Last week I wrote about the ongoing issue of Medicare Advantage (MA) denials related to appropriate transfer to a skilled nursing facility (SNF) and the
I took an unusual call from a colleague a few weeks ago. He was panicked, because his hospital has a physician who has been performing
When the federal Public Health Emergency (PHE) ended on May 11, many of the waivers that kept external audits in check also vanished. As a
The Centers for Medicare & Medicaid Services (CMS) has announced a new approach to penalties applied under the Hospital Price Transparency rule. Before I describe
May is National Mental Health Awareness month, and slightly more than half of American adults are estimated to be suffering from some form of mental
Last week, the chief medical officer (CMO) for the Centers for Medicare & Medicaid Services (CMS), Dora Hughes, MD, MPH, published a blog in Health
The origins of Health Maintenance Organizations (HMOs) can be traced back to the early 20th century, when prepaid group practice models began to emerge. These
On April 2, my 92-year-old father sustained a fall in his assisted living facility (ALF), which resulted in an emergency department evaluation. Fortunately, he hadn’t
When a frozen/thawed product is not infused and is destroyed can a hospital bill for the P-code for unused blood products?
How do you determine the appropriate code to report MRI of the foot? Should it be reported as an MRI of the lower extremity joint or as an MRI of the lower extremity non-joint?
Can you tell me more about the J2 modifier?
Can we assign 93460 if a left ventriculogram is performed?
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.
RACmonitor is proud to welcome back Dr. Ronald Hirsch, one of his most requested webcasts. In this highly anticipated session, Dr. Hirsch will break down the complex Two Midnight Rule Medicare regulations, translating them into clear, actionable guidance. He’ll walk you through the basics of the rule, offer expert interpretation, and apply the rule to real-world clinical scenarios—so you leave with greater clarity, confidence, and the tools to ensure compliance.
Bring your questions and join the conversation during this open forum series, live every Wednesday at 10 a.m. EST from June 11–July 30. Hosted by Chuck Buck, these fast-paced 30-minute sessions connect you directly with top healthcare experts tackling today’s most urgent compliance and policy issues.
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.
This third session in our 2026 IPPS Masterclass will feature a review of FY26 changes to the MS-DRG methodology and new technology add-on payments (NTAPs), presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.
This second session in our 2026 IPPS Masterclass will feature a review the FY26 changes to ICD-10-PCS codes. This information will be presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.
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