Medicare’s spinal-deformity-specific diagnosis-related group distribution has some limitations when it comes to understanding the nuances of surgeries, according to a study in the March 1 edition of ...

Colonoscopy billing can be very complex, hinging on distinctions between screening and diagnostic intent. A single ICD-10 code, CPT selection or missing modifier can shift a procedure from fully ...

Not long ago, I was sitting across from a nursing home leadership team as they stared at a quality measure report that didn’t make sense to them. “We’re ...

In 2018, Medicare established coverage and reimbursement for its first service using artificial intelligence (AI): computed tomography (CT) fractional flow reserve (FFRCT). FFRCT is used in ...

Billing and insurance–related costs are a significant source of wasteful health care spending in Organization for Economic Cooperation and Development nations, but these administrative burdens vary ...

Moby Strategic Transformation and Performance Drivers. Performance in 2025 was impacted by elevated medical cost trends, ...

Patients with oHCM experience significant variation in cardiovascular events, health care resource use, and costs across age, sex, race, and US region.

With private insurers set to receive $1.2 trillion in excess payments by 2036, retirees may soon face a reckoning over costs ...

Oakland, Calif.-based Kaiser Permanente is suing nine liability insurers for breach of contract, alleging they have refused to cover any portion of its $556 million settlement with the federal ...

Medical billing and coding systems ensure that health providers get paid for their services. Learn the steps in medical ...

Terry Gerton We’re going to talk about False Claims Act. The Department of Justice announced that 2025 was a record-breaking year for them, $6.8 billion in recoveries and almost 1,300 cases. What is ...

An analysis of nearly 28 million Medicare beneficiaries indicates that long-term exposure to air pollution is a risk factor ...