Beginning in 2027, services for antepartum care, labor management, delivery, and postpartum care will be coded separately. The old global approach to billing obstetric care was intended to simplify billing, but it no longer reflects the variation and complexity of care across the phases of pregnancy.
CMS intends to introduce multiple new codes next year, according to the proposed 2027 Medicare Physician Fee Schedule. The agency is considering codes for advance care planning services by clinical staff, assessment and treatment of patients who have a reaction to a vaccination, and speech-language services for pediatric patients.
The new ICD-10-CM code for cannabis hyperemesis syndrome improved clinical recognition of the condition, according to a new Centers for Disease Control and Prevention report. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Thyroid disorders challenge outpatient hospital coders because the record often contains symptoms, laboratory values, medications, imaging findings, and surgical history before it contains a clear final diagnosis. Those clues can help a coder understand the encounter, but they do not authorize the coder to diagnose the patient.
Most veterans receiving Veterans Health Administration outpatient care for major depressive disorder are receiving their recommended treatment, but a growing proportion aren’t, according to a recent study published in JAMA Network Open.
HCPro invites medical coding professionals to take part in the 2026 Coding Salary Survey. This is your chance to see how your salary, credentials, and role stack up against your peers nationwide. The...
Beginning January 1, 2027, services for antepartum care, labor management, delivery and postpartum will be coded separately. The old global approach to billing obstetric care was intended to simplify billing, but it no longer reflects the variation and complexity of care across the phases of pregnancy.
Expiring eviction moratoriums were associated with an increase in outpatient visits for serious mental illness, according to a study published in JAMA Health Forum.
Hospitals are mandated to separately bill HCPCS Level II codes. This longstanding guidance was recently reiterated by two Medicare Administrative Contractors who have published articles on their websites about this specific instruction.
In May 2026, outpatient volumes declined significantly month-over-month and year-over-year in comparison to inpatient admissions, according to a report by Strata Decision Technology. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: What are some red flags associated with modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) that might trigger payer audits?
Accurately telling the patient’s story requires a thorough review of the entire medical record to identify all conditions that were addressed during the encounter, whether directly or indirectly, by the provider.
AI is no longer a distant concept in medical coding and health information management; it is already part of daily work. For many professionals, daily encounters with AI bring a mix of curiosity, caution, and concern.
The redesign of ICD-11 allows for continuous updates, interoperative compatibility with other electronic systems, improved coordination with related terminologies, and a reduced need for post-production clinical modifications. With these changes in mind, Nancy Reading, BS, CPC, CPC-P, CPC-I, explores how this new framework supports significant enhancements to the classification of diagnoses that is built around stem and extension codes and its ability to cluster post-coordinated codes to describe a single condition.
You’ll select a modifier and receive a pay boost, one that’s amplified for eligible accountable care organization participants, if CMS goes through its plan to replace patient trust code G2211 with two modifiers.
AI is no longer a distant concept in medical coding and health information management; it is already part of daily work. For many professionals, daily encounters with AI bring a mix of curiosity, caution, and concern.
Train your coding and clinical teams to think like an auditor before you report modifier -25. Improper payments associated with the modifier have triggered more audits and a variety of attempts to detect and recoup improper payments or stop payments from being issued in the first place.
