Nicoletti Notes July 2026 Published on July 23rd, 2026 At our June webinar, Dr. Robert Oubre was asked about the phrase in the HPI “patient has a history of…” Although Dr. Oubre was discussing “CDI and Coding for Arrhythmias” and the question of history of a-fib, it raised the wider issue. We wanted to know […]
CMS’s 2027 Proposed Medicare Physician Fee Schedule Rule | Webinar
Can a pharmacist bill a 99213 or 99214 based on time, incident to a physician?
Question: Can a pharmacist bill a 99213 or 99214 based on time, incident to a physician? Answer: No. In some medical groups, pharmacists are part of the care team, working with patients on medication management. The pharmacist provides education to the patient and family. Some patients have complex medication regimens, and pharmacists work with patients […]
How Do I Know If My Documentation Is Enough for HCC Coding? | Webinar
Event date July 23, 2026
1 CEU expires 7/30/2027
Speaker Maria A. Mirt Sánchez, MD, MSc, CPC, CRC, CDEO
Providers consistently ask: “Is what I wrote enough?” This webinar answers that question directly, using the MEAT framework, real outpatient documentation examples, and the updated CMS-HCC Version 28 (V28) model fully in effect for CY 2026. From how the model calculates risk scores to what specific language in a note actually captures an HCC, every concept is grounded in current CMS standards and illustrated with the documentation patterns auditors see every day.
Coding Preventive Medicine Visits | Webinar
Event date July 16, 2026
1 CEU expires 7/30/2027
Coding preventive visits and Medicare wellness visits can be confusing for practitioners. This session will describe how to bill for them when they are performed alone or with the addition of a problem-oriented visit, and required documentation.
Dermatology, the OIG and Modifier 25
Nicoletti Notes June 2026 Published on June 11th, 2026 The OIG reviewed 100 claims with an E/M and minor procedure performed on the same calendar day and of the 100, only one (1) was assessed as not meeting the criteria for reporting the E/M with the minor procedure. Are we coders and auditors using a […]
CDI and Coding for Cardiac Arrhythmia | Webinar
Recorded June 22nd, 2026
1 CEU expires 6-30-2027
Guest presenter Dr. Robert Oubre
This educational activity provides a focused review of cardiac arrhythmias with an emphasis on atrial fibrillation and related rhythm disorders.
Maternity Care Coding Changes
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 […]
Precision in Spine Surgery Coding: Distinguishing Laminectomy from Discectomy Procedures | Webinar
Event date June 11th, 2026
1 CEU expires 6/30/27
Guest presenter Kim Pollock
Join nationally recognized coding consultant Kim Pollock for a focused, high‑impact 60‑minute webinar designed to demystify one of the most challenging areas in spine procedure coding: accurately distinguishing laminectomy from discectomy and applying the correct CPT® codes with confidence.
Can I Get Paid For…Removal of Sutures or Staples
In 2023, the AMA developed two new codes for removal of sutures or staples not requiring anesthesia. In years prior, we typically billed only an E/M service. These two new codes are add-on codes to E/M services. However, these codes have zero work RVUs assigned to them and have a very low payment. # + 15853 Removal of […]
CMS Split/Shared Services Rules | Reference Sheet
In 2024, CPT® expanded its definition of split/shared services, CMS updated their requirements. Neither CMS nor CPT® made changes to this policy in 2025 or 2026. Split/shared services are evaluation and management services (E/M) services performed jointly between a physician and a non-physician practitioner (NPP), also called advanced practice nurses or physician assistants. CMS pays […]
Documenting and Scoring the Data Element of MDM | Webinar
Recorded May 21st, 2026
1 CEU expires 5/30/27
Though the 2021/2023 changes to E/M coding eliminated much of the counting and confusion from the process of selecting an E/M level, Data scoring arguably became more complicated due to these changes, which has resulted in ongoing uncertainty as to when certain aspects of Data should be credited.
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 […]
Mandatory MIPS, 2 Conditions, 7 Specialties, Some Locations
The title makes it all clear, right? No? I didn’t think so. This article is an overview of CMS’s Ambulatory Specialty Model. CMS is implementing a mandatory, disease-specific reporting model beginning in the CY 2027, reporting due March 31, 2028. Who will be required to report? And for what conditions? Physicians who work in the […]
Telehealth Visit with a Patient at Home: Office Visit or Home Visit?
CPT® codes for patients at home in a residence: New patient: 99341, 99342, 99344, 99345 Established patient: 99347−99350 These codes are used to report services in a patient’s home or in a residence. “Home may be defined as a private residence, temporary lodging, or short -term accommodation (eg, hotel, campground, hostel, or cruise ship).” These […]
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 […]
The Ideal Audit Review Meeting
Do you hope for the perfect audit review meeting? You audit an entire team of providers who either have 100% accuracy or they don’t, but they greet your feedback with grace and humility. It helps when you of direct communication and real curiosity and engagement with the medical team, but results are not guaranteed. Auditing […]
Coding vs. Clinical Validation
Understanding Distinct Roles, Responsibilities, and Qualifications in Healthcare Documentation Two critical functions are often misunderstood or conflated: medical coding and clinical validation. While both are essential to accurate documentation, appropriate reimbursement, and regulatory compliance, they are fundamentally different disciplines that require distinct skill sets, credentials, and areas of expertise. Confusing these roles—or allowing one professional […]
In Focus: CPT® Coding for Revascularization Procedures – Lower Extremities | Webinar
Recorded April 16th, 2026
1 CEU expires 4/30/27
Guest presenter Shannon McCall of HCPro
CY 2026 ushered in a revamp of the prior Endovascular Revascularization of the Lower Extremities (CPT® 37254-37299) to reflect current practices, complexities, and technology.
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, […]
Depression Coding and Hierarchical Condition Coding (HCC)
Introduction | Depression coding in HCC In fee-for-service medicine: Diagnosis coding establishes the medical necessity for a service. At times, it may be the reason for a denial, particularly for diagnostic tests or procedures. Services with national or local coverage policies often have specific diagnosis codes that are required for payment. In V28 of HCC, […]
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