The newsletter outlines key differences between off-the-shelf (OTS), custom fitted, and custom fabricated knee orthoses, which dictate HCPCS coding and billing for these items. Physician and ...
This study examines the inconsistencies in prior authorizations across major insurers to create a searchable spreadsheet for HCPCS codes.
A new study finds that prior authorization requirements vary widely across major insurers and suggests large language models ...
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Medical Coding in 2026 Undergoes Major Shifts in CPT Additions and ICD-10 Structural Rules
In 2026, medical coding saw two defining changes: the addition of 288 CPT/HCPCS codes that formalize billing for emerging AI and digital health services, and an April ICD-10-CM update that overhauled ...
The Center for Medicare & Medicaid Services (CMS) issued the display copy of the final Calendar Year 2025 Physician Fee Schedule on November 1, 2024, which included three new Healthcare Common ...
Note: The words in the CPT description for codes 45383-45385 — “tumor (s), polyp (s), or other lesion (s)” — indicate that only one code may be assigned per colonoscopy. When the above procedures are ...
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