Articles

Savista Acquires ABW Medical, Expanding Ambulatory Revenue Cycle Management Across 49 States

On August 27, 2026, Savista, a premier healthcare operations firm with over 35 years of revenue cycle management (R

In a defining moment for the future of telehealth and medical coding and billing, over 200 healthcare stakeholders have formally p…

Penguin Ai Brings Autonomous Medical Coding and RCM to AWS Marketplace to Combat Claim Denials

PALO ALTO, Calif. — In a major leap for revenue cycle management automation, healthcare-native artificial intelligence company Pen…

As the healthcare industry gears up for the fourth quarter, the Centers for Medicare & Medicaid Services (CMS) has published a sle…

CMS Releases October 2026 HCPCS Update: New SNF Consolidated Billing Rules for Angiography & Lymphatic Services

The Centers for Medicare & Medicaid Services (CMS) [1.1.

** $380 Million Oversight: How Conflicting CMS Guidance Led to Massive Medicare Overpayments for Organ Acquisition

In early September 2026, the Department of Health and Human Services Office of Inspector General

The countdown to October has officially begun for healthcare revenue cycle teams. The Centers for Medicare & Medicaid

HHS Secretary RFK Jr. Targets AMA's $300M CPT Code Monopoly: What It Means for Medical Billing

On August 27, 2026, Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. released a video urging Americans to challenge…

ASCA Formally Urges CMS to Eliminate the ASC Weight Scalar in the 2027 Payment Rule Amid Threat of Severe Reimbursement Cuts

The Ambulatory Surgery Center Association (ASCA) is sounding the alarm over the Centers for

Medical coders, billers, and revenue cycle managers can finally breathe a sigh of relief. On Tuesday, September 1, 2026, UnitedHea…

Monogram Health Inks $2.4M Settlement Over Medicare Advantage Upcoding and False Diagnosis Codes

On August 24, 2026, the U.S. Department of Justice (DOJ) announced that Tennessee-based in

Half a Billion Dollar Diagnosis: The Villages Health System Agrees to $541.5M Settlement Over Medicare Advantage Coding Scheme

The tranquil golf cart paths of central Florida's massive retirement community are the backdrop for one of the most

The Centers for Medicare & Medicaid Services (CMS) is moving to close the final

AMA Accelerates Innovation: CPT Category III Early Release Schedule Expands to Three Updates Annually August 31, 2

Arintra Secures $25M Series B to Revolutionize Autonomous Medical Coding and Revenue Assurance

San Francisco, CA — The U.S. healthcare system is a $5 trillion enterprise, yet health systems and provider groups consistently he…

Waystar Unveils Agentic AI to Autonomously Resolve Denied Claims and Transform the Revenue Cycle

Healthcare providers have long battled the staggering administrative waste and lost revenue associated with denied medical claims.…

CMS Deploys AI to Crush $1.6 Billion in Medicare Lab Fraud and Up-Coded Claims

WASHINGTON, D.C. — In a massive crackdown on medical billing fraud, the Centers for Medicare & Medicaid Services (CMS) announced o…

AHA Formally Urges CMS to Abandon 2027 OPPS Clawbacks and 340B Cuts: What It Means for Medical Billing

The American Hospital Association (AHA) is pushing back fiercely against the Centers

For healthcare organizations, the gap between clinical documentation and revenue cycle management has long been a source of admini…

CMS Shakes Up SDOH Billing: Z-Code Downgrades and Mandatory Reporting Set to Impact 2027 IPPS Reimbursement

The Centers for Medicare & Medicaid Services (CMS) has officially finalized the Fiscal Year (FY) 2027 Inpatient Prospective Paymen…

AAPC Launches Codie™: The New AI-Powered Assistant Redefining Medical Coding

The medical coding and billing landscape is undergoing a massive technological shift. On August 25, 2026, AAPC—the healthcare indu…

The landscape of medical coding and billing for maternal health is about to undergo its most significant transformation in over th…

CMS Proposes Retroactive Medicare Enrollment Revocations and Expanded Private Equity Disclosures in 2027 Rule Update

As the August 31, 2026, public comment deadline approaches, medical coders, billers, and healthcare administrators are raising ala…

OIG Exposes Ongoing Medicare DME Fraud Vulnerabilities: CMS Deploys FDOC to Suspend Suspect Claims

The federal government is intensifying its crackdown on healthcare fraud, and a newly released white paper from the Department of…

(August 23, 2026) — At its 2026 Users Group Meeting (UGM) in Verona,

AMA Sounds the Alarm: CMS Proposed 50% Cut to Modifier 25 E/M Visits Threatens Independent Practices

The medical billing and coding community is bracing for what could be one of the most disruptive regulatory shifts in

Medical coding and billing have always been the financial lifeblood of the American healthcare

CMS Launches ACCESS Payment Model: New HCPCS Co-Management Codes for Tech-Supported Chronic Care

The medical billing and coding landscape is undergoing a massive shift this summer. On July 5, 2026, the Centers for Medicare & Me…

In an era where healthcare systems are battling shrinking margins and severe staffing shortages, administrative waste remains a mu…

When the Centers for Medicare & Medicaid Services (CMS) [1] implemented the Maximum Fair Prices (MFPs) for

AMA Applauds CMS for Cracking Down on Hidden Medicare Advantage Prior Authorization Rules

In the complex world of medical coding and billing, precision is everything. Whether a billing specialist is assigning ICD-10-CM c…

CMS Eliminates Alternative NTAP Pathway for FDA Breakthrough Devices in Fiscal 2027 Rule: What It Means for Medical Coders

The Centers for Medicare & Medicaid Services (CMS) has officially published its Fiscal Year

Medical coders and billing managers are accustomed to hunting down missing documentation and fighting claim denials, but

