The newsletter outlines key differences between off-the-shelf (OTS), custom fitted, and custom fabricated knee orthoses, which dictate HCPCS coding and billing for these items. Physician and ...

Variations in commercial insurers’ rules for prior authorization contribute to administrative burden and may be delaying efforts to collect PA rules into a single, searchable database.

In 2026, medical coding saw two defining changes: the addition of 288 CPT/HCPCS codes that formalize billing for emerging AI and digital health services, and an April ICD-10-CM update that overhauled ...