Understanding the 2025 Telemedicine E&M Codes

The American Medical Association (AMA) introduced 17 new telemedicine evaluation and management (E&M) codes this year. Here’s the breakdown of these new codes: CPT® code range 98000-98007 are reported for…

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CMS Proposes Elimination of Inpatient-Only List

The Centers for Medicare & Medicaid Services (CMS) issued its Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Proposed Rule for the 2026 fiscal year this week, and…

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DRG Downgrades by Commercial Payers: Documentation Defense Tactics

In the current climate of cost containment, commercial payers are increasingly downgrading MS-DRGs after claims are submitted, not disputing the need for inpatient care, but questioning the clinical support for…

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The Devil’s in the Diagnosis Details

I think it is important to challenge one portion of an article that was widely distributed two weeks ago. The article included a statement that, while accurately characterizing the way…

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Coding Alert: Welcome to Summer!  

The first day of summer will be this week, so it’s a good time for a look at some codes we may be assigning. Summertime brings more time outside relaxing…

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ICD-11 in 2025: Evolution, Global Progress, and What to Watch

In the ever-evolving world of health information, few transitions generate as much anticipation and uncertainty as the adoption of a new international classification system. The 11th Revision of the International…

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The Expanding Role of Medical Billers and Coders

As the healthcare industry continues to evolve in 2025, the demand for skilled medical billers and coders has reached unprecedented levels. This growth is fueled by ongoing changes in healthcare…

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