Artificial intelligence has revolutionized healthcare operations, offering speed and efficiency in certain tasks, but in a field where precision drives reimbursement and compliance, speed without accuracy can turn efficiency into liability. Karen R. Lane, MSN.ed, CCDS, CCDS-O, CDIP, RN, delves deep into one critical risk of using AI: hallucinations in the context of appeals.
Beginning January 1, 2026, the AMA will add a number of changes to CPT codes for two related sections: Digitally Stored Data Services/Remote Physiologic Monitoring; and Remote Physiologic Monitoring Treatment Management Services.
Our experts answer questions on bridging the gap between DSM-5 and ICD-10 for substance-related disorders; differentiating between poisoning, adverse effects, underdosing, and toxic effects; and reporting pancreatic cancer with ICD-10-CM.
Our experts answer questions about emergency transport services, the medical necessity requirements for epidurals to treat chronic pain, and medication noncompliance vs. underdosing.
In the ever-evolving world of healthcare coding, staying grounded in the fundamentals is not just best practice, it’s a necessity. As regulations shift, payer expectations tighten, and productivity pressures mount, coding professionals must continually revisit the core principles that ensure accuracy, compliance, and integrity in clinical documentation and billing.
MDaudit, a revenue integrity software platform, recently released its annual report that examines trends in coding denials, audits, and technology based on data from the first three quarters of 2025. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS finalized changes to the Medicare Diabetes Prevention Program in the 2026 Medicare Physician Fee Schedule final rule, including updating weight collection requirements, extending flexibilities allowed during the COVID-19 public health emergency, and updating the online delivery modality of the program.
Providers will have more opportunities to report +G2211, the complexity of care HCPCS add-on code. Effective January 1, 2026, providers will be able to report the code with evaluation and management encounters in more settings, CMS announced in the final 2026 Medicare Physician Fee Schedule.
Failure to rescue is a compelling quality metric because it offers a lens through which healthcare organizations can illuminate, analyze, and improve the rescue zone of patient care. Teresa Brown, RN, CCDS, CCDS-O, CDIP, CCS , shows how this metric can guide meaningful improvement in patient safety and outcomes when coding and CDI professionals help use it thoughtfully.
