On our COVID floors, we have big flat-screen monitors that are scoreboards in the COVID race: heart rate, QT interval, and, critically, oxygen saturation. They are a kind of electronic cheat sheet that allows you to handicap a patient’s chance of winning the COVID contest before you even meet them in person.
I went into a room this morning with the impression that a patient wasn’t going to either win, place, or show in their race with COVID. The patient, it seemed, had come to the same conclusion, and had chosen neither to be resuscitated nor intubated.
It was a sound bet to make. We were pumping in all the oxygen we could, and her oxygen saturation was still low enough to qualify for home O2. She would finish this COVID race under her own power – one way or another.
I asked the medically rhetorical question, “how are you doing?”
The patient answered, “do you know why aunt…” Her voice trailed off behind the hermetically sealed BiPAP mask she was trapped in.
“What about your aunt?”
“Not aunt! Ants, ants!”
“You mean the bugs?”
The BiPAP-masked patient nodded in assent and shouted through a positive pressure of 18/8 cm, “do you know why ants don’t get sick?”
“No, I don’t. Why.”
And through a positive pressure-enhanced smile, the patient answered, “because they have anty-bodies!” Then she laughed upstream against the onrushing BiPAP airflow.
I laughed an N-95-stifled laugh – it was laughter, even if it was only PPE laughter. My laughing choked off as I watched her oxygen saturation drop from a very low 87 percent, to a really, really low 84 percent, to a breathtakingly low 81 percent.
“Take slow breaths!”, was my post-joke advice. “Slow and deep.”
“Thanks,” she kind of coughed.
“Thanks for what?” I asked back.
“For getting my joke!” she chortled. It was a hypoxic, anti-COVID chuckle. She was one of the rare COVID patients to make me feel a little bit of glee. Hers was one of the few COVID rooms I left feeling better coming out than going in.
I went back to the medical scoreboard. Her O2 sat was still only 84 percent. I watched it until it got back up to 87 percent. Then satisfied her joke wasn’t going to kill her at the moment, I walked on.
I do not know if ants get sick, I do not know if she will win her COVID race, but in her own joyful way, she had already beaten COVID, even though the scoreboard flashed that she was losing.
For decades, clinical documentation integrity (CDI) programs have been synonymous with inpatient care. They evolved from early efforts to improve Diagnosis-Related Group (DRG) accuracy into
The 2026 Medicare Physician Schedule Final Rule includes several distinct policy changes in which the Centers for Medicare & Medicaid Services (CMS) modifies how it
Please log in to your account to comment on this article.
Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY26 IPPS, including new ICD-10-CM/PCS codes, CCs/MCCs, and MS-DRGs, plus insights, analysis and answers to your questions from two of the country’s most respected subject matter experts.
Get clear, practical answers to Medicare’s most confusing regulations. Join Dr. Ronald Hirsch as he breaks down real-world compliance challenges and shares guidance your team can apply right away.
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.
Learn how to navigate the proposed elimination of the Inpatient-Only list. Gain strategies to assess admission status, avoid denials, protect compliance, and address impacts across Medicare and non-Medicare payors. Essential insights for hospitals.
Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
