Most years, the physician fee schedule proposed rule is an incremental update a coding team notes and moves past. For orthopedics, the CY 2027 rule is not that. It takes direct aim at total joint replacement, at the office visit billed on the same day as a procedure, and at the global surgical package that … Read more
As cosmetic medicine, medical spas, concierge practices, and wellness clinics continue to grow, one misconception keeps resurfacing: “If I’m not billing insurance and the patient is here by choice—not because they’re sick—do I still have to document the visit?” The answer is yes. There is no single federal or state law that says, in those … Read more
Posterior column osteotomies performed during scoliosis correction frequently generate a coding question that is easy to answer incorrectly. When a surgeon removes lamina, ligamentum flavum, and portions of the facets to mobilize a rigid curve, the operative note can resemble a decompression. The controlling guidance in this area is the December 2021 CPT® Assistant, “Reviewing … Read more
Eligibility verification gets treated as a clerical box to check before a patient is roomed. In practice, it is the front-end decision point where a large share of preventable denials are quietly set in motion. By the time a claim rejects for “coverage terminated,” “service not covered,” or “no authorization on file,” the opportunity to … Read more
Feedback is one of those topics that most of us in healthcare have strong feelings about usually because we’ve been on the receiving end of it at some point, and not always in a way that left us feeling clear or empowered. I’ll be honest: I’ve received feedback that left me more confused than when … Read more
In healthcare, few environments move as quickly as trauma and urgent care settings. Patients arrive with a wide range of conditions from minor injuries and acute illnesses to life-threatening emergencies requiring immediate intervention. In these critical moments, success depends on more than clinical expertise alone. It requires seamless coordination, clear communication, and a well-prepared team … Read more
Z codes get dismissed as filler — the codes you reach for when there is no “real” diagnosis to report. In orthopedic coding that mindset is expensive. The Z code family carries the encounters that have no acute disease or injury to anchor them, the status of every implant and amputation a patient walks in … Read more
Physicians and coding professionals often face a difficult challenge when reporting services that lack a specific CPT® code. While the goal is always to secure appropriate reimbursement for medically necessary services, coding decisions must first be grounded in compliance. Unlisted procedure codes exist to bridge the gap when a service or procedure is not accurately … Read more
Men’s Health Month each June draws attention to a well-documented disparity in care-seeking behavior. Men are less likely than women to engage in routine preventive care, more likely to defer evaluation of symptoms, and consequently more likely to present with advanced disease. The clinical and financial consequences of that pattern are considerable. Prostate cancer illustrates … Read more
Workplace safety continues to be a critical part of protecting employee health, reducing preventable injuries, and creating safer work environments across every industry. From healthcare and construction to office settings and transportation, workplace injuries can have lasting physical, emotional, and financial impacts on employees and organizations alike. While many injuries are preventable, factors such as … Read more