No Surprises Act Features Some Unpleasant Surprises for Providers
OON providers in particular are troubled by certain provisions of the legislation. The interim final rule (IFR) for the federal No Surprises Act was released
OON providers in particular are troubled by certain provisions of the legislation. The interim final rule (IFR) for the federal No Surprises Act was released
If overpayments are found, then the extrapolation recoupment number will go up; if underpayments are found, the extrapolation will go down. EDITOR’S NOTE: This is
Dr. Remer was very conflicted about attending, but had committed, so she went. This is her story. I’m not going to lie. I was anxious
What can medical assistants (MAs) do and not do? Medical assistants (MAs) have a narrow list of things they can do for patients or a
This year’s flu vaccine was designed to protect against four distinct strains of the virus. Flu season has arrived! The best time to get vaccinated
Severe maternal morbidity often intersects with cesarean deliveries. Reducing the number of cesarean deliveries can lower the maternal mortality rate, and one of the drivers
What do U0003 and U0004 identify?
Is a face-to-face clinical evaluation required for a sleep study?
If a magnetic resonance imaging (MRI) study is not completed due to the patient being in too much pain, how should this be billed for a non-hospital office? We used a 52 modifier, but Medicare is denying it saying that is an inappropriate modifier. Would you just bill it as a regular study?
We are adjusting off quite a few computed tomography (CT) scans that are performed to follow up a cancer diagnosis after treatment is complete. Our state’s local coverage determination (LCD) covers the cancer diagnosis code but does not cover the “history of” the specific cancer nor does it cover Z08 for completion of treatment. Is there any compliant way around this denial? For instance, can we bill the cancer diagnosis that is covered even though the report states no evidence of recurrence or metastasis?
How is Iodine I-123 used for 78015?
If biventricular lead insertion into the coronary sinus is unsuccessful, what modifier would we use for coding 33224 and 33225 when reporting physician claims?

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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