Top Denial Codes in Medical Billing and Root Causes
Understanding who pays the adjustment—not just the code number—determines your next move.
Suri Eldridge
Section
Denial Management
6 stories in Denial Management.
Medical Necessity Documentation for Infusion Claim Denials
Payers audit documentation against policy, not clinical reality.
Callum Holloway
Infusion Prior Authorization Denial Overturn Rates by Payer
Only 11.5% of denied infusions are appealed, yet 80.7% of appeals succeed.
Vera Calloway
Medical Documentation Audit Process for Billing Compliance
Incomplete documentation, not fraud, drives most infusion billing denials on audit.
Callum Holloway
CO 97 Denial Code in Infusion Billing
CO-97 denials stem from three different rule systems, and confusing them costs recoverable revenue.
Vera Calloway
COB Sequencing Rules in Infusion Billing Workflows
Permanent COB errors at intake create cascading denials weeks after treatment.
Suri Eldridge