Three significant changes that will affect reimbursement rates go into effect January 1, 2026:
Conversion factor changes
Relative Value Unit (RVU) efficiency adjustment
Practice Expense changes
If you're a Find-A-Code subscriber, there's no need to worry. Find-A-Code's fee calculators are ready for the change. You can count on Find-A-Code for the most complete and accurate information you need as a medical coder/biller.
Reader Question: Cataract Coding Face-Off: Physician Practice vs. Surgery Center
Question: I code for a surgery center and an associated physician clinic. Most of our patients are diagnosed with bilateral cataracts, but only come in for surgery on one eye at a time. In case of an audit, is it important that the facility claims match the clinic claims?
Florida Subscriber
Answer: You should always be coding for the highest level of specificity, says Rhonda Buckholtz, CPC, CPCI, CPMA, CDEO, CRC, CHPSE, COPC, CENTC, CPEDC, CGSC, vice president of practice optimization at Eye Care Leaders. The coding guidelines for this situation say that when a patient presents...
To read the full article, sign in and subscribe to tci Outpatient Facility Coding Alert.
TCI's Outpatient Facility Coding Alert helps your facility stay profitable by covering issues that are important to you — everything from billing strategies and appropriate payment indicators to coding tips and tricks, analysis of industry trends, and so much more. Subscribe today and let our experts make your job easier.
Current newsletters added each month
Fully searchable archives - over 650 articles
ALL years/issues back to 2012 organized by year and issue
Codes mentioned in articles are linked to Code Information pages
Code Information pages link back to related articles
This feature is currently unavailable for online purchase. For more information, please call 801-770-4203 or Contact Us.
Quick, Current, Complete - www.findacode.com