Part B News | Tool of the Month

CY 2026 work RVUs for new, revised and potentially misvalued codes

07/25/2025

You'll find a preview of more than 90 CPT codes that CMS plans to cover in 2026 inside the proposed 2026 Medicare physician fee schedule. While the codes themselves take a placeholder five-digit sequence, the full descriptors and work relative value units (RVU) are available, providing insight on the services soon to be and the monetary value placed on them.

NCCI update, April 1, 2025: PTP edits with short descriptors

03/27/2025

by: Julia Kyles, CPC

Help your staff prepare for the April 1, 2025, National Correct Coding Initiative update with the new, revised and deleted procedure-to-procedure (PTP) edits with short descriptors.

NCCI update, April 1, 2025: MUE edits with short descriptors

03/27/2025

by: Julia Kyles, CPC

Help your staff prepare for the April 1, 2025, National Correct Coding Initiative update with the new, revised and deleted medically unlikely edits (MUE) with short descriptors.

Active status physician fee schedule codes with an XXX global surgery indicator

01/20/2025

by: Julia Kyles, CPC

CMS updated the guidelines for reporting an E/M service on the same day as a procedure with an XXX global surgery indicator – global surgery concept does not apply – in the latest National Correct Coding Initiative (NCCI) Manual.

Train your team with the complete ICD-10-CM code set

08/05/2024

by: Julia Kyles, CPC

Prepare members of your treatment and coding teams for changes to the diagnosis code set that will go into effect Oct. 1, 2024. Download and share the Excel file that contains five spreadsheets.

Give providers an illustrated guide to the new SDOH risk assessment code

01/15/2024

by: Julia Kyles, CPC

Make sure your physicians and qualified health care professionals (QHP) are ready for their crucial role in reporting G0136 (Administration of a standardized, evidence-based Social Determinants of Health [SDOH] Risk Assessment tool, 5-15 minutes, not more often than every 6 months).

Cultivate Medicare prolonged service rule compliance with a decision tree

08/07/2023

by: Julia Kyles, CPC

Use this decision tree to illustrate Medicare’s rules for coding prolonged E/M services. Medicare created codes and rules for prolonged services performed by a physician or qualified health care professional (QHP) because it disagrees with portions of the CPT guidelines.

The Medical Practice Guide to Telehealth and Remote Patient Monitoring

06/26/2023

by: DecisionHealth Staff

CMS and other federal agencies have opened up telehealth coverage policies during the COVID-19 public health emergency (PHE), while a series of virtual care options have come online in recent months.

April 1, 2023 ICD-10-CM code file

04/04/2023

by: Julia Kyles, CPC

Bring your staff up to date on the ICD-10-CM code changes that went into effect April 1.

Use new E/M coding worksheet for level-based E/M encounters

03/06/2023

by: Julia Kyles, CPC

DecisionHealth has revised its tool for office/other outpatient E/M visits (99202-99215) to include encounters performed in the inpatient or observation (99221-99223 and 99231-99236), emergency department (99281-99285), nursing facility (99304-99310) and home or residence (99341-99350) settings and consults (99242-99245 and 99252-99255).

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