IRF Denials for Medical Necessity: Can We Defend Our Admissions?
With an expected ramp-up in audits and denials for care across all healthcare services in the coming months, we continue to hear questions related to
With an expected ramp-up in audits and denials for care across all healthcare services in the coming months, we continue to hear questions related to
Coding must be supported by documentation, but also by the Official Coding Guidelines. While preparing for a clinical validation presentation on acute kidney injury denials,
A well-known complication of atrial fibrillation for patients to form clots. EDITOR’S NOTE: Dr. Remer reported this story during a recent edition of Talk Ten
The term “antibody” has entered our main-stream vocabulary due to the advent of SARS-CoV-2 with manifestation of disease as COVID-19. Antibodies are also called immunoglobulins.
As we all know, President Trump has returned to the White House after a three-day stay at Walter Reed National Military Medical Center, where he
There is a term we now use for patients who are suffering from sequela conditions of COVID-19 which is Long Haulers. There are many conditions/signs
All payers are becoming more aggressive with their claim reviews. COVID-19 alone may trigger enough denials or requests for records to keep one or more
When we perform a nuclear medicine thyroid scan and uptake using I 123 capsules are we allowed to charge the patient for the standard capsules?
Can extremity angiography codes 75710 and 75716 be assigned for selective and non-selective imaging?
When billing for infusion services, would we need to validate the NCD on a claim for the drug vial?
How many components of a complete blood count should be ordered if we want to report a comprehensive code?
I just have a quick question on which charge is sent for a pediatric transthoracic echocardiogram complete. This would be on a newborn of 21 days. Some articles say the first echo is 93306, then if dx with a congenital anomaly, then follow-ups are 93303. What is your guidance?
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.
Learn how to navigate the proposed elimination of the Inpatient-Only list. Gain strategies to assess admission status, avoid denials, protect compliance, and address impacts across Medicare and non-Medicare payors. Essential insights for hospitals.
RACmonitor is proud to welcome back Dr. Ronald Hirsch, one of his most requested webcasts. In this highly anticipated session, Dr. Hirsch will break down the complex Two Midnight Rule Medicare regulations, translating them into clear, actionable guidance. He’ll walk you through the basics of the rule, offer expert interpretation, and apply the rule to real-world clinical scenarios—so you leave with greater clarity, confidence, and the tools to ensure compliance.
Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY26 IPPS, including new ICD-10-CM/PCS codes, CCs/MCCs, and MS-DRGs, plus insights, analysis and answers to your questions from two of the country’s most respected subject matter experts.
This third session in our 2026 IPPS Masterclass will feature a review of FY26 changes to the MS-DRG methodology and new technology add-on payments (NTAPs), presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.
This second session in our 2026 IPPS Masterclass will feature a review the FY26 changes to ICD-10-PCS codes. This information will be presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.
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