Audits rise, revenues fall. Hospitals across the nation are seeing lower profits, and it’s all because of a sudden tsunami of Medicare and Medicaid provider
The CMS Two-Midnight rules continues to prompt questions. Well, I finally read through the 1,394-page 2022 Outpatient Prospective Payment System (OPPS) Final Rule, and luckily,
Omnibus COVID-19 healthcare staff vaccination mandates—what does it mean for you? Physician practices and facilities have been doing everything they can to get staff and
The changes mark a fundamental shift to a regulatory provision that could have drastic financial ramifications for providers. The 2022 Medicare Physician Fee Schedule (MPFS)
Providers need to stay alert as to the areas being targeted for review by federally contracted entities. Medicare Part A covers, among other things, inpatient
Making the case for outpatient CDI in the emergency department. The emergency department (ED) is often the first place a patient is seen before being
I’ve heard that CMS changed payment for high throughput testing, is this true? If yes, how so?
When should we report code 95813?
We have a patient who received 3 hours of IV hydration. During that time, the patient received 2 different drugs by intravenous push. Can the entire 3 hours of IV hydration be coded with the intravenous push injections?
Our radiologist interpreted a right upper and lower quadrant (RUQ and RLQ) ultrasound ordered by the ER physician. The spleen was not examined so we cannot code a 76700 exam. Is it appropriate to code 76705 twice and add a 59 modifier to the second one?
How do we charge for radiopharmaceuticals when introducing them in the lumbar canal as part of reporting 78630? Do you have any other tips for reporting this situation?
In the instance when more than one site in the same vessel is treated with percutaneous transluminal coronary thrombectomy (92973), is it appropriate to report for each site treated?
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.
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.
Breast biopsy procedures may be clinically straightforward but accurately translating them into compliant billing can be anything but. In this focused webcast, Shawn Blackburn, CPC, CPMA, CIC, CRC, CCS-P breaks down how imaging guidance, lesion count, laterality, and payer expectations all impact how these procedures should be reported. Through clear explanations and real-world scenarios, you’ll gain practical insight into aligning clinical workflows with billing requirements, avoiding common pitfalls, and ensuring your documentation supports accurate reimbursement and compliance.
Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Sherri L. Clayton, RHIT, CSS. 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.
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