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Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
July 2026 NCCI Edits and HCPCS Update: What to Load Before Your Next Claim Run
The third-quarter code update took effect July 1, 2026: a new HCPCS Level II file, practitioner NCCI edits version 322 and the Q3 add-on code edits. Here is what changed in the cycle, where each file lives, and the order in which we load and test them.
FY 2027 ICD-10-CM Update: 190 New Codes Take Effect October 1, 2026
The FY 2027 ICD-10-CM files are posted: 190 new billable codes, 4 revised, and about 30 that lose billable status, effective for dates of service on or after October 1, 2026. Here is what changed by specialty, the codes most practices will actually use, and the September checklist for your EHR and payer edits.
Run Your Coding Audit Now, Before the October 1, 2026 Diagnosis Code Update
A coding audit in June gives you three months to fix habits before the FY 2027 ICD-10-CM codes take effect on October 1. Here is the sample design we use, the six error types that account for most findings, a worked scoring example, how to read an E/M level distribution, and what to do with the results.
Skin Lesion Removal Coding in Primary Care: Excision, Destruction and Pathology
Skin lesion removal coding turns on three decisions: excision or destruction, the measured size including margins, and what pathology says. Here is how to pick the code family, measure before the cut, hold the claim for the path report and avoid the denials that follow a wrong diagnosis code.
How to Run an E/M Distribution Analysis by Provider and Read the Bell Curve
An E/M distribution analysis shows how each provider spreads office visits across 99212 to 99215 and how that compares to peers. Here is how to pull the report, what a normal curve looks like after the 2021 rules, and what an outlier pattern usually means when we open the notes.
NCCI Edits for July 1, 2026 Are Posted: 2,199 New Pairs and How to Load Them
CMS posted the July 1, 2026 NCCI procedure-to-procedure files on June 1. Version 322 adds 2,199 edit pairs and deletes 708. Here is how we read the quarterly change files, load them into the scrubber, and find the pairs that will hit your own top codes before the first July claim run.
Coding Hypertension With Heart and Kidney Disease: I10 to I13 and Sequencing
Hypertension is the most common diagnosis in primary care and one of the most often miscoded once the heart or kidneys are involved. We explain coding hypertension with heart and kidney disease: when I10 is wrong, how I11, I12 and I13 work, the presumed causal link and the N18 and I50 codes that must follow.
How a CPT Code Gets Made: The May 2026 Panel Meeting and the CPT 2028 Cycle
The AMA posted the summary of actions from the May 2026 CPT Editorial Panel meeting on May 15, the second of three meetings that will shape the 2028 code set. We explain how the CPT code process works, what the summary tells a practice, why it takes two years, and what to watch between now and January 2028.
Well-Child Visit Coding: 99381 to 99395, Same-Day Vaccines and Modifier 25
Well-child visit coding looks simple until a vaccine, a screening and an ear infection land in the same appointment. We walk through the 99381 to 99395 age bands, the Z00.1 diagnosis choices, 90460 versus 90471, the screening add-ons and the modifier 25 decision, with a worked example.
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