This week’s Medicare updates include the 2025 fourth quarter NCCI edit files, provider education instructions concerning prior authorization for certain ASC services, and more!
Machine learning (ML) has evolved beyond its status as a technological trend to become an indispensable asset in outpatient surgical risk stratification. Within the domains of medical coding and claims adjudication, coding professionals play a pivotal role in optimizing ML model performance.
Make sure your providers are showing the mental work that goes into evaluating the risk associated with a medication before you count it toward the risk element of an E/M visit that is coded based on medical decision-making.
