Use this handy checklist as you update your facility for the Second Quarter. April is the beginning of a new quarter, and a checklist
Office billing is now based solely on either MDM or total time. Last week, I declared that it is my opinion that medical decision-making (MDM)
The challenges of obtaining prior authorizations are further compounded by staffing shortages and a tightened labor market. For proposed rule 87 FR 3475, the Office
The case of the convicted nurse and the criminalization of errors made without intent is beyond troubling. In Tennessee, a 37-year-old nurse was recently convicted
COVID-19 is still a pandemic for the unvaccinated. We may be done with COVID, but it’s not done with us. No surprise, but there’s a
Dear Colleague… Please take a moment from your very busy schedule to join me in commemoration of World Health Day, coming up on Thursday, April
For cervical carotid stenting, is there a code for ‘each additional vessel’?
Can injection procedure codes 93563-93568 be reported in conjunction with one another?
As a follow-up question to last week’s topic, can you provide any examples of per flat-rate trip billing?
We received an order from a referring physician that requested an ultrasound (US) thyroid for nodule assessment and a US soft tissue for a submental mass palpable on the exam. The facility coder believes that the facility should get two charges. The interpretation covers both areas in one report. It is my understanding that US head and neck (CPT® 76536) would cover both of these assessments. Am I correct? The evaluation is performed for two separate reasons, but the imaging is of the neck.
What are the codes for extended EEG monitoring and how do they differ from normal EEG monitoring?
Sticker shock no more. Today I will be giving you my point of view on the No Surprises Act – a topic of great interest
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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