Coding & Documentation

Heal 360's $20 million settlement over swabs billed as full office visits shows how scribe and template notes can expose any practice.

CMS' 2027 fee schedule proposal would pay for RPM and RTM only when practice employees do the work. Here's what practices should review now.

From payer contract homework to a 15-minute morning huddle, these are the moves practice administrators can make after four days of sessions and interviews at MGMA's centennial meeting.

A 2027 Medicare proposal would stop paying for RPM time logged by vendor staff and cut device payments. Our handbook walks through what to do.

Madison Hynes of MGMA explained what practice leaders should watch as electronic prior authorization and Medicaid work requirements arrive Jan. 1.

New ICD-10 codes, NCCI edits and Medicaid eligibility limits all took effect Oct. 1. Here's what practices should check this week.

Hold times, delayed approvals and denials on authorized care dominated member feedback to MGMA's government affairs team.

A spreadsheet and the question ‘why?’ are enough to get started, an expert says.

MGMA is pushing back on any delay as insurers describe a three-step build.

Heel pain gets laterality, BRCA gets its own code and liver fibrosis gets a middle stage. These are the FY 2027 additions your physicians will reach for.

The FY 2027 code set lands Oct. 1 with no grace period. Deleted codes, quiet demotions and new laterality rules start denials on Day 1.

Nearly 150 medical groups want CMS to fix same-day E/M overlap code by code instead of cutting payment 50 percent.

The AMA is pressing CMS to withdraw a proposed 50 percent cut for office visits billed the same day as a procedure.

Medicare wants to pay half for the lesser service on same-day claims. Our new handbook works out what modifier 25 encounters stand to lose.

Heat, ticks and fireworks reshape the summer case mix. Why ICD-10 denials pile up on visits where the medicine was never in doubt.

CMS posted the FY 2027 ICD-10-CM update: 238 new codes effective October 1, including plantar fasciitis and cardiomyopathy changes.

Up to 85 percent of revenue cycle touches never generate a dime. MedEvolve CEO Matt Seefeld explains the touch tax and how to stop paying it.

A quick-reference guide to the ICD-10 codes practices lean on every July 4, from firework injuries and grill burns to heat illness and stings.

A nurse-led framework for when independent practices should bill CHI, PIN or CCM for Medicare care coordination work.

Operational levers that practice administrators can pull to give clinicians their evenings back

AI scribes get the headlines, but the highest-yield documentation fixes are workflow changes practices can make without a new vendor contract.

How one medical group used AI scribing to redeploy scribes into a revenue-generating chronic care management program.

As AI takes on a larger role in clinical decision-making, the diagnostic coding system underpinning health care data may be too imprecise to keep patients safe.

How the widespread adoption of electronic medical records quietly transformed the way primary care physicians code office visits, and their bottom lines.

From missed submission windows to overlooked bonuses, here is what MIPS participants need to review now to protect their Medicare payments.