AHRQ Funding Collapse Puts CDI’s Evidence Base at Risk
AHRQ’s near-halt on grantmaking is starving the sepsis and patient-safety guidance CDI teams depend on daily — coding leaders need a plan before it breaks.
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Prior Auth Automation Raises the Bar on Coding Accuracy
R1’s Humata Health deal shows prior-auth automation is tightening the link between coding accuracy and claims approval — and raising the cost of coding errors.
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AI Upcoding and the New False Claims Act Risk for Coders
A new claims analysis puts AI-driven upcoding exposure at $2.3 billion. Here’s why evidence-linked coding is becoming a compliance necessity.
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Clinical Validation Denials: Where Agentic AI CDI Fits
Payers increasingly split DRG denials into coding downgrades and clinical validation disputes. Here’s how agentic AI helps CDI teams tell the two apart.
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Oracle Health Puts AI Coding Suggestions Inside the EHR
Oracle Health’s Clinical AI Agent now suggests professional fee codes at the point of care — a sign coding AI is moving inside the EHR itself.
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Cardiology’s 2026 CPT Reset Tests Static Coding Rules
Cardiology’s 2026 CPT set brought 288 new codes and 84 deletions across PCI, echo, and remote monitoring. Static rule engines can’t keep pace — here’s what agentic AI changes.
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XiFin-Notable Deal Signals Coding’s Agentic AI Shift
XiFin’s Series B investment in Notable Systems replaces OCR-based document intake with agentic AI. Here’s what that shift means for coders and denial-prone claims heading into 2027.
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ModMed’s Agentic RCM Launch Signals Where AI Coding Is Headed
ModMed’s agentic RCM platform folds coding guidance into denial prevention and appeals — a sign that coding accuracy and revenue recovery are converging.
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Why Quarterly NCCI Edits Expose Gaps in Static Coding Rules
NCCI PTP edits version 32.2 took effect July 1, 2026 with roughly 4.4 million edit pairs. Static rule engines routinely miss the update window — here’s what that costs coders.
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CMS’s 2025 PEPPER Flags Psychiatric Facility Coding Risk
CMS’s newly released 2025 PEPPER for inpatient psychiatric facilities flags under- and over-coded claims — here’s what it means for coding accuracy and audit risk.
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