Coding Compliance Lessons From CMS’s $203M Fraud Recovery
CMS’s Medicaid Fraud War Room stopped $203M in improper Medicaid payments in just 88 days — here’s what it means for medical coding compliance.
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CPT 2027 Category III Codes: What Medical Coders Must Track
AMA just added 58 new Category III CPT codes for 2027, spanning six specialties. Here’s what medical coders need to track before the January 1 effective date.
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Agentic AI Tackles E/M Coding Compliance and Audit Risk
Under-documented E/M levels leave revenue on the table, and over-coded ones invite audits. Agentic AI is closing that E/M coding compliance gap for good.
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Agentic AI Brings Real-Time CDI to Behavioral Health Coding
Behavioral health coders face rising audit risk and thin margins. Agentic AI now flags documentation gaps in real time, before a note or claim goes out.
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Agentic AI Oncology Coding: Taming the Infusion Hierarchy
Oncology’s chemo-injection-hydration hierarchy trips up coders and drains revenue. Here’s how agentic AI oncology coding validates sequencing before claims go out.
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How Agentic AI Prevents RPM Billing Compliance Risks
CMS’s new short-duration RPM code cuts billing to 2 days of data. Agentic AI validation closes the compliance gaps OIG’s 2025 audit already flagged.
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How Agentic AI Closes the Hospital Underpayment Gap in RCM
Underpayments silently cost hospitals 2-5% of net revenue every year. Agentic AI is now closing that gap by modeling every payer contract automatically.
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Agentic AI for HCC Coding: Lessons From OIG’s $462M Audit
OIG found every sampled acute stroke HCC code unsupported, a $462M miss. Here’s how agentic AI validation can catch these HCC coding gaps before submission.
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AGS Health Debuts Agentic AI for Medical Coding, RCM
AGS Health’s new InnovationWorks center applies agentic AI to autonomous coding, CAC, and CDI via AWS Bedrock AgentCore — built for auditability, not speed.
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