2026 CPT Updates: High-Stakes Coding Changes Providers Can’t Afford to Miss

-
Image
  2026 CPT Updates: The High-Stakes Changes Your Providers Might Have Missed The 2026 CPT updates are not just another routine annual refresh. They represent a decisive shift in how healthcare services are documented, coded, reimbursed, and audited. For providers, billers, and healthcare executives, these changes carry real financial and compliance consequences. Missing even a single revision could mean denied claims, underpayments, or worse—an audit that unravels months of revenue. What makes 2026 different is the sheer scope of the changes. The American Medical Association (AMA) has aligned CPT updates more closely with evolving care models, including digital health, value-based reimbursement, and complex chronic care management. In plain terms, the rulebook didn’t just get edited—it got re-written in places. And while many organizations focus on headline changes, the most dangerous updates are often the subtle ones buried in descriptors, time thresholds, and parenthetical note...
Post a Comment

5 Tips to Increase Revenue of Cardiology Practices

-

For the last couple of years, cardiology practices have encountered increasing administrative and overhead costs which have prompted a substantial decrease in payment reimbursements for cardiologists. As of late, cardiology practices have increased in size because of the advancing nature of this stream and the emergence of various ailments and their remedies. This has caused apprehension amongst practicing physicians as to how to evaluate and address the changes that are taking place or are being proposed. Henceforth, they rather pay attention to cardiovascular medicine than administrative or structural aspects of their practice. 

Industry Fact File 

The essential nature of the Cardiology industry has maintained demand and supported the industry expansion in the last five years. The increasing overhead expenses and lack of interest in administrative activities have prompted decreasing profit margins. The industry is fixed at $34 billion and annually it is slated to develop at the rate of two percent. It utilizes more than two lakh individuals. 

Tips to Increase Revenue 

Cardiologists are usually compensated more than primary care physicians (PCPs) and generalist doctors. Be that as it may, increasing overhead and administrative expenses have brought about decreasing profit margins. Allow us to take a gander at a couple of focuses that cardiology practitioners can consider for increasing revenue: 

1. Educating the physicians on coding rules: It is imperative for physicians to be appropriately educated on the coding rules to guarantee under coding doesn't take place. At each level under coding happens it decreases the pay by about half. Physicians should keep a mind their reports and encourage discussions as to why this lapse happens. This could add about $45,000 each year per physician on average. Actually, this increased revenue is for the work which has already been done by the physicians. 

2. Developing a tracking system for denials: Payers, physicians, or the back-end staff should keep a mind the denials. The important aspect is to work the denials and not simply book them. The reasons for denials should be ascertained and they ought to be fixed. They ought not to assume that if the payer has denied the claim it should be correct. Physicians ought to have a knowledgeable person investigating this, one who is very much aware of the rules and can appeal or battle for the correctly raised claims. 

3. Monitoring scheduling of physicians: There ought to be a mind the quantity of patients a physician finds in a day. This ought to be compared to other practices and check whether the physician is having fewer patients than others. On the off chance that indeed, it should be checked as to how long is it taking for the scheduling interaction of new patients and if there are any irrelevant advances they need to obliterate. 

4. Monitoring the referrals: Physicians need to keep a check as to how they are getting alluded and if there is an increase or decrease in the footfall. Continue talking to the alluding physicians and become acquainted with how they can improve. 

5. Building a strong provider relation program: This will guarantee that the practice retains its patients and alluding physicians and seeking new referral sources too. 

Conclusion 

MedicalBillersandCoders.com is a team of specialists that work enthusiastically to offer the best types of assistance to providers. They take care of the back-end activities for them. Cardiology practices would do well by tying up with such facilitators who can help them in increasing their revenues.

Location: 108 W 13th St, Wilmington, DE 19801, USA

Comments

Post a Comment

Popular posts from this blog

How to Reduce Days in A/R with Smart Denial Management Strategies

-
Image
 Timely reimbursement is the lifeblood of a financially healthy medical practice. Yet, increasing Days in Accounts Receivable (A/R) continues to be one of the most pressing revenue cycle issues for healthcare providers. One of the major culprits behind this issue? Denials. In this blog, we explore how strategic denial management not only reduces days in A/R but also improves cash flow and strengthens your bottom line. Understanding Days in A/R Days in A/R refers to the average number of days it takes for a practice to collect payments due after services have been provided. Industry benchmarks typically suggest keeping A/R days under 35. Anything higher signals inefficiencies - and likely unresolved denials. How Claim Denials Affect A/R Denied claims delay payments and increase administrative burden. Without an effective process to identify, appeal, and correct them, your A/R days will climb - and revenue will suffer. Top causes of denials include: Missing or incorrect ...
Read more

How Outsourced Medical Billing Can Improve Your Practice’s Profitability

-
Image
Managing a medical practice comes with its fair share of challenges—from patient care to staffing and compliance. But one of the most overlooked factors impacting a practice’s financial health is inefficient billing . That’s where outsourced medical billing comes in—not just as a cost-cutting solution, but as a profitability booster . Here’s how outsourcing your medical billing can significantly improve your bottom line. 1. Reduced Administrative Costs Running an in-house billing department requires trained staff, billing software, continual updates, and compliance oversight. These overhead costs can add up quickly. Outsourcing eliminates the need for these expenses, allowing you to pay only for the services you use —often at a fraction of the cost. 2. Faster Claim Submission and Reimbursement Professional billing companies are equipped with experienced teams and advanced tools that ensure quick and accurate claim submission . This minimizes delays and accelerates cash flow , g...
Read more

Understanding the Differences Between Claim Denials and Rejections in Medical Billing

-
Image
In the world of medical billing, two terms often cause confusion for healthcare providers and billing staff alike: claim rejections and claim denials . While both impact revenue and delay reimbursements, they are not the same —and understanding the difference is key to faster, cleaner claim processing. Let’s break it down. What Is a Claim Rejection? A claim rejection occurs when a claim is never accepted into the payer’s adjudication system . It is blocked due to errors or missing information , such as: Incorrect patient demographics Invalid insurance ID numbers Incomplete CPT or ICD-10 codes Formatting errors (especially in EDI files) These claims must be corrected and resubmitted —but the good news is they haven't been officially processed yet, so no appeal is needed . What Is a Claim Denial? A claim denial happens after the payer reviews and processes the claim , then decides not to pay it . Reasons may include: Lack of medical necessity Services n...
Read more