Kepro and the Case of 18 Prescriptions for One Patient
The newsletter reveals a startling revelation. Last week Kepro, the BFCC-QIO (Beneficiary and Family Centered Care Quality Improvement Organization), hereafter referred to as “QIO”) for
The newsletter reveals a startling revelation. Last week Kepro, the BFCC-QIO (Beneficiary and Family Centered Care Quality Improvement Organization), hereafter referred to as “QIO”) for
Most rural hospitals do not have physician advisors but clearly need them. Last week RACmonitor published an article written by John K. Hall, MD, JD, MBA,
New code becomes effective Oct. 1, 2022. I participated in the development of a diagnosis proposal on PTEN Hamartoma Tumor Syndrome for the Coordination and
Colleen Deighan and ICD10monitor are producing an editorial series to report on the updated changes from the AMA. EDITOR’S NOTE: This morning, Colleen Deighan continues
Growing evidence suggests that claim denials are often based on a secondary diagnosis of severe malnutrition. Hospital inpatient denials continue at a furious pace. From
We noticed that descriptors for both CPT® codes 82803 and 82805 begin with the word “gases,” and had some confusion around measuring. In this case, should it mean that two or more blood gases must be measured? Please advise.
What modifier is needed when completing diagnostic cardiac catheterization when performed in conjunction with a coronary intervention?
What do left heart congenital catheterization codes (93595, 93596, 93597) include?
What is the intended use of codes 95812 and 95813?
How do you know when it is appropriate to report code 36218 for additional 2nd or 3rd order vessels selectively catheterized?
As discussed last month, the 2023 Medicare Physician Fee Schedule (PFS) rule has arrived, released by the Centers for Medicare & Medicaid Services (CMS) on
CMS is discontinuing certificates for medical necessity and durable medical equipment. CMS is discontinuing Certificates of Medical Necessity and Durable Medical Equipment (DME) information forms

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.

Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.

Stay ahead of the 2026-2027 audit surge with “Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue,” a high-impact webcast led by Michael Calahan, PA, MBA. This concise session gives hospitals and physicians clear insight into the most likely federal audit targets, such as E/M services, split/shared and critical care, observation and admissions, device credits, and Two-Midnight Rule changes, and shows how to tighten documentation, coding, and internal processes to reduce denials, recoupments, and penalties. Attendees walk away with practical best practices to protect revenue, strengthen compliance, and better prepare their teams for inevitable audits.

Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Stacey Shillito, CDIP, CPMA, CCS, CCS‑P, CPEDC, COPC. You’ll learn how to apply global maternity package rules accurately, select the right CPT codes for procedures and visits, and identify documentation gaps that lead to denials. With practical guidance and real examples, this session helps you strengthen compliance, reduce audit risk, and ensure accurate reimbursement for women’s health services.

Uncover essential coding insights with nationally recognized coding authority Kay Piper, RHIA, CDIP, CCS. Through ICD10monitor’s interactive, on‑demand webcast series, Kay walks you through the AHA’s 2026 ICD‑10‑CM/PCS Quarterly Coding Clinics, translating each update into practical, easy‑to‑apply guidance designed to sharpen precision, ensure compliance, and strengthen day‑to‑day decision‑making. Available shortly after each official release.

Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.

Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s third quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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