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…
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,…
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…
Physicians are asking for greater certainty around Medicare reimbursement, arguing that compounding payment decreases over time have drastically increased the pressure on practices. Industry organizations, individual physicians and others weighed…
If you’re waiting for the perfect moment to bring AI into your business, here’s a thought: What if your first win isn’t flashy—it’s just functional? Let me show you what…
The robots aren’t coming. They’re already here. Last week, I had a chat with my accountant, a 45-year veteran who said his son's job just got replaced by ChatGPT. I…
Across the industry, health systems are laying the foundation for artificial intelligence success, ensuring they have the infrastructure, governance and technical expertise to make the most of the technology. Organizations…
As we progress through 2025, the landscape of medical coding is shaped by a wave of new regulations from both governmental and commercial payers. These changes are designed to increase…
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…
The Centers for Medicare & Medicaid Services (CMS) has launched the Fraud Detection Operation Center (FDOC) to fight waste, fraud and abuse, the agency announced this week. Listed on a…
Dawson Ballard, a coding auditor and educator for Chicago-based Rush University Medical Center who has more than 20 years experience in the profession, sees artificial intelligence coding platforms as beneficial. …
Few topics crop up in our articles more often than the Two-Midnight Rule. While it is frequently discussed and debated, I would posit that few regulations are easier to explain.…
The 2025 updates to the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) are now in effect, running from October 1, 2024, through September 30, 2025. While perhaps not…
Interoperability has been a longstanding goal for healthcare: The promise of being able to exchange data seamlessly between health information networks has been a goal the industry has been working…
While many of you are used to me aiming my wrath at payers, today I have a different target: the U.S. Department of Health and Human Services (HHS) Office of…