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Path/Lab Coding:

Brace Yourself for Bad News in the 2027 MPFS

Published on Tue Jul 28, 2026

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Other Articles of

July 2026

Primary Care Coding:
Code Palpitations as a Symptom When Supported by Documentation
Question: A 19-year-old patient presents to a family medicine clinic reporting episodes of what they [...]

Anesthesia Coding:
Understand Why Physical Status Modifiers Are Useful, Even When Not Reimbursable
Some payers consider physical status just information, but they contextualize some anesthesia services. Coding and [...]

Diagnostic Radiology Coding:
Identify the Different Imaging Tests for Suspected Osteomyelitis
Find out which modality is considered the gold standard. One of the most challenging conditions [...]

Urology Coding:
Understand CPT® ESWL and Ureteroscopic Stone Treatment Coding
Do you need modifier 53 for an ESWL converted to surgical treatment? Urinary stone disease [...]

Pulmonology Coding:
Decipher Interstitial Lung Disease Diagnosis Coding
Learn how to identify the phases of ILD. Coding for interstitial lung disease (ILD) is [...]

Emergency Department Coding:
Get Your Facts Straight to Code FAST Exams
FAST vs. eFAST: Do you know the difference? A patient presents to the emergency department [...]

Cardiology Coding:
Document the Complete Clinical Picture Beyond Chest Pain
Consider these best practices for documenting diagnostic evaluations, supporting medical necessity, and improving coding accuracy. [...]

Neurology & Pain Management Coding:
Know Steps to Follow for Arthrocentesis Coding
Physician will start with E/M, imaging to decide if service is necessary. Arthrocentesis is a [...]

Diagnostic Radiology Coding:
Differentiate Between 93970 and 93971 for Suspected DVT
Question: A senior patient came into our radiology practice with left calf swelling, tenderness, warmth, [...]

Urology Coding:
Pinpoint the Correct Nephrolithotomy Procedure Code
Question: A 54-year-old patient presented to the emergency department (ED) with severe lower abdominal pain [...]

Medicare Regulations:
Find Modifier Clarity for Facet Joint Injection in LCD
Question: I know Medicare sets coverage limits on the number of therapeutic facet joint injections [...]

Compliance:
Be Proactive About Compliance to Reduce Chance of Fraud
Educating providers about others’ mistakes can emphasize the risk of upcoding. Upcoding, unbundling, and inaccurate [...]

Gastroenterology Coding:
Is 43239 Restricted to a Certain Number of Biopsies?
Question: I have a procedure note for an esophagogastroduodenoscopy (EGD) with a biopsy. The 45-year-old [...]

Pediatric Coding:
Get Ready for Back-to-School Visits With These FAQs
Strengthen your screening and immunization coding skills before the rush! This season brings a familiar [...]

Path/Lab Coding:
Understand Uncertain Does Not Mean Unspecified
Question: What does it mean when a pathologist describes a neoplasm of the breast as [...]

Path/Lab Coding:
Brace Yourself for Bad News in the 2027 MPFS
Big reductions in CDLT valuations are heading your way. Labs don’t have much to look [...]

Path/Lab Coding:
Know When to Bill for Cellular Enhancement When Examining Breast Aspiration
Question: Our pathologist performed a fine needle aspiration (FNA) on a patient’s breast, then examined [...]

Diagnostic Radiology Coding:
Learn Why a Head CT Without Contrast Is Needed in Emergency Situations
Question: A 65-year-old patient arrived at the emergency department (ED) claiming a sudden onset of [...]

Technology & Innovation in Healthcare:
Learn How RPM/RTM Reimbursement Rules Could Change in 2027
Also, CMS is seeking input on remote monitoring code adjustments. On July 16, 2026, the [...]

Optometry/Ophthalmology Coding:
Decode Visual Field Testing Codes With Confidence
Do VF testing codes apply to one or both eyes? Visual field (VF) testing, also [...]

Otolaryngology Coding:
Get the Answers to These 4 Frequently Asked Tonsillitis Questions
Also, remember to stay alert for these key coding considerations. Tonsillitis is probably one of [...]

Urology Coding:
Use Neoplasm Codes for Confirmed Pathology Results
Question: A patient presented to the urologist complaining of blood in their urine. After reviewing [...]

ICD-10-CM Coding:
Use an ‘Other’ Code to Best Capture African Tick Bite Fever
Question: I’m reading notes for a recent patient encounter. The patient presented with fever, headache, [...]

Neurosurgery Coding:
Get Treatment Types, Diagnoses Straight on Vertebral Fracture Repairs
Do you know the different fracture and treatment types? When your surgeon repairs a patient’s [...]

Orthopedic Coding:
Get Paid for Your Bankart and Synovectomy Claims
Don’t let 1 missing sentence lead to a denial. Shoulder arthroscopy procedures can present unique [...]

