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Coding

Coding

Workplace bullying

Why Your POS Code 22 Billing Is Getting Denied and What to Do

When you submit claims, small details like Place of Service (POS) codes can make or break your reimbursement. POS codes tell payers exactly where care was provided—and they use that information to determine how much you get paid and whether your claim is even valid. If you get it wrong, you risk denials, delays, audits, […]
Published Date: April 16, 2026
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E/M downcoding

Stop Losing Thousands: How E/M Downcoding Is Draining Your Practice Revenue in 2026

If your practice feels like it’s working harder but getting paid less, you’re not imagining it. Between Medicare fee schedule cuts, rising overhead, staffing shortages, and increased payer scrutiny, margins are tighter than ever in 2026. Even well-run practices with compliant billing processes are seeing unexplained revenue shortfalls month after month. One of the biggest […]
Published Date: February 18, 2026
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Evaluation and Management

What Your Practice Must Do Now to Get Paid for 99470, 99445, and RPM Services

The 2026 CPT code changes are no longer theoretical—they took effect January 1, 2026, and Medicare is already paying (or denying) claims based on them. If your billing team hasn’t updated workflows, documentation habits, and coding logic, your practice is likely missing reimbursement or triggering denials. These changes directly affect how Medicare recognizes physician time, […]
Published Date: January 28, 2026
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Conversion factor

How to Navigate Two Conversion Factor Options in 2026

When CMS released the 2026 Fee Schedule Final Rule in November, medical practices were surprised to see that it included not one conversion factor, but two. Read on to discover how to determine which conversion factor will apply to you. Most Practices Will See a Conversion Factor of $33.40 The majority of medical practices will […]
Published Date: December 18, 2025
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2026 HCPCS

Get to Know Over a Dozen New Jan. 2026 HCPCS Codes

If your practice provides epinephrine, esketamine nasal spray, testosterone pellets or a wide range of other drugs or supplies, you may have new options for reporting these products starting in January, thanks to adjustments to the 2026 HCPCS code set. Read on to discover which 2026 HCPCS codes may impact your practice in the new […]
Published Date: December 12, 2025
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Iron Out Vaccination Codes With New CPT 2026 Options

When CPT 2026 debuted last month, it was easy for many practices to get confused about the new coding options. This was particularly true for practices that perform a lot of vaccinations, since CPT rolled out quite a few new codes that apply to immunization services. If your practice performs inoculations, now’s the time to […]
Published Date: December 3, 2025
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Aetna Softens New Medicare Advantage Downcoding Policy

Another day, another downcoding policy to grapple with. And while that’s unfortunately the reality in today’s healthcare world, the latest news from Aetna isn’t all bad. The payer has issued a new downcoding policy, but swiftly relaxed it and pushed back the implementation date. Check out the essentials you must know to prepare for Aetna’s […]
Published Date: November 26, 2025
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Telehealth Flexibilities Extended Through Jan. 30, 2026

When the Medicare telehealth flexibilities expired on October 1, most Medicare administrative contractors (MACs) held back on processing telehealth claims since it was unclear whether the waivers would be extended. Fortunately, when the government shutdown ended on November 13, telehealth claims were once again payable — but not for long. Keep reading to discover more […]
Published Date: November 20, 2025
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Expect 5 New Remote Therapeutic Monitoring Codes Jan. 1

Practices that perform remote therapeutic monitoring (RTM) will have the opportunity to collect for these services even if patients aren’t monitored for a full 30 days, thanks to CPT 2026. Five new codes will represent shorter time periods than in the past, and they go into effect on January 1st. Check out a few remote […]
Published Date: November 18, 2025
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