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Quarterly code edits are out: Navigate new NCCI updates

03/16/2026

Take an early look at the latest updates to the National Correct Coding Initiative (NCCI) procedure-to-procedure (PTP) and medically unlikely edits (MUE), which go into effect April 1, 2026. You’ll find more than 3,750 new PTP code pairs bundled together, placing restrictions on billing eligibility.

CMS rolls out first MUEs for new CPT codes, effective April 1

03/16/2026

by: Julia Kyles, CPC and Laura Evans, CPC

Prepare your staff for the first batch of medically unlikely edits (MUE) for CPT codes that went into effect Jan. 1, 2026. The new edits go into effect April 1. The latest National Correct Coding Initiative (NCCI) update contains MUEs for many, but not all, of the new CPT codes. For example, edits for new remote physiologic and therapeutic monitoring codes are not included in the update.

Tax time approaches; check your practice-friendly deductions

03/16/2026

by: Roy Edroso

As the calendar approaches April 15, it’s a good idea for both physicians and owners of the practices they serve to review the tax topics that tend to apply to them

Track telehealth, remote monitoring updates for CY 2026

03/16/2026

by: HCPro staff

Take note of recent updates to CMS’ MLN Booklet on telehealth and remote monitoring requirements. The guidance now includes key policy changes and payment updates in the final 2026 Medicare physician fee schedule.

There’s more to high risk than the examples in the E/M guidelines

03/16/2026

by: Julia Kyles, CPC

Question: For the purposes of E/M coding, does intravenous (IV) contrast for diagnostic imaging fit the definition of “Drug therapy requiring intensive monitoring for toxicity” under the high-risk section of the medical decision-making (MDM) table’s “Risk of complications and/or morbidity or mortality of patient management”?

How to report multiple sclerosis medication administration

03/16/2026

by: HCPro staff

Question: How do you code medication administration for a patient with multiple sclerosis?

Neuro, psych test codes continue utilization rise, denial rates steady

03/16/2026

by: Roy Edroso

A utilization jump for several primary psychological, neuropsychological and neurobehavioral testing codes that began in 2019 continued in 2024, the latest year of available Medicare numbers. Even the runt of the litter — a seldom-claimed test code plagued by high denial rates (96146) — saw a usage boost.

Do you need AI policy? Experts suggest guardrails as ‘shadow AI’ spreads

03/09/2026

by: Roy Edroso

https://pbn.decisionhealth.com/Articles/Detail.aspx?id=550145A recent survey suggests that more physicians are using AI than previously thought, including for clinical decision support. It also suggests that physician management isn’t keeping pace — and that practices should be setting guardrails and policies if they aren’t already.

Train staff to report new immunization counseling codes, stick to E/M for Medicare

03/09/2026

by: Julia Kyles, CPC

Instruct your team to track the commercial plans that cover the new immunization counseling codes and share tips on how to credit the work of counseling Medicare patients when a patient opts not to receive a vaccine.

Build provider education that sticks: Strategies for documentation success

03/09/2026

by: Tatyana C. Mallory, MBA, RHIA

Accurate provider documentation is the foundation of compliant coding, appropriate reimbursement and defensible claims. Yet, in a rapidly changing health care landscape, even highly skilled clinicians can find it difficult to stay current with evolving E/M criteria, CPT updates and ICD-10-CM coding specificity.

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