Cardiology coding in 2026 is undergoing sweeping changes, with new ICD-10 and CPT updates transforming how services are documented, billed, and justified. These shifts span from E/M reporting changes ...

Medical coders often walk a fine line between meeting employer demands and upholding ethical standards. When pressured to miscode for higher reimbursement, the stakes include legal risk, professional ...

Blue Cross Blue Shield of Massachusetts is expanding its claims review process to address what it is describing as potential overcoding among physicians who routinely bill for high-complexity visits.

Here are five notable developments from Cigna over the last month: 1. The Cigna Group has named Eva Borden as chief product officer for its commercial insurance business. Ms. Borden, who joined Cigna ...

A startup called Empromptu Inc. is looking to deliver where all other artificial intelligence-based application building tools have failed. It’s launching what it says is the first platform of its ...

In the U.S. healthcare industry, claim denials are a significant issue, costing healthcare providers billions of dollars every year. it’s estimated that denied claims amount to astounding $250 billion ...

Although Recovery Audit Contractors (RACs) are not currently evaluating facility evaluation and management (E&M) services, it may not be long before they do. In the 2010 final rule for the hospital ...

The practice of medicine, as a business, is a challenging model. You have minimal control over your prices, no ability to negotiate with your biggest payers (the governmental ones, that is), and ...