We stay up to date on the ever-changing insurance market's impacts on your specialty for you...because it's basically a full time job in and of itself.
Payer contracts set the financial baseline for your whole practice. What credentialing and contracting really take, why rate negotiation is a 12–18 month specialist job, and how to decide as a new practice.
Free-flap breast reconstruction (CPT 19364: DIEP, fTRAM, SIEA, GAP) is WHCRA-mandated. The S-code sunset and co-surgeon billing decide what it pays.
Does your EMR’s AI actually exist yet? A vendor-by-vendor 2026 scorecard of specialty EMR/EHR AI — what shipped, what’s roadmap, and what to ask.
Endovenous vein ablation (36475 RF, 36478 laser) is covered for documented saphenous reflux after a failed compression trial — not for spider veins or appearance.
Breast reduction (CPT 19318) coverage isn’t only the Schnur gram threshold — two documented symptoms can qualify it, and prior auth decides whether it pays.
Functional blepharoplasty (CPT 15823) is covered only when excess eyelid skin blocks vision — and the visual field test, not the photo, is what proves it.
What’s new in plastic surgery and dermatology EMRs for 2026 — Nextech, ModMed, Symplast, EZDERM, and more — and how to pick the best fit for your practice.
Lipedema liposuction (CPT 15877-15879) uses the same codes as cosmetic lipo, so payers deny by default. The documentation that actually gets it covered.
Therapeutic Botox (J0585 + 64615) is covered for chronic migraine and more — but the unit count, JW/JZ wastage, and failed-preventive gate decide the claim.
Benign lesion removal (CPT 17110, 11400-11446) is covered only when symptomatic — and the ICD-10 diagnosis, not the procedure, decides whether it pays.
