and supplies without DME denials?

Insulin pump billing runs on two tracks that most practices collapse into one. The pump and supplies go to the DME MAC under E0784; the training goes on the practice claim as diabetes self-management training, and it is the half nobody bills.

Shivam Pujara, Founder

ENT Sinus Coding

October 22, 2026

Which sinus surgery codes bundle together, and which can be billed bilaterally?

Which sinus endoscopy codes absorb each other on the same side, which take modifier 50, and how Medicare actually prices a bilateral FESS with several codes.

Shivam Pujara, Founder

Home Dialysis Billing

October 22, 2026

How is home dialysis training billed separately from the MCP?

Training is not an MCP exclusion. It is paid under its own regulation, which says the amount is in addition to the monthly capitation payment, and the facility is paid again through a separate ESRD PPS add-on.

Shivam Pujara, Founder

ENT procedure coding

October 16, 2026

When can a nasal endoscopy and an office visit be billed together with modifier 25?

When a same-day office visit can be billed with diagnostic nasal endoscopy 31231, what the record needs, what the pair pays in 2026, and how the 2027 proposal would cut it.

Shivam Pujara, Founder

Reconstruction Coverage Law

October 16, 2026

What does the Women’s Health and Cancer Rights Act require payers to cover in reconstruction?

The four benefits WHCRA requires, which plans it binds, what it leaves out, and how to code and appeal the symmetry and fat grafting stages payers deny most.

Shivam Pujara, Founder

PRACTICAL GUIDES FOR PRACTICE OWNERS AND ADMINISTRATORS

Latest posts

How to set up automated medical billing for a private practice

How do you bill continuous glucose monitoring codes 95249, 95250 and 95251?

How do revenue cycle management services handle patient billing disputes?

How do you use the biopsy add-on codes 11102 to 11107 correctly?

How do pharmacists bill MTM codes 99605 to 99607?

How do you bill insulin pump training and supplies without DME denials?

Which sinus surgery codes bundle together, and which can be billed bilaterally?

How is home dialysis training billed separately from the MCP?

When can a nasal endoscopy and an office visit be billed together with modifier 25?

What does the Women’s Health and Cancer Rights Act require payers to cover in reconstruction?