Category: Blog

ICD code updates

ICD-10-CM Code Updates: New, Revised & Deleted Codes You Need to Know

For the 2026 ICD-10-CM code updates, you’ll find 16 new “R” codes that offer greater detail for reporting pain and tenderness in the pelvic, perineal, subpubic, abdominal, and flank regions. The existing code R10.2- (Pelvic and perineal pain) will become a parent code. A notable addition is R11.16 (Cannabis hyperemesis syndrome (CHS)), specifically for nausea […]
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MIPS Penalties

MIPS Penalties Hit Small Practices Harder – RCM Solutions Key

When it comes to the Merit-based Incentive Payment System (MIPS), 2025 data reveals a striking disparity: small and rural medical practices were disproportionately penalized, facing significantly higher penalties than their larger, urban counterparts. While the vast majority of MIPS-eligible clinicians (86%) successfully avoided penalties this year, based on their 2023 data, those who did incur […]
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CPT 95165

CPT Code 95165: Reimbursement Updates for Allergen Immunotherapy

Allergen immunotherapy remains a cornerstone of treatment for many patients suffering from allergic conditions, offering long-term relief and potentially altering the course of disease. For allergy and immunology practices, CPT code 95165, which covers the professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, is a vital component of their […]
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Fixing EHR EMR Errors

Fixing EHR/EMR Errors: A Guide to Data Integrity & Patient Safety

In the digital age of healthcare, Electronic Health Records (EHRs) and Electronic Medical Records (EMRs) have revolutionized how patient information is stored, accessed, and shared. They promise greater efficiency, improved coordination of care, and enhanced patient safety. However, the reality is that errors within these systems are not uncommon, ranging from minor data entry mistakes […]
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Prior Authorization Automation

Can Automation Solve the Prior Authorization Problem in Healthcare?

In today’s healthcare ecosystem, prior authorization (PA) remains one of the most burdensome administrative processes, creating delays, denials, and dissatisfaction among providers and patients alike. Originally designed to ensure appropriate care and control costs, the process has become a major pain point due to its manual, repetitive, and inconsistent nature. But with the rise of […]
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patient billing information

Impact of Healthcare Data Breaches on Patient Billing Information

The healthcare industry, a repository of highly sensitive personal and financial data, has become a prime target for cybercriminals. Data breaches affecting patient billing information are particularly insidious, leading to not only privacy violations but also direct financial harm for both patients and healthcare organizations. These breaches can result in identity theft, insurance fraud, financial […]
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Five Common Medical Billing Myths Busted

Five Common Medical Billing Myths Busted

In the fast-paced and ever-evolving world of healthcare, medical billing services play a critical role in ensuring a provider’s financial health. Yet, despite its importance, medical billing is still surrounded by several misconceptions that lead to inefficiencies, revenue loss, and administrative burnout. Whether you’re a physician, clinic manager, or revenue cycle professional, falling for these […]
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Medical coding strategies

Top Medical Coding Strategies to Maximize Reimbursements

The difference between a thriving medical facility and one struggling with cash flow often lies in the precision and strategic application of its coding processes. Maximizing reimbursements and strengthening financial health hinges on a proactive approach to medical coding – one that goes beyond simply assigning codes and delves into optimizing every facet of the […]
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failing on prior auth reform

Health Insurance Industry Is Failing on Prior Authorization Reform

In theory, prior authorization (PA) exists to ensure that healthcare services are medically necessary and cost-effective. But in practice, it has become a bureaucratic roadblock causing treatment delays, administrative overload, and provider burnout. Despite increasing pressure from physicians, hospitals, patient advocacy groups, and even bipartisan lawmakers, the health insurance industry failing on prior authorization reform […]
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