The ALJ Backlog Dissolves – and SMRC Audits Escalate
The long-running backlog at the ALJ may soon be a non-issue. The administrative law judge (ALJ) backlog will soon be no more. Yes, the 4-6-year
The long-running backlog at the ALJ may soon be a non-issue. The administrative law judge (ALJ) backlog will soon be no more. Yes, the 4-6-year
The CDC stance finally affirms how serious a threat racism is for population health. The date of April 8 is important in my world:
Providers would do well to prepare by taking a close look at their short stays. After a multi-year pause due to the COVID-19 pandemic and
Dear Colleague, Please join me in recognizing the outstanding work done every day by dedicated and compassionate Health Information Professionals (HIPs). We here at ICD10monitor,
Chronic or acute: questions persist in the new guidelines. You know, we have been using the new evaluation and management (E&M) guidelines for 96 days
Reflections on ICD-11. I would like to share some thoughts on ICD-11, for your consideration. First, ICD-11 is fully electronic; there will be no books.
Current issue includes most frequently asked questions about coding COVID-19. The American Hospital Association (AHA) central office is the official United States clearinghouse on medical coding for the
Proposed rules offer insight into the Administration’s priorities. The Centers for Medicare & Medicaid Services (CMS) has issued its first proposed payment rules under the
Can modifier 91 be appended to every laboratory code that is reported more than one time on the same date of service?
If a nurse is furnishing services that do not require the need for a respiratory therapist would the service be separately billable?
In the example of the EKG with an EP study, do you agree that we should report the 93005 but not modify it with modifier 59? Do other hospitals override the edit instead of using the GZ? If the entire claim is denied due to the GZ modifier being on the claim, what action should we take? Should we reach out to our FI?
Can you tell me more about when to use initial service codes versus additional codes for drug administration services?

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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