Significant updates to maternity care services coding are set to take effect with the release of CPT® 2027, causing considerable discussion among healthcare providers, coding professionals, and policy makers—including the...
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Deep RCM Vendor Partnerships: Unlocking Greater Collections and Efficiency
A recent industry report has spotlighted a significant trend in the healthcare revenue cycle management (RCM) landscape: providers leveraging multiple RCM modules from a single vendor are realizing tangible benefits...
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Top 10 Essential Value-Based Care Fundamentals for Medical Practices
Key Takeaways: V28’s code eliminations and coefficient reductions have significantly lowered RAF (Risk Adjustment Factor) scores, making insufficient documentation a costly oversight and compelling practices to meticulously “code to the...
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ICD-10-CM FY 2027 Code Updates
The Centers for Medicare and Medicaid Services (CMS) has unveiled the Fiscal Year 2027 ICD-10-CM update, introducing a sweeping set of changes that will significantly affect physician practices and medical...
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Trends in healthcare spending
In 2024, the landscape of healthcare spending in the United States underwent another significant shift, continuing a trend seen in recent years. Total health expenditures in the country rose by...
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A 2027 Medicare payment cliff is taking shape for medical practices
As the healthcare industry looks toward 2027, medical practices are encountering significant financial uncertainty. This is due to a temporary Medicare pay raise, a new efficiency adjustment, and stalled progress...
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FY 2027 ICD-10-CM Updates: 238 New Codes, 4 Revisions, and 21 Deletions
The ICD-10-CM code set update for Fiscal Year (FY) 2027 has been officially released on the Centers for Medicare & Medicaid Services (CMS) website. The annual ICD-10-CM 2027 Update introduces...
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No Surprises Act IDR rule 2026 with MGMA’s
Federal regulators have completed a long-anticipated update to the No Surprises Act’s Independent Dispute Resolution (IDR) process. The most significant change is the administrative fee to initiate a dispute, which...
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Status Integrity in Hospitals: What CDI and UR Teams Need to Know
Hospitals have spent years addressing medical necessity denials after claims are submitted. Traditionally, this has involved writing appeals, completing peer-to-peer reviews, discussing payer trends, and reviewing denial dashboards. However, the...
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HCPCS Level II code Changes to service and supply codes
On May 21, the Centers for Medicare & Medicaid Services (CMS) published the anticipated quarterly update to the HCPCS Level II code set. This update is significant as it introduces...
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