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Coding

Coding

2026 ICD-10

How the 2027 ICD-10 Update Could Impact Your Medical Practice Revenue

The FY 2027 ICD-10-CM update is one of the most significant coding changes physician practices have faced in recent years. Beginning October 1, 2026, medical practices must implement the updated code set, which includes 238 new code entries and 190 new billable codes. Practices that continue using deleted or invalid codes after the deadline risk […]
CMS Physician Fee Schedule

What the 2027 Medicare Physician Fee Schedule Means for Your Practice

Medicare reimbursement continues to be one of the biggest financial concerns facing physician practices. The proposed 2027 Medicare Physician Fee Schedule (PFS) signals continued reimbursement pressure, new quality reporting expectations, and ongoing uncertainty surrounding telehealth services. If your practice depends on Medicare revenue, now is the time to understand what these proposed changes could mean […]
Time-Based Coding

Master E/M Time-Based Coding: Next-Day Results & Multi-Day Encounters Explained for Your Practice

If you’re not fully capturing your provider time, you’re leaving revenue on the table—and increasing compliance risk. That means your documentation must reflect the total time you spend managing care, not just what happens in the exam room. When you apply time-based coding correctly, you can often justify higher-level codes—especially in complex cases. But here’s […]
Billing errors

E/M Coding Errors: The Compliance Risk of “Fixing” Codes Without Documentation

When you’re managing coding and billing, it’s tempting to “fix” a code before submission—especially when you know the visit could support a higher level. But making a silent edit (changing a code without provider documentation) puts your entire practice at risk. What feels like efficiency can quickly turn into a compliance violation. According to the […]
CPT Code Changes

Most Medical Practices Underuse ICD-10 Z Codes — Here’s Why That Matters

Most medical practices focus heavily on diagnosis coding, procedure coding, and claim submission accuracy. But many practices overlook one of the most important sections of ICD-10-CM: Z codes. These codes help document the real-world factors affecting your patients’ health, compliance risks, treatment outcomes, and healthcare costs. According to the Centers for Medicare & Medicaid Services […]
2026 HCPCS

39 New HCPCS Codes Are Coming: Is Your Practice Ready?

The Q3 2026 HCPCS Level II update is one of the most significant mid-year coding changes in recent years. With 39 new HCPCS Level II codes being introduced, your medical practice needs to act quickly to ensure coding accuracy, avoid claim denials, and protect reimbursement. These updates are more than administrative changes. They directly affect […]
Using modifier 25

Modifier 25 Errors That Are Costing Your Practice Thousands

If your practice is billing Evaluation and Management (E/​M) services alongside procedures, Modifier 25 can make or break your reimbursement. When used correctly, it ensures you get paid for the full scope of care you provide. When used incorrectly, it can trigger denials, audits, and lost revenue. Modifier 25 is one of the most scrutinized […]
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, […]
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 […]
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, […]