Neurology & Pain Management Coding:
Go to 6th Character for Epilepsy Diagnoses
Question: Encounter notes indicate that a patient suffers from “epilepsy w/grand mal on waking.” There [...]

Primary Care:
Document the Diagnostic Journey
Focus on capturing clinical reasoning in primary care. A patient presents with fatigue. Initial testing [...]

Cardiology Coding:
Know the True Meaning of ‘With’ in the ICD-10-CM Alphabetic Index
Question: I work for a cardiology office and reviewed a progress note for a patient [...]

Orthopedic Coding:
Step up to Code This Ankle Injury
Question: A patient who injured their left ankle after falling from a ladder reports to [...]

Otolaryngology Coding:
Get the Full Picture on Partial Thyroidectomy Coding
Question: A patient returned to our surgeon after previously having a thyroidectomy. The surgeon removed [...]

Podiatry Coding:
Don’t Stress About Coding This Foot Fracture Case
Question: A 30-year-old patient presented to the podiatrist with dorsal left foot pain that had [...]

Practice Management:
Prepare for Possible Reimbursement Redistribution in 2027
CMS is proposing making PE reimbursement more responsive to current market conditions. In the CY [...]

Medicare Regulations:
Beware of Possible, Big-Picture Changes to Medicare Eligibility for Some Individuals
Question: I’ve looked at the calendar year (CY) 2027 Medicare Physician Fee Schedule (MPFS) and [...]

Anesthesia Coding:
Sometimes You Can Bill for Anesthesiologist’s Time Despite Canceled Surgery
Question: I’m newer to anesthesia coding and need help with a canceled case. The surgery [...]

Neurology & Pain Management Coding:
Ace Autonomic Nerve Injection Encounters With These Codes
Question: If the physician performs an autonomic nerve injection of an anesthetic agent, is there [...]

Ob-Gyn Coding:
Use ‘0’ as the 7th Character With Single Gestation Maternal Complication Codes
Question: I’m new to ob-gyn coding and I’m having a lot of trouble understanding the [...]

Pulmonology Coding:
Identify the Correct Diagnosis Code for Idiopathic Pulmonary Fibrosis
Question: A 75-year-old new patient presented to the pulmonologist with chronic cough, fatigue, and weight [...]

Pulmonology Coding:
Can You Report Asthma With a COPD Exacerbation Case?
Question: Our pulmonologist saw a senior patient who was experiencing an exacerbation of their chronic [...]

Podiatry Coding:
Navigate Routine Foot Care Coverage Across the 7 MACs
Same procedure, 7 personalities — a field guide to Medicare podiatry billing. Routine foot care [...]

Oncology/Hematology Coding:
Take These 4 Steps for Accurate RETACRIT® Coding
Question: What is the correct way to bill for RETACRIT® for a patient undergoing erythropoiesis [...]

Ob-Gyn Coding:
Does Granulation Tissue Cauterization Fall Under Postpartum Care?
Question: A patient presented to their gynecologist with perineal irritation and urinary frequency. Six months [...]

Medicare Regulations:
Get a Glimpse of Future Payment Possibilities via CY 2027 MPFS
CMS is continuing with two CFs, but primary care may make out better than specialties. [...]

E/M Coding:
See How CMS Proposes to Reshape E/M Payments in 2027
CMS seems to move in opposite directions, but the changes all affect reimbursement more than [...]

General Coding:
CMS Proposing Changes to Advance Care Planning
Two new HCPCS codes could change how you bill ACP. The Centers for Medicare & [...]

In Case You Missed It (RCI Bonus Content):
Understand the Clover Health Ruling, Rethink Coding and Documentation in a Value-Based Care Environment
The ruling points to the need for proactive documentation. The Medicare Advantage (MA) Star Ratings [...]

E/M Coding:
Code Patient Portal Discussions With Virtual E/M Rules in Mind
Question: A provider asked me about possibly billing a lengthy patient portal exchange with an [...]

Anesthesia Coding:
Bill the OR Case, Not Just the Surgeon’s CPT® Code
Question: I’m newer to anesthesia coding and need help with an operating room (OR) case. [...]

Podiatry Coding:
Base Your Lesion Shaving Codes on Pre-Procedure Measurements
Question: A podiatrist shaved an epidermal lesion measuring 1.2 cm from a patient’s left foot. [...]

General Surgery Coding:
Use These 3 Tips to Guide Your Expert-Level Appendectomy Coding
Reporting complications and conversions just got easier, thanks to these key tips. Appendectomies can be [...]

Cardiology Coding:
Pin Down Heart Failure Specificity Before Choosing I50.-
Question: I’m reviewing a cardiology note for a 72-year-old established patient seen after an emergency [...]

ICD-10-CM Coding:
Rely on Reason for Visit if Allergy Tests Don’t Provoke Reaction
Question: I just started at an allergist’s office and sometimes we see patients who come [...]

