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.
On October 31, 2025, CMS released the 2026 Medicare Physician Fee Schedule (MPFS) final rule, which includes implementing two separate conversion factors, updating telehealth services, and changing the payment policy for skin substitutes. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
A systematic review and meta-analysis published by JAMA Network Open suggests that outpatient follow-up within 30 days of discharge can be associated with reduced risk of readmission, but that association may vary due to risk factors, such as the patient’s age and disease.
Coders will find a fresh batch of CPT codes that they can begin reporting on January 1, 2026, with 288 new codes coming online. The code update, announced with the release of the 2026 CPT Manual, also includes 46 revised code descriptors and 84 deleted codes.
It’s been two weeks since the federal government shutdown began, as well as when Medicare telehealth waivers and flexibilities were set to expire. In a special edition of the MLN Connects newsletter released just as the shutdown began on October 1, 2025, CMS provided some guidance to providers. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
A review of 800 studies found that electrocardiogram interpretation assisted by artificial intelligence has the potential to improve diagnostic accuracy and enable earlier detection of cardiac conditions, particularly in resource-limited outpatient settings.
Q: In the 2026 ICD-10-CM update, in the neoplasm chapter there are some added specific codes for inflammatory neoplasm of the breast. How do those differ from other types of breast cancer?
The 2026 Medicare Physician Fee Schedule proposed rule includes significant potential changes to telehealth billing and coverage, conversion factor calculations, relative value unit weights based on site, skin substitutes, behavioral health, and more.
The ICD-10-CM update for 2026 included 213 new codes that incorporated the “flank” as an anatomic area related to injuries. Genetic diseases also continue to make big inroads into the tabular list of diagnoses.
Chronic conditions are among the most frequently encountered diagnoses in the outpatient setting. Accurate coding of these conditions is critical not only for proper reimbursement but also for compliance, quality reporting, and patient care continuity.
CMS recently updated its MLN Booklet for evaluation and management services with changes to the sections regarding office or outpatient E/M visits, critical care services, hospital outpatient clinic visits, and telehealth services.
The American Medical Association recently issued its 2026 CPT code set, which includes 288 new codes, 84 deletions, and 46 revisions. Review the changes to ensure proper procedure coding. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Skin substitutes continue to play a critical role in the treatment of chronic wounds, and there are more products available today than ever before. Although Medicare Administrative Contractors have slowly started to spell out their coverage criteria for skin substitute grafts used to treat certain conditions, progress has been slow.
Updated coding guidance can be found in CMS’ Medicare Preventive Services educational tool for several services. Review the changes to ensure proper coding of preventive services.
Changes are being made to the ICD-10-CM conventions, general guidelines, and chapter-specific guidelines for fiscal year 2026, which will be effective October 1, 2025. This article summarizes some of the changes coders need to be aware of.
Medicare coverage of mental health services has expanded in recent years. Along with authorizing payment for additional services and telehealth options, CMS has established several new provider types. Steps have been made to expand access to care, but many healthcare facilities are still working to establish a solid foundation in CPT coding for mental health services.
Q: The 2026 ICD-10-CM code update, effective October 1, 2025, has new codes for flank tenderness (R10.8A-) and flank pain (R10.A-). What's the difference between pain and tenderness?
