The ICD-10-CM diagnosis code set, which is maintained by the CDC's National Center for Health Statistics (NCHS), announced the fiscal year (FY) 2027 update in June 2026; CMS posted the official code files, tabular listings, and addenda on its ICD-10 webpage. The American Hospital Association (AHA) will publish follow-on advice in Coding Clinic for ICD-10-CM.

The HHS Office of Inspector General (OIG) has added a Work Plan item reviewing Medicare payments for evaluation and management (E/M) services performed on the same date as minor surgical procedures when modifier 25 was not appended.

The American Medical Association (AMA) has now taken a firm stance to eliminate ambiguity in healthcare communication by declaring that the term “provider” should not be used to refer to physicians. This shift is not about semantics—it is about patient safety, transparency, and preserving the integrity of physician-led care.

CMS has identified Modifier 25 as one of the most commonly misused modifiers in dermatology, and practices are increasingly being targeted for improper use and documentation deficiencies. When E/M services are billed alongside minor procedures, providers must clearly demonstrate that the evaluation and management service was significant, separately identifiable, and medically necessary.

CMS has implemented a 2.5% “efficiency adjustment” to most non-time-based CPT and HCPCS codes under the CY 2026 Physician Fee Schedule—and for many procedural and surgical specialties, the impact may be greater than it initially appears. In this KZA Alert, we break down what the adjustment means, why surgeons and procedural practices may be disproportionately affected, and how the change could influence Medicare and commercial payer reimbursement moving forward.

AI is transforming medical coding and documentation, but without proper oversight, it can quietly introduce costly errors into your practice.

Beginning May 1, 2026, BCBS of Michigan and Blue Cross Network (BCN) will reduce reimbursement for Evaluation & Management (E/M) services billed with Modifier 25 when performed on the same calendar date as a minor procedure by the same provider for the same patient.

HHS has adopted the first HIPAA standards for electronic claims attachments and electronic signatures. This modernization replaces manual, paper‑based methods with standardized, secure electronic transactions, reducing administrative cost and improving claims turnaround.

CMS has released a revised Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, effective March 13, 2026. All providers who issue ABNs to Original Medicare beneficiaries must begin using the updated form by May 12, 2026.

A new federal law (H.R. 7148), signed on February 3, 2026, extends key Medicare telehealth policies that expanded access to virtual care during the pandemic. These flexibilities now remain in effect through December 31, 2027, providing much-needed stability for providers and patients alike.