May 28, 2025
News & Insights

Learn how CMS plans to enhance its risk adjustment data validation auditing efforts for Medicare Advantage (MA) plans and recover overpayments.

May 21, 2025
News & Insights

CMS is seeking feedback on potential policy changes ahead of the third cycle of negotiations under the Medicare Drug Price Negotiation Program.

May 21, 2025
HIM Briefings

Learn how HIM professionals can leverage data related to social determinants of health (SDOH) to improve patient care and secure proper reimbursement.

May 21, 2025
Briefings on APCs

Even though Congress didn’t fully unleash telehealth services, instead extending the long-running telehealth waivers through September, making your telehealth services a permanent offering can improve your practice’s financial health.

April 30, 2025
News & Insights

Analyze CMS' recent coverage expansion for hepatitis B vaccines and their administration.

April 23, 2025
News & Insights

CMS recently issued a final rule detailing policy and technical changes to Medicare Advantage (MA) and Part D programs for contract year (CY) 2026. 

April 16, 2025
News & Insights

Analyze key provisions in the 2026 Inpatient Prospective Payment System (IPPS) proposed rule to understand potential updates to Medicare inpatient coding and billing.

April 9, 2025
News & Insights

Recent data shows that all improper payments for bacterial culture lab tests can be traced back to insufficient documentation. Review CMS' provider compliance tip to prevent denials. 

March 19, 2025
Briefings on APCs

Practices upped their use of modifier 59 (Distinct procedural service) in recent years, adding nearly 1 million 59-appended claims to the most frequently reported same-day procedural codes.

March 5, 2025
Briefings on APCs

On November 1, 2024, CMS released its final rule describing calendar year 2025 policies and rates for Medicare’s Outpatient Prospective Payment System and the final rule was published in the Federal Register. This article is a comprehensive overview of all the major highlights, allowing coders to stay informed about key updates and navigate the changes throughout the year. 

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