CMS Plans $1 Billion in Lab Fee Schedule Cuts for 2027 and What It Means for Your Practice
Quick Answers As of September 2026, CMS has announced plans to better align the 2027 Clinical Laboratory Fee Schedule (CLFS) rates with private sector payment
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Discover practical guidance and useful insights on managing medical billing efficiently with our collection of tips and advice.
Charge Entry in Medical Billing: The Complete Guide
Discover the critical role of charge entry in medical billing, how it impacts healthcare revenue, and best practices for accuracy and efficiency.
September 2026 Payer Reimbursement Changes Every Practice Needs to Know
Quick Answers As of September 2026, at least six major payer reimbursement policy changes took effect across UnitedHealthcare, Aetna, Blue Cross Blue Shield of Michigan,
CPT Code 99417: Prolonged Outpatient E/M Services Billing Guide for 2026
Quick Answers CPT code 99417 is an add-on code for prolonged outpatient evaluation and management services. It is reported in 15-minute increments when a provider
CMS Bars 11 Companies in $3.4 Billion Medicare Billing Fraud Crackdown
Quick Answers As of September 2026, the Centers for Medicare and Medicaid Services (CMS) has barred 11 durable medical equipment (DMEPOS) suppliers from receiving future
FY 2027 ICD-10-CM Code Changes: What Every Practice Must Update Before October 1, 2026
Quick Answers As of October 1, 2026, the FY 2027 ICD-10-CM code update adds 238 new diagnosis codes and deletes 21 existing codes from the
PR-1 Denial Code in Medical Billing: The Complete 2026 Guide
Quick Answers The PR-1 denial code is a patient responsibility adjustment with the description “Deductible Amount,” meaning the payer processed the claim, applied the allowed
CMS Prior Authorization Changes for 2027: What Your Practice Must Do Before January
Quick Answers As of August 2026, the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) requires impacted payers to implement FHIR-based prior authorization APIs by
CO-29 Denial Code in Medical Billing: Timely Filing Limits, Appeals, and Prevention
Quick Answers The CO-29 denial code means the payer denied the claim because it was not submitted within the timely filing window allowed by the
The CPT Copyright Lawsuit: What It Means for Medical Billing in 2026
What Is the CPT Copyright Lawsuit and Why Does It Matter for Medical Billing? As of August 2026, a nonprofit organization called PatientRightsAdvocate.org has filed