What is electronic remittance advice (ERA)?
An electronic remittance advice (ERA) is the electronic file a health plan sends to explain how it processed your claims. Its standard format is the HIPAA 835, which is why ERA and 835 file get used interchangeably. An ERA only accounts for insured visits, so cash-pay revenue from aesthetic services needs its own tracking, which […]
Denial codes in medical billing: The top 20 CARC codes and how to fix them
Download your free denial code cheat sheet A one-page PDF listing all 20 codes with the official X12 meaning, the usual cause, and the first action to take. It also carries a key to the CO, PR, OA and PI group prefixes, the four response routes, and a worked ERA example. Sized to print and […]
CPT code 20102: Penetrating wound exploration billing
CPT code 20102 covers exploration of a penetrating wound of the abdomen, flank, or back. It is the code a surgeon reports after following a stab or gunshot tract to see how deep the damage runs. The coding looks simple until the claim comes back denied. Two words in the descriptor, separate procedure, decide whether […]
CPT code 21432: Open treatment of craniofacial separation (LeFort III)
CPT code 21432 describes the open treatment of craniofacial separation (LeFort III type); with wiring and/or internal fixation. That is the descriptor published by the American Medical Association’s CPT Editorial Panel in the AMA CPT code set. Two elements of it carry the whole code. The injury must be a LeFort III craniofacial separation, and […]
CPT code 24410: Humeral osteotomy with intramedullary rod
CPT code 24410 is the American Medical Association (AMA) descriptor for “Osteotomy, multiple, with realignment on intramedullary rod, humeral shaft (eg, Sofield type procedure).” It sits in the musculoskeletal section of the CPT manual, in the 24000 series for the humerus and elbow. Two elements in that descriptor decide whether the code is billable. The […]
CPT code 21465: Open treatment of mandibular condylar fracture
CPT code 21465 reports the open treatment of a mandibular condylar fracture. It sits in the Musculoskeletal System chapter of the AMA’s CPT code set, in the Head range that runs from 21000 to 21499. The code covers surgical access to the fracture, reduction of the condylar segment, and any plates or screws the surgeon […]
HCPCS code J1800: Propranolol HCl injection billing guide
Attribute Detail HCPCS code J1800 Full descriptor Injection, propranolol HCl, up to 1 mg Drug name Propranolol hydrochloride Drug class Beta-adrenergic blocker Code type HCPCS Level II J-code Dosage unit Up to 1 mg per unit billed Code status Active Maintaining body CMS HCPCS National Panel Propranolol HCl: Clinical indications and dosage form Propranolol hydrochloride […]
Bulk billing in 2026: What the incentive changes mean for your practice
The bulk billing decision used to be settled on principle. Two changes moved it onto a spreadsheet. Since 1 November 2025, the MBS bulk billing incentives apply when you bulk bill any Medicare-eligible patient. Practices that bulk bill everything now collect a 12.5% loading on top of that. Our roundup of the best medical spa […]
ICD-10 Code O61.1: Failed instrumental induction of labor
ICD-10 Code O61.1: definition and billable status ICD-10 Code O61.1 is defined in the ICD-10-CM tabular list as “Failed instrumental induction of labor.” It is a billable, specific code valid for reimbursement claim submission. The 2026 edition took effect on October 1, 2025 and runs through September 30, 2026, per CMS annual ICD-10-CM update schedules. […]
Medicare billing for practices: Models, claiming channels and compliance
A practice’s billing setup shows up in three places. Gap revenue that never gets invoiced. Claims that come back rejected. And how the practice fares if the Department of Health ever asks it to substantiate what it billed. Practices that also run cosmetic services outside Medicare can compare medical spa systems for that side of […]