Blog

We stay up to date on the ever-changing insurance market's impacts on your specialty for you...because it's basically a full time job in and of itself.

June 27, 2026

Panniculectomy Pays. Abdominoplasty Doesn’t.

Panniculectomy (15830) is covered when the panniculus impairs function. Abdominoplasty is cosmetic. The add-on +15847 is the line where covered claims turn into denials.

June 24, 2026

Multiple Biopsy Techniques, One Primary Code. Most Practices Bill Two.

CPT 11102, 11104, and 11106 are biopsy primaries by technique. Use multiple techniques in one visit and you still report one primary plus add-ons, not two primaries.

June 22, 2026

Your Breast Reduction Denial Is a Schnur Problem

One in five medically necessary breast reductions gets denied, and the number doing the denying is the Schnur scale. Here’s how each payer sets the bar.

June 18, 2026

17110 Is Not a Per-Lesion Code. Most Practices Bill It Like One.

CPT 17110 covers up to 14 benign lesions in one unit, not one per lesion. Bill it per lesion and the payer strips the overage before it pays.

June 10, 2026

In-House Plastic Surgery Billing Is a System, Not a Hire

Running plastic surgery billing in-house isn’t one hire — it’s a full revenue-cycle system. Here’s the whole machine, end to end.

June 10, 2026

In-House vs Outsourced Plastic Surgery Billing

In-house or outsourced plastic surgery billing — the real trade isn’t cost. It’s who owns your AR, your follow-up, and your denials.

June 2, 2026

Outsourced vs. In-House Dermatology Billing

Outsourced or in-house billing for your dermatology practice? The real cost, where revenue leaks, and five questions to answer before you switch.

June 1, 2026

The 2026 Skin Substitute Rule: Margin Gone, Flap Intact

On January 1, 2026, Medicare cut skin substitute pay ~90% to a flat $127.14/cm². What survives for plastic surgery and dermatology — and what doesn’t.

May 9, 2026

Gender-Affirming Surgery Billing: What the Code Actually Pays (And What It Doesn’t)

The Core Problem: One Code, Many Techniques The technique changes depending on the patient. The CPT code doesn’t. For top surgery — augmentation, reduction, mastectomy with nipple reconstruction — reimbursement is tied to the standard diagnosis for that procedure type. A reduction for macromasty and a reduction for masculinization carry the same code, same reimbursement, […]

May 9, 2026

Clean Claim Rate, AR Aging, and DRO: The 4 Billing KPIs Every Practice Should Track

What Is a Good Clean Claim Rate? Ninety-five percent. That’s the floor. The reciprocal is a 5% denial rate — which sounds manageable until you see how many follow-up hours that 5% generates downstream. Most practices below 95% aren’t losing to payer behavior. They’re losing to their own intake process. Three variables move this number […]

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