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“I'm in PA, and this is an 80-year-old patient..... Cigna denied both charges stating the diagnosis codes do not support the procedure (as per what my billing company told me). This was before we were notified that notes must be sent in with all Cigna claims where an E&M is billed with a procedure.

Have You Registered for Your 2026 MVP?

FDA Recalls July 28, 2026 - August 4, 2026

“I am looking for clarification regarding dispensing a post-operative shoe in conjunction with performing a surgery (days before surgery, day of surgery or days following surgery). Can we have patients pay out of pocket for the device? Does the payer, Medicare or commercial carriers, factor into the rules?”

FDA Recalls July 22, 2026 - July 27, 2026

“I have a very specific question about a new patient visit. Here is what my billing company said in a recent email about that for 2026: ‘You can bill a new patient visit with the procedure if you are noting that something completely different than the procedure was discussed. They are just saying that they will no longer pay an E/M code with a procedure if you just spent extra time with the patient on the procedure or if you are going over patient history. They no longer feel that is payable. Which is unfair due to the time each provider spends with a new patient. But that is our reality. They are saying that if you are seeing a new patient and doing a procedure you cannot just bill for a new patient visit just because they are new. You can bill an E/M code if you feel it’s warranted. Many carriers will likely deny, and we will then appeal it for you. If you are not discussing anything with that patient other than the procedure or history, then it’s up to you if you bill for the new patient visit alone or the procedure alone. Completely up to you.’ Please help us sort this out as I cannot find specific information on this. Do we bill a new patient visit with procedures as always with detailed documentation, or must we pick one or the other?”