Emergency medicine (EM) has always been subject to payer scrutiny, but today’s reimbursement pressure is different: it is ...
Medical coding professionals are entering a pivotal moment in 2026 as the industry grapples with the April 1 ICD-10-CM guideline updates and the most extensive CPT changes in recent memory, featuring ...
The Compliance Clinic examines key Medicare, Medicaid, and government enforcement developments across the healthcare industry. Each edition focuses ...
Some limits on how the assessments are used for adding new diagnosis codes might be justified to ensure Medicare Advantage plans aren’t overpaid, researchers wrote. Under MA, insurers contract with ...
The main difference between MedPAC and CMS estimates of uncorrected coding intensity is that MedPAC’s estimate accounts for the upward trend in coding intensity. The growth of the Medicare Advantage ...
As of January 1, 2026, the medical coding landscape has undergone its most significant transformation in years, with the AMA releasing 418 CPT changes and CMS finalizing updated ICD-10-CM guidelines ...
Geisinger Health Plan in Danville, Pa., implemented automated coding technology from Talix to streamline risk adjustment processes. The application, Coding InSight, is designed to help professional ...
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