Our experts answer questions about emergency transport services, the medical necessity requirements for epidurals to treat chronic pain, and medication noncompliance vs. underdosing.
When a woman is pregnant, relational connections between multiple organ systems can affect both mother and fetus and thereby alter, and perhaps complicate, the care they require. In addition, determining whether a condition was pre-existing or due to the pregnancy is important but can be tricky. Shelley C. Safian, PhD, MAOM/HIM/HI, RHIA, CCS-P, COC, CPC-I, provides clarifications for these types of scenarios.
You’ll have to wait a while longer for National Correct Coding Initiative edits for 2026-effective codes. However, the latest quarterly NCCI update will include new medically unlikely edits for a variety of HCPCS codes that went into effect in July and October 2025.
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.
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.
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.
A study published in JAMA found that people who experience a traumatic spinal cord injury are at a greater risk of developing long-term chronic conditions such as hypertension, stroke, heart disease, diabetes, and other neurological and psychiatric conditions.
