Category Archives: Coding

Orthopedic billing in 2026 reflects some of the most meaningful coding shifts in recent years. While total joint arthroplasty and fracture care remain core revenue drivers, the expansion of short-duration Remote Therapeutic Monitoring (RTM), refined sacroiliac joint fusion reporting, and new intramedullary limb-lengthening codes require immediate operational adjustments. If your team is relying on last …

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Dialysis billing in 2026 reflects two major financial shifts: a positive adjustment to the ESRD Prospective Payment System (PPS) base rate and the permanent adoption of virtual direct supervision. At the same time, physician services remain subject to the -2.5% efficiency adjustment applied across much of the Medicare Physician Fee Schedule. These layered changes affect …

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Pathology billing in 2026 reflects a major shift toward precision reporting, artificial intelligence integration, and genome-wide molecular diagnostics. Advances in digital slide analytics, Optical Genome Mapping (OGM), and expanded Proprietary Laboratory Analyses (PLA) codes have created new CPT® pathways that replace older bundled or unlisted reporting methods. If your pathology team is still relying on …

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Hospitalist billing in 2026 reflects a major shift: simplified code structures on the surface, paired with heightened documentation scrutiny behind the scenes. Hospitalists manage admissions, daily rounds, critical care, and discharge planning in some of the most complex clinical environments in medicine. As CMS refines expectations around split/shared services, discharge time, drug waste reporting, and …

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Urgent care billing operates at high speed and high volume—often combining E/M services, in-office procedures, respiratory testing, injections, and short-term follow-up monitoring in a single encounter. That complexity makes documentation precision and correct CPT® reporting essential in 2026. With updated commercial bundling rules, remote monitoring changes, modifier enforcement, and increased payer scrutiny around social determinants …

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Endocrinology billing in 2026 is defined by remote monitoring expansion, stricter documentation requirements, new ICD-10 specificity, and targeted reimbursement adjustments. From continuous glucose monitoring (CGM) to short-duration RPM codes and modifier enforcement, small compliance gaps can now create measurable revenue loss. If your team hasn’t fully adapted to the 2026 updates, denials and underpayments are …

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Podiatry billing in 2026 requires more precision than ever. From routine foot care audits to total ankle replacement revisions and major HCPCS restructuring for skin substitutes, podiatry practices are facing a year defined by specificity, documentation scrutiny, and payer enforcement. If your team is relying on last year’s workflows, small compliance gaps could quickly turn …

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Ophthalmology billing spans routine eye exams, high-volume cataract surgery, retinal injections, laser procedures, and advanced diagnostic imaging—often across multiple sites of service. In 2026, reimbursement shifts, drug modifier enforcement, and new diagnostic code distinctions directly affect ophthalmology revenue. If your team is relying on last year’s coding assumptions, you may already be experiencing preventable denials …

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Oncology billing spans complex consultations, chemotherapy administration, immunotherapy, radiation therapy, infusion services, drug wastage reporting, and high-cost treatment delivery. In 2026, oncology faces one of the most significant CPT® restructures in years—particularly in radiation oncology and supportive chemotherapy care. Using the correct Oncology CPT® codes and modifiers for 2026 is essential to prevent denials, protect …

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Sleep medicine billing spans high-cost in-lab diagnostics, home sleep apnea testing, remote physiologic monitoring, and advanced interventional procedures like hypoglossal nerve stimulation (HGNS). With multiple reimbursement shifts, stricter documentation expectations, and upcoming code deletions, 2026 is a pivotal year for sleep centers. If your team is still using last year’s workflows, you may already be …

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