Part B News | Part B News

Wrap in 2026 ICD-10-CM updates for the flank, genetic disorders

02/09/2026

by: Nancy Reading, BS, CPC, CPC-P, CPC-I

The ICD-10-CM update for 2026 incorporated 487 new codes, revised 38 codes and deleted 28 codes. This included 213 new codes that incorporated the “flank” as an anatomic area related to injuries and 116 new codes for chronic non-pressure skin ulcers. These new codes went into effect October 1, 2025.

Cover Medicare documentation requirements for physical, occupational therapy

02/09/2026

by: DecisionHealth staff

Medicare pays for physical and occupational therapy services when the medical record and the information on the claim form accurately report covered therapy services. That means the documentation must be legible, relevant and sufficient to justify the services billed.

QHPs most likely to be involved in assistant-at-surgery claims

02/09/2026

by: Julia Kyles, CPC

A physician can serve as an assistant at surgery, but Medicare Part B claims data show that a qualified health care professional (QHP) is most likely to answer the call when the primary surgeon needs an extra pair of hands that are guided by advanced clinical training.

Shore up HIPAA Part 2 record-keeping as new rule looms

02/02/2026

by: Roy Edroso

Even if you’re not enrolled as a Part 2 program, you may have reason to study up on a new Part 2 privacy rule, for which the compliance deadline is fast approaching.

Worried about flu spread? Use masks, but check the law

02/02/2026

by: Roy Edroso

With flu spreading fast, it may be time to revisit your in-office masking policies and check for legal issues.

Will your risk analysis stand up to scrutiny? Map out a plan

02/02/2026

by: Dom Nicastro

The Office for Civil Rights (OCR) is clearly watching how organizations evaluate risk assessments, conduct vendor oversight and execute breach preparedness. The findings detailed in OCR’s recent settlement with Comstar LLC were not obscure legal nuances. Instead, they revealed a basic failure to conduct a thorough organization-wide risk analysis, a core expectation under the HIPAA Security Rule.

Use a checklist to prevent real-life virtual direct supervision mistakes

02/02/2026

by: Julia Kyles, CPC

Medicare’s new rule that allows virtual direct supervision gives your providers more flexibility and creates the potential to bill more services under incident-to rules.

Prolonged services E/M code gains favor as practices gain millions

02/02/2026

by: Richard Scott

In the four years since prolonged services code G2212 made its debut in 2021, practices have ramped up their use of the 15-minute add-on code, with claims surging 88% between 2021 and 2024.

Watch for E/M scrutiny with diagnostic X-rays, as denials rise

01/26/2026

by: Laura Evans, CPC

Some coders at this year’s Advanced Specialty Coding Virtual Summit reported increased denials for E/M visits billed at the same encounter as an X-ray. Practices should be watchful for these and challenge them when they occur, billing experts advise.

New CMMI model to award proposals on chronic conditions, ‘lifestyle’ interventions

01/26/2026

by: Roy Edroso

Up to 30 proposals will be accepted under a new $100 million Center for Medicare and Medicaid Innovation (CMMI) model. While details about the MAHA ELEVATE (Make America Healthy Again: Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence) model are scarce, early signs suggest that behavioral health providers, and those currently coordinating complex care, will have an advantage.

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