Public Intelligence Report · Updated Daily

State of Medical Coding AuditsActive CMS & MAC Alert Summary — June 2026

The table below maps every major medical specialty to its primary MAC jurisdiction, the number of currently active CMS and MAC reimbursement policy alerts, the highest-risk CPT code in that specialty's alert set, and the overall audit risk level — derived from live signal scoring of CMS transmittals, MAC LCDs, Federal Register notices, and OIG publications. Data is updated daily by CLV Intelligence.

438 total active alerts15 specialties monitored7 MAC contractors

Active alerts by specialty & MAC jurisdiction

State of Medical Coding Audits — Active CMS and MAC reimbursement alert summary by specialty and MAC jurisdiction as of June 24, 2026. Source: CLV Intelligence.
Specialty	MAC Jurisdiction	Active Alerts	Critical	Highest-Risk CPT	Risk Level
Oncology	NoridianJE, JF	78	24	CPT 96413Chemotherapy admin, IV push, initial	Critical
Pain Management	NoridianJE, JF	47	6	CPT 64490Injection, paravertebral facet joint, cervical	Moderate
Cardiology	CGSJ15	43	11	CPT 93306Echocardiography, complete transthoracic	Elevated
Source: CLV Intelligence · Updated daily from CMS, MAC LCD feeds, and Federal Register		438total	As of June 24, 2026

State of Medical Coding Audits — Active CMS and MAC reimbursement alert summary by specialty and MAC jurisdiction as of June 24, 2026. Source: CLV Intelligence.
Specialty	MAC Jurisdiction	Active Alerts	Critical	Highest-Risk CPT	Risk Level
Clinical Laboratory	NoridianJE, JF	38	7	CPT 80053Comprehensive metabolic panel	Moderate
Orthopedics	Palmetto GBAJJ, JM	21	8	CPT 27447Arthroplasty, knee, condyle and plateau	Elevated
Neurology	NGSJ6, JK	28	9	CPT 95819EEG, routine, awake and asleep	Elevated
Source: CLV Intelligence · Updated daily from CMS, MAC LCD feeds, and Federal Register		438total	As of June 24, 2026

+ 12 more specialties monitored

Create a free account to see the full audit intelligence table

Create free account

Data sources & methodology

All alert data is sourced exclusively from publicly available government and regulatory publications:

Centers for Medicare & Medicaid Services (CMS) — Transmittals, NCCI edits, fee schedule updates, program integrity notices
Medicare Administrative Contractors (MACs) — Local Coverage Determinations (LCDs), Billing & Coding Articles, provider bulletins
Federal Register — Proposed rules, final rules, CMS program transmittals with comment periods
OIG — Office of Inspector General — Work Plan updates, compliance guidance, fraud alerts

Signal scores (0–100) are assigned to each alert using the stored AI-scored value from CLV Intelligence's automated ingestion pipeline. Critical ≥ 80 · High ≥ 60 · Routine ≥ 40 · Low < 40. This table does not constitute legal, billing, or compliance advice.

Get full alert text, action recommendations, and source links

This table shows alert counts. Subscribers see complete alert details, effective dates, MAC LCD links, and coding action recommendations — updated every day.

Create free account View plans →

Get the weekly coding audit briefing — free

A summary of the week's highest-signal alerts across all specialties. No subscription required.