Nicoletti Notes May 2026 Published on May 12th, 2026 HEALTHCON in Dallas was filled with great presentations and enthusiastic coders, billers, and compliance professionals. One of the sessions I was most grateful to attend was the AMA’s session on maternity care coding, presented by Leslie Prellwitz, MBA, CCS, CCS-P, CPMA. Her title at the AMA […]
CoCM and Medical Necessity
Nicoletti Notes April 2026 Published on April 14th, 2026 Let me start with two pieces of advice: Don’t post coding questions that will raise compliance eyebrows on message boards. Don’t respond to postings with capital letters or the word “fraud.” Here are the posts in question. The original post was deleted moments later, after the […]
The Prime Directive of HCC coding
The Department of Justice, Office of Public Affairs released a notice on Jan. 14, 2026 stating that the government had entered into a settlement with Kaiser Permanente, et al for false claims related to HCC coding. The government contended that Kaiser had overbilled CMS by a billion dollars over a nine-year period. Kaiser agreed to […]
RVUs and Physician Compensation
Nicoletti Notes March 2026 Published on March 10th, 2026 It’s the time of year when residents are looking for jobs, evaluating offers, and deciding where to take their first attending job. It’s exciting. Congratulations to finishing med school and residency. It’s the time of year when residents are weighing geography, the culture of an organization, […]
CPT® 99459 Guidelines
Nicoletti Notes August 2025 Published on August 28th, 2025 The July 2025 CPT® Assistant had a question about whether CPT® 99459 could be used on a male patient for an examination of external male genitalia and a digital rectal exam. CPT® said no. 99459 is intended to be used with a pelvic exam to cover “the additional supplies […]
Avoid These Coding Mistakes: A Guide for Accuracy and Compliance
Nicoletti Notes October 2025 Published on October 2nd, 2025 We’ve updated CodingIntel’s Telehealth article again. We’ll keep you up-to-date with the latest Medicare rules. Medical coding is a high-stakes discipline as accuracy affects reimbursement, compliance, and the overall health of the revenue cycle. Just as a reminder, here are three frequent mistakes to watch out for—and how […]
G0136: Out With the Old, in With the New
Nicoletti Notes November 2025 Published on November 18th, 2025 CMS is changing the definition of HCPCS code G0136. They are keeping the code and the valuation of the code. The code is staying on the telehealth list. But there is a completely new definition. Between now and 12/31/2025, G0136 is for an assessment of a patient […]
E/M MLN guide
Nicoletti Notes September 2025 Published on September 9th, 2025 CMS released an updated MLN guide for Evaluation and Management Services in July and removed it in August. I’ve saved a copy, however, and you can download it from CodingIntel’s site. (link below) What’s new in the guide? This is old news. Since 1-1-2025, a practice could […]
Three Compliance Tips Every Clinic Should Know
Nicoletti Notes December 2025 Published on December 16th, 2025 Coding and billing compliance are big subjects, and small errors can lead to big consequences. Whether you’re managing a clinic, overseeing billing operations, or leading a coding team, staying vigilant is key. Here are three essential tips to help your organization stay on track and avoid […]
Time Statements for E/M Visits: What Coders and Providers Need to Know
Nicoletti Notes January 2026 Published on January 13th, 2026 Time-based coding for Evaluation and Management (E/M) services can be a powerful tool, but only when used correctly. Incomplete or vague documentation of time can lead to denials, audits, and compliance issues. Here’s a breakdown of the best and worst practices when documenting time for E/M […]
TCM Frequency
Nicoletti Notes February 2026 Published February 10th, 2026 Transitional Care Management (99495, 99496) Family practice and internal medicine providers continue to ramp up their use of transitional care management (TCM) services. As background, the TCM services comprise two codes – the “at least moderate” level of medical decision-making (MDM) code 99495 and the “high MDM” […]
Can We Bill Advanced Primary Care Management (APCM) Every Month?
Question: Can we bill Advanced Primary Care Management every month for a patient we sign up, even if we don’t provide any services during that month? Answer: In my opinion, no. Although other consultants have other opinions and believe they are per member/per month codes. The CMS website doesn’t address this directly in the article here. […]
CDI and Coding for Myocardial Injury and Infarction | Webinar
Recorded February 9th, 2026
1 CEU Expires 2-28-2027
Guest presenter Dr. Robert Oubre
Dr. Oubre will provide a practical, clinically grounded review of myocardial injury and myocardial infarction through the lens of accurate documentation and compliant coding