Have you heard that the Medicare Advantage (MA) plans are required to follow the provisions of the Two-Midnight Rule, as of Jan. 1? Well, they
While billing for services “incident to a physician’s” comes with challenges, the difficulties are often exaggerated. First, do you need to have a physician present
The Centers for Medicare & Medicaid Services (CMS) has recently unveiled the Calendar Year (CY) 2025 Advance Notice of Methodological Changes for Medicare Advantage (MA)
The disease afflicts about 100,000 Americans and drastically lowers life expectancy. Federal officials announced last week that sickle cell disease (SCD) will be the
I am currently performing a fraud assessment, and since I can’t go back and educate the provider in question, I am going to share my
Today I want to write about one of our current hot-button topics: artificial intelligence, better known as AI. First, I want to pose the question:
This report includes a collection of topics. Compliance, CPT® Panel Meeting, and new CPT codes for respiratory syncytial virus (RSV) vaccine administration are included in
For 2024, what are the latest practice parameters in regard to image quality in mammography?
What is meant by a “port” in central venous access procedures?
A patient undergoes remote physiologic monitoring (RPM) for weight, blood pressure, pulse oximetry, and respiratory flow rates using a medical device that meets the FDA’s definition. The collected and transmitted data are digitally transmitted, and the service is ordered by a physician. The patient receives education on using the device, and the device is supplied for daily recording or programmed alert transmissions. The monitoring duration is over 30 days. Which codes should be reported in 2024 for this remote physiologic monitoring service, and are there any specific conditions or limitations associated with reporting these codes?
How should a laboratory document the miles traveled to collect a specimen in 2024?
We had an interventional cardiologist perform a percutaneous left heart catheterization, then selective injections of the left ventricle and coronary arteries for diagnostic purposes. This was followed by mechanical thrombectomy of the LAD artery with subsequent drug-eluting stent placement in the LAD. How would we code this?
Medicare regulations are complex and even seasoned professionals struggle to apply them consistently. Due to overwhelming demand, Dr. Hirsch returns for Part 2 of Ask Dr. Hirsch: Clarifying Medicare’s Most Misunderstood Rules to answer even more of Medicare’s most misunderstood questions, covering inpatient status, observation, SNF access, Medicare Advantage denials, and more. Join Dr. Hirsch as he provides clear, referenced answers to real-world questions submitted by your peers, helping you navigate Medicare compliance with confidence and clarity.
Traditional utilization management models can no longer keep pace with regulatory shifts, payer scrutiny, and operational pressures. In this webcast, Tiffany Ferguson, LMSW, CMAC, ACM, ACPA-C, introduces an Adaptive Model strategy that modernizes UM through role specialization, technology-driven workflows, and proactive, team-based processes. Attendees will learn how to restructure programs to improve efficiency, strengthen clinical collaboration, and enhance financial performance in a rapidly changing healthcare environment.
Federal auditors are intensifying their focus on inpatient psychiatric facilities, using advanced data analytics to spotlight outliers and pursue high‑dollar repayments. In this high‑impact webcast, Michael Calahan, PA, MBA, Compliance Officer and V.P., Hospital & Physician Compliance, breaks down what regulators are really targeting in IPF-PPS admissions, documentation, treatment and discharge planning. Attendees will learn practical steps to tighten processes, avoid common audit triggers and protect reimbursement and reduce the risk of multimillion-dollar repayment demands.
In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.
Artificial intelligence is rapidly transforming healthcare revenue cycle operations, from coding and auditing to compliance and denials. Join industry leaders Pam Warren (MaineHealth) and Raemarie Jimenez (AAPC) for a live fireside chat exploring how AI is changing workflows, workforce roles, payer-provider dynamics, and compliance risk—and what organizations should be doing now to prepare.
Prepare for FY 2027 IPPS changes with a comprehensive 3-part masterclass covering ICD-10-CM/PCS updates, MS-DRG shifts, NTAPs, compliance risks, and reimbursement strategies.
Stay ahead of FY 2027 reimbursement changes with expert analysis of MS-DRG shifts, NTAP updates, Medicare Code Edits, and emerging technologies impacting inpatient payment accuracy.
Stay ahead of FY 2027 ICD-10-PCS changes with expert analysis of new procedure codes, revised guidelines, and high-impact updates affecting reimbursement, compliance, and inpatient coding accuracy.
This Memorial Day, we honor those who gave all for our freedom. Take 20% off sitewide through May 29 with code MEMORIAL26 at checkout
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
