CMS Flags Improper Payments: A Warning for Coding Teams
CMS’s September 2026 MLN alert found a 32.6% improper payment rate on a routine DME code — a reminder that documentation, not fraud, drives most denials.
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Oracle Health’s New AI Tools Target Coding and CDI
Oracle Health unveiled five AI revenue cycle modules at its September 2026 summit, including autonomous coding and real-time CDI tools built to catch gaps before claims go out.
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CPT 2027 ABA Codes: The Compliance Clock Coders Face
The AMA’s 2027 CPT set splits code 97155 in two and retires two Category III codes. Coders have about 15 weeks to update systems before the Jan. 1 deadline.
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CMS-0057-F Prior Auth Rule: What RCM Teams Must Know
CMS-0057-F’s January 2027 API deadline is approaching fast — here’s what the prior authorization rule really means for medical coding and RCM teams.
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AMA September 2026 CPT Panel: AI Coding Rules Take Shape
AMA’s September 2026 CPT Editorial Panel quietly added AI validation criteria to code applications — a first for the process coders rely on.
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CMS’s HCPCS Level II Meeting Signals 2027 Coding Changes
CMS just set the agenda for its biannual HCPCS Level II public meeting. Here’s why coding and RCM teams should be watching, alongside CPT 2027’s new AI codes.
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AI Coding Compliance: What Tandem Health’s $100M Means
Tandem Health’s $100M raise came with Class IIa medical device certification for its AI coding tool — a compliance signal US health systems should watch.
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CMS WISeR AI Prior Auth Pilot: A Compliance Warning
FOIA documents reveal CMS rushed its AI prior-authorization pilot despite vendor warnings — a compliance signal coders and RCM teams shouldn’t ignore.
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Abridge’s Pre-Bill Tool Puts Coding Compliance First
Abridge’s new pre-bill review tool flags DRG and POA mismatches against clinical documentation before claims go out — a compliance play as much as a coding one.
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Agentic AI Revenue Cycle: What GenHealth.ai’s $16.5M Signals
GenHealth.ai raised $16.5M to scale AI agents that act inside payer portals on billing and denials — a preview of how far agentic AI in RCM is moving.
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