As we approach 2026, students preparing for medical coding certifications like the CPC (Certified Professional Coder from AAPC) and CCA (Certified Coding Associate from AHIMA) face an exciting yet demanding…
H.R. 1 doesn’t directly rewrite ICD-10 or CPT, but it does change the environment in which you’re coding. The impact is mostly indirect – through eligibility, documentation, the social determinants…
Let me start with the two big news items. First, Nina Youngstrom, the editor of the Report on Medicare Compliance, actually got a response from the Centers for Medicare &…
Once again, a well-known consulting organization has mischaracterized the “incident-to” requirements. A few months ago, I wrote about an article that asserted you can’t bill “incident to” when the patient…
Have you ever caught yourself wondering if you should pursue an AAPC or AHIMA certification—and, more importantly, which one is the right fit? I've talked with so many aspiring coders…
Lots of things happening last week for me to talk about. First, still no sign of the 2026 Outpatient Prospective Payment System (OPPS) Final Rule. Many of us expected a…
The 2026 Medicare Physician Schedule Final Rule includes several distinct policy changes in which the Centers for Medicare & Medicaid Services (CMS) modifies how it uses or pays for services…
When I first walked into the revenue cycle department of a midsize outpatient clinic in Raleigh, I expected to see stacks of patient charts and billing ledgers. What I found…
The global AI in medical coding market is projected to reach USD 8.4 billion by 2033, rising from USD 2.4 billion in 2023. A CAGR of 13.6% is anticipated during…
In today’s data-driven world, accurate and efficient medical coding is essential for patient care, insurance claims, and regulatory compliance within the healthcare system. However, manual medical coding can be time-consuming,…
When a patient leaves the hospital against medical advice (AMA), the discharge is not only a clinical concern, but it can also create coding and compliance challenges. Ensuring the process…
With so much focus within the federal government on abuse, fraud, and waste, I thought it might be helpful to review a couple of federal compliance requirements that are directly…
Weight loss can indicate a variety of health conditions, from minor nutritional changes to serious medical disorders. For healthcare providers, accurately documenting this symptom isn’t just important for clinical care;…
There are times when the Centers for Medicare & Medicaid Services (CMS) doesn’t agree with itself. I am dealing with a situation in which one team at CMS is saying…
The Coming Storm in Healthcare Finance America’s healthcare system is heading toward a breaking point. By 2030 the US will face a shortage of more than 86,000 physicians. Hospital margins…
For decades, armies of medical coders have served as the translators of American healthcare, converting physician notes and hospital encounters into ICD, CPT®, and HCPCS codes that power reimbursement, compliance,…