CMS is preparing to conduct the Outpatient Prospective Payment System (OPPS) Drug Acquisition Cost Survey (ODACS) to collect specific acquisition costs for outpatient drugs and biologicals purchased by hospitals paid under the OPPS.
This week’s Medicare updates include a fact sheet on the final LCDs for certain skin substitutes, a correction notice regarding the 2026 Inpatient Rehabilitation Prospective Payment System final rule, and more!
You’ll have to wait a while longer for National Correct Coding Initiative edits for 2026-effective codes. However, the latest quarterly NCCI update will include new medically unlikely edits for a variety of HCPCS codes that went into effect in July and October 2025.
Our experts answer questions about emergency transport services, the medical necessity requirements for epidurals to treat chronic pain, and medication noncompliance vs. underdosing.
Q: What considerations should coders keep in mind when referring to problem lists for determining the principal diagnosis and proper sequencing of all documented conditions in the inpatient setting?
In the ever-evolving world of healthcare coding, staying grounded in the fundamentals is not just best practice, it’s a necessity. As regulations shift, payer expectations tighten, and productivity pressures mount, coding professionals must continually revisit the core principles that ensure accuracy, compliance, and integrity in clinical documentation and billing.
