Delays in transitions to post-acute care are a vexing issue. I am continuing to see a significant number of healthcare organizations dealing with denials and
Is there a CPT code to report when a respiratory therapist provides instruction on how to use incentive spirometry in a physician’s office?
When are the code series 0537T-0540T reported?
What is the update to the local clinical laboratory fee for 2023?
For IVUS coding, what code do we report if a single pathology such as a bridging lesion crosses from one vessel to another?
Can contrast-enhanced ultrasound codes (76978–76979) be reported in addition to grayscale ultrasound codes if performed in the same session?
Hospitals are vulnerable to tragedies. EDITOR’S NOTE: Dr. John Zelem, a physician advisor for three community hospitals, shares his thoughts on the tragedy that struck
One of the most important payment areas to understand is the Outpatient Prospective Payment System (OPPS), which is used to provide payment for most hospital
The horror story of 99214. 99214. Is that Jean Valjean’s number? No. It is an evaluation and management (E&M) code of moderate complexity. Few CPT®
MAC advice to one hospital seems too good to be true. Boy, do I have a story to tell. Now, let me start by noting
The issue is reimbursement for overpayments made by the government. Today I’m writing about an unusual situation that Ronald Hirsch, MD raised recently. As a
During the last several months, the federal government has been siding with healthcare providers in an all-out assault on the prior authorization process, which requires
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.
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