Coding Considerations When Waiting for Transfer

Published: Fri, 09/19/25

Updated: Tue, 09/23/25

Link to all things medical coding & billing

Coding Considerations When Waiting for Transfer

Today’s topic is in reference to a coder question posed about discharge status for inpatients who are waiting for discharge to a nursing home. The questioner noted the possibility of discharging to outpatient status while waiting for nursing home placement. The information request also noted not being able to find any rules that apply to this...

AMA releases CPT 2026 code set

The American Medical Association (AMA) announced the release of the Current Procedural Terminology (CPT^®) 2026 code set adding 288 new codes designating the latest advances in medical, surgical, and diagnostic services available to patients. The CPT code set is trusted as the backbone of health data interoperability in the U.S.

Docs warn that Medicare payment rates put them in a precarious financial situation

Physicians are asking for greater certainty around Medicare reimbursement, arguing that compounding payment decreases over time have drastically increased the pressure on practices. Industry organizations, individual physicians and others weighed in through comments on the proposed Physician Fee Schedule, which were due Friday...

Update on PEPPER, Discharge Planning Guidelines, and Coding AMA Discharges

Let’s start with some updates. We have all been Program for Evaluating Payment Patterns Electronic Report (PEPPER)-free for quite a while now, but I can report that there is finally new information. First, there is a new contractor, Index Analytics, LLC. They appear to do a lot of data work with the federal government, so we will see how they do with...

Looking Forward to 2026: What CDI Leadership Needs to Know

The biggest impacts to clinical documentation integrity (CDI) professionals for the 2026 fiscal year (FY) will not be associated with updates to the ICD-10-CM code set or the Inpatient Prospective Payment System (IPPS). The biggest impacts will have to do with impending policy changes to Medicare and Medicaid. In my last article, I...

Your first AI win might be the one you don’t see

If you’re waiting for the perfect moment to bring AI into your business, here’s a thought: What if your first win isn’t flashy—it’s just functional? Let me show you what I mean, right here in Baton Rouge. At Baton Rouge General Medical Center, doctors and nurses are using AI to improve patient care—not by replacing anyone, but by supporting clinicians behind the...

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