The Affordable Care Act (ACA) marketplace is bracing for a

CMS Cracks Down on Medicare Advantage Plans Hiding Prior Auth Rules Behind 832-Page Code Walls

The Centers for Medicare & Medicaid Services (CMS) is moving to close glaring loopholes in prior authorization transparency follow…

CMS Grants Milestone NTAP Reimbursement for Aidoc's CARE Multi-Triage CT Body AI

NEW YORK — In a landmark decision for healthcare artificial intelligence and revenue cycle management, the Centers for Medicare &…

CMS Unveils RAPID Pathway: A Game-Changer for Breakthrough Device Coverage and Medical Billing

In a move set to reshape the landscape of healthcare innovation and revenue cycle management, the Centers for Medicare & Medicaid…

August 15, 2026 — As the healthcare landscape continues to evolve, staying on top of the latest

CMS Finalizes Rule Blocking Federal Medicaid & CHIP Funds for Pediatric Gender-Affirming Care: What Billers and Coders Need to Know

On August 11, 2026, the Centers for Medicare & Medicaid Services (CMS) finalized a

Paywalled Healthcare: Why PatientRightsAdvocate.org is Suing the AMA Over CPT Codes

On August 13, 2026, the non-profit transparency group PatientRightsAdvocate.org (PRA) filed a landmark

The world of medical coding rarely stands still, and for emergency department (ED) coders, the landscape is about to shift once ag…

Imagine a patient repeatedly admitted to the hospital for diabetic ketoacidosis. The clinical diagnosis is clear, and the treatmen…

The human digestive tract is a complex, winding labyrinth—and for medical coders and billers, the journey through it can be just a…

The landscape of medical coding and billing is in a constant state of evolution. Following the massive overhauls to Evaluation and…

The pandemic may have faded from the daily headlines, but for millions of patients—and the medical coders who document their care—…

In an era where healthcare practices are constantly battling declining reimbursements and rising operational costs, medical biller…

The traditional waiting room is rapidly being replaced by the living room. As healthcare pivots toward proactive, continuous care,…

The world of medical coding and billing moves at breakneck speed. Between mastering the annual updates to the ICD-10-CM guidelines…

The landscape of modern medicine is nothing short of miraculous. From monoclonal antibodies that halt the progression of autoimmun…

The shift toward outpatient care has transformed Ambulatory Surgery Centers (ASCs) into the bustling hubs of the modern healthcare…

It is a scenario every healthcare provider knows all too well. The physician has just wrapped up a routine annual physical. The ch…

For decades, the medical coding and billing industry operated on a relatively straightforward premise: providers performed a servi…

For medical coders and billers, the transition from ICD-9 to ICD-10 was a seismic event. It expanded the diagnostic code set from…

The demand for mental health services has skyrocketed over the past decade, transforming the landscape of behavioral health. But f…

Dermatology practices process thousands of skin-related procedures every year, yet revenue leaks remain a persistent industry head…

Every healthcare administrator knows the creeping dread of watching Days in Accounts Receivable (A/R) climb. When claims languish…

The era of traditional fee-for-service reimbursement in orthopedics is rapidly shrinking in the rearview mirror. In its place, val…

In the high-stakes world of medical billing and coding, few diagnoses trigger as much clinical urgency—and auditor scrutiny—as sep…

Cardiology coding is often viewed as the Everest of medical billing. Between the intricate anatomy of the cardiovascular system an…

The journey of motherhood is a profound, complex, and deeply personal experience. But behind the ultrasound images and heartbeat m…

The prevalence of diabetes in the United States is staggering, with the CDC reporting that over 38 million Americans are living wi…

In the fast-paced world of neurology, the clinical mantra is "time is brain." But in the revenue cycle management department, the…

The aging demographic in the United States is driving a significant surge in urological care, placing Benign Prostatic Hyperplasia…

Cataract surgery is one of the most frequently performed surgical procedures in the world. For ophthalmology practices, it represe…

In the rapidly evolving landscape of healthcare revenue cycle management, few specialties demand as much precision as oncology. Fo…

For patients struggling with severe obesity, bariatric surgery is often a life-altering, and sometimes life-saving, intervention.…

Children are not just miniature adults—and any medical coder or biller who works in pediatrics will be the first to tell you that.…

Medical billing in the field of nephrology is a complex ecosystem of eGFR scores, systemic comorbidities, and strict payer guideli…

Wound care is a medical specialty defined by patience, precision, and profound clinical expertise. Yet, for many wound care clinic…

The healthcare industry has just been dealt a staggering blow. Unlimited Technology Systems, a prominent third-party vendor that m…

Orthopedic surgery is a high-stakes, high-revenue specialty. From complex joint replacements to intricate arthroscopic repairs, th…

The digital health revolution has permanently altered the landscape of modern medicine. What began as a pandemic-era necessity has…

By The Medical Billing & Coding Chronicle | Industry Insights Radiology coding is rarely as black and white as the images on a lig…

The landscape of medical coding and billing is notoriously complex, but few areas require as much multidisciplinary precision as h…

For most medical specialties, medical coding is a straightforward translation: a provider performs a procedure, a coder assigns a…

If there is one two-digit code that keeps medical billers, coders, and practice managers awake at night, it is Modifier 25. Define…

If there is one universal truth in medical coding, it’s that the smallest detail can trigger the biggest revenue drain. For rehabi…

The healthcare industry is experiencing a massive surge in demand for certified medical coders, making the AAPC’s Certified Profes…

Stepping into the world of medical coding and billing can feel like learning a new language. With tens of thousands of diagnostic…

The gap between a healthy revenue cycle and a nightmare of claim denials usually comes down to one thing: documentation. As a medi…

The financial health of a medical practice hinges on a delicate, alphanumeric thread: accurate medical coding. As insurance payers…