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10/13/2025
Like previous federal government shutdowns, the one that ensued when Congress failed to produce a continuing resolution (CR) on the budget by Oct. 1 has implications for providers. You should reduce the chances of harm by planning to address them now.
10/13/2025
A new draft local coverage determination (LCD) reminds practices to keep an eye on their Medicare administrative contractor’s (MAC) LCD activity. Based on the proposed LCD and several existing uniform LCDs for pain management, when MACs team up, the new policy is always stricter than the LCD it will replace.
10/13/2025
Practices in 76% of the U.S. will be subject to a new, strict local coverage determination (LCD) for chronic pain treatments if five Medicare administrative contractors implement a proposed LCD. 
10/13/2025
Don’t miss updated coding guidance that can be found in CMS’ Medicare preventive services educational tool for several services.
10/13/2025
Chronic conditions are among the most frequently encountered diagnoses in the outpatient setting. Accurately coding these conditions is critical not only for proper reimbursement but also for compliance, quality reporting and patient care continuity.
10/13/2025
Pay attention to your same-day E/M claims when reporting modifier 25 (Significant, separately identifiable E/M service). Denial rates climbed across the board on the codes most frequently billed with the E/M modifier.

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