Medical Coding Transparency: 10 Codes That Deserve Closer Attention in 2026
By Dr Santosh Guptha , CEO-MEDESUN Healthcare Solutions21+ Years Experience in Medical Coding, Billing Audits, and Compliance In my 21 years of working inside hospitals, payer audits, and real-world billing disputes, I’ve learned that unexpected medical bills are rarely caused...
Certification or Fellowship in Medical Coding: Which One Builds Real-World Skills
In medical coding, learning never truly stops. As guidelines change, audits increase, and compliance expectations become stricter, coders are constantly upgrading their skills. At this stage, many coders face a common question: Should I do another certification or enroll in...
7 Medicare Billing Codes Triggering Unexpected Charges (2026 Update)
Below are the seven Medicare billing codes most likely to trigger surprise charges in 2026. 1. HCPCS G2211 – The Complexity Add-On This is the most common surprise code appearing on 2026 Medicare bills. G2211 is an add-on code reported...
Medical Coders Alert: Anthem’s E/M Policy Could Change Everything
Expert insights from Dr Santosh Guptha, CEO Medesun, bringing 21 years experience, 45 certifications, world record holder in medical coding and billing. Anthem Blue Cross E/M Policy 2026: Why Medical Coders Must Pay Attention Now A Major E/M Policy Change...
2026 CMS Lab Billing Changes Every Medical Coder and Biller Must Understand
Starting January 1, 2026, the Centers for Medicare & Medicaid Services (CMS) finalized major updates to the Clinical Laboratory Fee Schedule (CLFS) that are changing how laboratory services are billed across the United States. For years, many lab-related services were...
ASC Coding in 2026 New Opportunities for Outpatient Coders
On Nov 21, CMS finalized the 2026 Hospital Outpatient Prospective Payment System OPPS and Ambulatory Surgical Center ASC rule The rule focuses on Expanding outpatient care Reducing inpatient only services Improving hospital price transparency Strengthening safety and accountability These changes...
The Great Outsourcing Wave: How CMS 2026 Policies Boost Indian Medical Coding and RCM Jobs
The year 2026 is a defining milestone for the global healthcare industry. Major policy reforms in the United States related to reimbursement, audits, prior authorization, risk adjustment, price transparency, and artificial intelligence are reshaping how healthcare organizations function. While these...
Cleveland Clinic’s AI Coding Move and What It Means for Medical Coders – Insights from Dr. Santosh Guptha, Medesun
Cleveland Clinic partnered with Akasa to deploy AI tools within mid-revenue cycle workflows, where patient care documentation is translated into standardized medical codes for: Billing Reporting Continuity of care According to system leadership: Coders may review 100+ clinical documents per...
Medical Coding Errors Will Now Be Public – The Price Transparency Shock
Healthcare in the United States is entering a new phase of transparency and accountability. With renewed efforts by the Trump Administration to strengthen insurer price transparency requirements, healthcare prices are expected to become clearer, more accurate, and more actionable for...