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…
The Centers for Medicaid and Medicare Services this week released a report on complaints and enforcement efforts concerning the Public Health Service Act, which includes the No Surprises Act. As…
If you have been listening to the discussions on Monitor Monday and Talk Ten Tuesday about the use of the new HCPCS code G2211, you know there remains some uncertainty…
In recent years, generative artificial intelligence (GenAI) has passed medical exams, diagnosed complex cases, and even come up with ways to combat a pandemic. In fact, large language models (LLMs) such as…
The proposed new Medicare billing codes in the proposed Physician Fee Schedule (PFS) for 2025 include three specific codes for digital mental health treatment (DMHT) relating to professional services involving…
The 60-day Refund Rule, created by the 2010 Patient Protection and Affordable Care Act (PPACA), requires providers to report and return Medicare and Medicaid overpayments within 60 days of identifying…
In the last 50 years, there have been significant developments that have forever improved the delivery of healthcare. Consider imaging (MRI/CT scans), minimally invasive surgery, anti-viral therapies, precision medicine (e.g.,…
Current treatment for traumatic arterial injury of the extremities consists primarily of replacement with autologous venous or synthetic graft. However, the need for emergent repair or the unsuitability of a…
The American Medical Association’s coding panel, which is responsible for creating medical billing codes, is set to meet September 19-21 in Albuquerque where it will consider yet another proposal to…