Med Learn
MedLearn Publishing, a division of MedLearn Media, Inc., is a nationally recognized healthcare publishing and media firm specializing in all aspects of coding, compliance, reimbursement and the revenue cycle. For more than 30 years, MedLearn Publishing has delivered actionable answers that equip healthcare organizations to confidently meet their revenue and compliance obligations. Our clients access this information through a variety of resources, including publications, newsletters, and webcasts.
MedLearn is dedicated to fighting Non-Patient Outcome Spending (NPOS), especially in the areas of billing and compliance. NPOS is the sum of all non-frontline portions of hospital and clinic operations. You can count on us to walk you through recent and upcoming developments in niche coding, compliance and reimbursement— regardless of how complex and overwhelming they may seem. Our experts constantly watch the horizon for what’s coming, carefully research how you’ll be impacted, and articulate the steps required to keep your facility compliant and fiscally strong in a variety of settings. Source
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Recent Articles
Search ArticlesMalnutrition: The Diagnosis CMS Wants Hospitals to Find but Does Not Trust Them to Code Appropriately
The confusion about when to code severe malnutrition is likely to be back in the spotlight as malnutrition screening becomes a mandatory electronic quality measure creating a contradictory message from The Centers for Medicare & Medicaid Services (CMS) as hospitals continue to have this diagnosis removed from their claims.
When Advance Care Planning Becomes a Hospital Quality Measure
The Centers for Medicare & Medicaid Services (CMS) finalized adoption of the Advance Care Planning electronic Clinical Quality Measure (eCQM) as a new self-selected electronic quality measure in the FY 2027 finalized Inpatient Prospective Payment System (IPPS) ruling.
Are We Measuring the Same Sepsis Patient?
Sepsis has never been a simple diagnosis in healthcare. Ask a bedside clinician, a clinical documentation integrity (CDI) specialist, a coding professional, a quality leader, and a payer to evaluate the same case, and you may not always get the same answer. Different clinical criteria, coding requirements, quality specifications, clinical validation expectations, and payer interpretations have made sepsis one of the most complex diagnoses we encounter.
Respiratory Question for the Week of August 10, 2026
What is a CCMI and how is it utilized? Each NCCI procedure-to-procedure (PTP) edit has been assigned a Correct Coding Modifier Indicator (CCMI). A CCMI of “0” indicates that NCCI PTP-associated modifiers cannot be used to bypass the edit. A CCMI of “1” indicates that NCCI PTP-associated modifiers may be used to bypass an edit under appropriate circumstances. A CCMI of “9” indicates that the use of NCCI PTP-associated modifiers is not specified.
Cardiology Question for the Week of August 10, 2026
Can an abdominal aortogram be reported if performed at the same session as selective renal angiography? No, an abdominal aortogram performed at the same session as selective renal angiography is included in the bundled codes 36251–36254. Do not code 75625 or 75630 with one of the renal angiography codes. TAGS: Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use.
Radiology Question for the Week of August 10, 2026
If two cysts in the same breast are aspirated under ultrasound guidance, how do we code the procedure? The initial cyst aspirated would be reported with code 19000. Each additional cyst aspiration is coded as +19001 if the second (additional) cyst is aspirated from the same breast. Assign the imaging guidance with 76942 once.
General Question for the Week of August 10, 2026
When is modifier 25 appropriately reported with an outpatient Evaluation and Management (E/M) service? The 25 modifier is only applicable for reporting with an outpatient Evaluation and Management (E/M) visit code. This modifier is used to help bypass National Correct Coding Initiative (NCCI) edits when an outpatient E/M visit code is reported on the same date of service as a separately codable procedure or service.
Laboratory Question for the Week of August 10, 2026
What coding and billing considerations should laboratories keep in mind when reporting point-of-care testing (POCT) blood gas analyses? In response to the demand for rapid turnaround times, point-of-care testing (POCT) is commonplace in today’s healthcare workflow. The POCT instrumentation available provides options for expanded “custom” profiles that include blood gases as well as chemistry and hematology analytes.
What the DOJ Data-Sharing Agreements Actually Mean
In connection with the annual Nationwide Health Care Fraud Takedown, the Department of Justice (DOJ) announced recently a series of interagency data-sharing agreements that I do not think our industry has fully processed yet. The announcement itself was easy to miss. It arrived alongside the Takedown numbers, which are always the headline, and it read on the surface as a bureaucratic update. It is not.
First Health-related AI Lawsuit: Uploading Your Medical Records to ChatGPT
For the last few weeks, we reported on the concept of artificial intelligence (AI) as doctor and the ethical and safety considerations that come with a non-human being involved in healthcare decisions. One of those questions we posed is an obvious one: who is to blame when AI gets it wrong? That is the dilemma at issue in a first-of-its-kind pair of lawsuits filed recently. In the latest, a Florida man details how he consulted ChatGPT about his symptoms of dizziness and variable blood pressure.