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Physician associate E/M claims are up, buoyed by high-level codes

04/06/2026

After several years of decline, E/M office visit utilization increased across the board in 2024, and claims submitted by physician associates (formerly known as physician assistants) not only kept pace with the rate of recovery but exceeded it.

HHS issues warnings on info blocking; make sure you’re ready

03/30/2026

by: Roy Edroso

Some recent hints from an HHS official underline what’s been known for a while: That the federal government is about to step up enforcement of its information blocking rules. Make sure you have the basics in place before it happens.

Distribute the new ICD-10-CM guidelines, take note of hypertension guidelines

03/30/2026

by: Julia Kyles, CPC

Share the new ICD-10-CM guidelines with staff before the guidelines’ April 1 effective date. In particular, you should point out the revisions to the subsection on hypertension in Chapter 9: Diseases of the circulatory system.

Plaintiffs, Congress seek to end $100K fee to bring new doctors from abroad

03/30/2026

by: Roy Edroso

A bill before Congress seeks to reverse an onerous fee placed on H-1B visas for foreign-born doctors. But its chances are uncertain, so if your practice relies on out-of-country providers, you may want to consider alternatives.

Modifier mastery: Known when to use modifier 50 vs. RT/LT

03/30/2026

by: DecisionHealth staff

Modifiers 50, RT and LT are laterality modifiers that clarify a CPT code by defining which side of the body the service was performed on. But knowing when to use them is not always immediately clear.

Providers zig left, zag right with HCPCS modifiers on injection, X-ray codes

03/30/2026

by: Richard Scott

No matter which laterality modifier medical practices opted for in their claims reporting, one trend stood out: the most-reported code appended with CPT modifier 50 (Bilateral procedure) and HCPCS modifiers LT (Left side) and RT (Right side) was arthrocentesis service 20610 (Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance).

Keep LER documentation, coding straightforward with Q&As

03/23/2026

by: Julia Kyles, CPC

The difference between straightforward and complex cases is now one of the main factors for coding lower endovascular revascularization (LER). Find out what attendees of the CPT & RBRVS 2026 Annual Symposium had questions about the new codes (37254-37299).

Drawing pushback, PA name change signals NPPs’ leap into advanced practice

03/23/2026

by: Roy Edroso

A burst of publicity around the nomenclature for PAs — physician associates, as these providers prefer, or physician assistants — is a minor but telling sign of the increase in their numbers and influence of non-physician providers. So is the pushback they’re getting in some quarters. But the state of health care in the U.S. suggests that PAs, as well as nurse practitioners (NP), will continue to advance.

Code chronic conditions accurately in outpatient settings

03/23/2026

by: Amanda Rubin, CPC, CRC

Chronic conditions are among the most frequently encountered diagnoses in the outpatient setting. Accurate coding of these conditions is critical not only for proper reimbursement but also for compliance, quality reporting and patient care continuity.

Botox injection denials hint at painful transition to uniform LCD

03/23/2026

by: Julia Kyles, CPC

Practices that bill botulinum toxin injections in 38 states should make sure they’re following the new uniform policy. Medicare administrative contractors (MAC) CGS Administrators, Palmetto GBA, National Government Services, Noridian and WPS implemented the local coverage determination (LCD), effective Feb. 22. It applies to the treatment of 19 conditions, including chemodenervation for blepharospasm, urinary incontinence and chronic migraine.

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