Emergency Department Coding:
Learn How to Navigate SDOH Code Reporting
Question: I’m reviewing an emergency department (ED) visit where the provider documents that the patient [...]

Gastroenterology Coding:
Check out These 7 Steps to Coding Colonoscopies After Positive Fecal Results
Here’s how to use Medicare modifier PT. Colorectal cancer screening has changed significantly over the [...]

Otolaryngology Coding:
Don’t Let This Code Choice Strike the Wrong Nerve
Question: We recently got denied for billing 64450 with R05.3. Why is this, and what [...]

Pediatric Coding:
Confidently Code This Muscle Weakness Case
Question: A 10-year-old patient presents to outpatient physical therapy six weeks after sustaining a closed [...]

General Surgery Coding:
Look to Soft-Tissue Tumor Codes for a Lipoma Excision
Question: I have a surgical report that lists the procedure as an excision of a [...]

Ob-Gyn Coding:
Learn How to Sequence High-Risk OB and IVF Pregnancy Codes
Don’t assume every IVF pregnancy qualifies for an O09.81- code. Advances in reproductive medicine have [...]

Neurology & Pain Management Coding:
Look to Combo Codes on Some Evoked Potentials
Question: A 58-year-old presents with a year of progressive weakness and stiffness in both legs [...]

Oncology/Hematology Coding:
Know to Avoid Compliance Pitfalls and Support Accurate Cancer Dx Coding, Part 1
Look at these OIG audit results and learn. The Office of Inspector General (OIG) recently [...]

Primary Care Coding:
Evaluate MDM for Acute Symptoms With Tests Ordered
Question: An established 46-year-old patient presented to the primary care office reporting vomiting and diarrhea [...]

Emergency Department Coding:
Separate E/M From FBR Before Making Coding Decision
Question: A patient was working under their car when a fragment of metal fell from [...]

Neurosurgery Coding:
Be Sure to Code Only for Surgeon’s Services in ED Encounters
Question: A 73-year-old patient presents to the emergency department (ED) with a severe, sudden onset [...]

General Surgery Coding:
Hit the Target With Your Tendon Sheath Surgical Coding
Question: I’m having trouble choosing between 26055 and 26145 for a procedure. The patient presented [...]

Gastroenterology Coding:
Understand Why Waiting for Pathology Matters in Coding
Question: I read the Revenue Cycle Insider article, “Use These 5 Steps to Code [...]

Technology & Innovation in Healthcare:
Examine How Senior Citizens Can Use VR for OT and PT
Question: Are virtual reality (VR) therapies only beneficial to patients who are middle aged or [...]

Compliance:
Avoid Billing Mistakes in Multi-Location Practices
Question: If a patient receives an evaluation and management (E/M) service at one practice location and [...]

Compliance Coding:
Understand E/M Billing for Preoperative Visits
Question: Our surgeon saw a patient in the office, evaluated their condition, and scheduled surgery. [...]

Orthopedic Coding:
Don’t Overcode This Arthroplasty Procedure
Question: The practitioner’s notes show that a diagnostic arthroscopy of the right hip was performed. During [...]

Pediatric Coding:
See What a Difference a Day Makes
Question: When a physician provides critical care to a neonate, and the patient turns 29 days [...]

General Coding:
Apply MEAT to Support Chronic Condition Coding
Question: A Medicare Advantage patient presents for a routine follow-up visit. The provider documents type [...]

Optometry/Ophthalmology Coding:
Remember That an IOL Is an Implant
Question: Is there a separate code only for intraocular lens removal (IOL) or should we [...]

Technology & Innovation in Healthcare:
Watch Out for Copy-Forward and Imported Information
Question: After reading the Revenue Cycle Insider article, “Learn What You Can — and [...]

Oncology/Hematology Coding:
Look to Medicare Guidance for Breast Reduction Reimbursement
Question: One of our patients needs breast reduction to ensure breast symmetry following breast reconstruction [...]

Optometry/Ophthalmology Coding:
Don’t Forget a Cause Code for Burn Injuries
Question: I have a report for an encounter with a 12-year-old patient. The patient was [...]

General Coding:
Bill 96372 for Injection With Medication Supplied From Elsewhere
Question: Our office administers patient-supplied intramuscular medications. Can we report CPT® 96372 for the injection [...]

ICD-10-CM Coding:
Drug Toxicity Coding: Know When It’s an Adverse Effect, Poisoning, or Toxic Effect
Poisoning symptoms and adverse effects from proper use may look similar, but they require different [...]

Practice Management:
Revenue Cycle: Don’t Let Deductibles Drain Your Early-Year Cash Flow
Verify benefits, educate patients, and wait for the payer adjudication when the deductible amount is [...]

E/M Coding:
Look at All Elements of MDM, Not Just Symptoms
Question: An established patient presents with two days of sore throat, congestion, cough, fatigue, and [...]

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