Pharmacy Question for the Week of October 26, 2020
MedLearn Publishing
October 24, 2020
We are administering Kytril by injecting it into the bag of hydrating fluid, what codes would we use to bill?
We are administering Kytril by injecting it into the bag of hydrating fluid, what codes would we use to bill?
What criteria must be met for NGS for germline cancer coverage to be considered reasonable and necessary?
Can we use 94799 to report the reassessment of cardio/respiratory response of infants, and if so how must we support it?
We have a referring physician that insists on ordering a unilateral screening mammogram on the same script as a unilateral diagnostic mammogram. Can you please advise as to the correctness of this order?
The pandemic continues to impact Medicare reimbursement. COVID-19 continues to make news on the regulatory front with two new directives from the Centers for Medicare
A culture of compliance is the key to success. There are no indications that audits of healthcare entities by government payers are slowing down –
There is hope for a resolution before the Nov. 3 election. Watching negotiations for the next federal COVID-19 relief package for the past two weeks
Never ignore a request for records by the single-state agency in your state. One of the best examples that illustrates the importance of the “single
Political discussions with family and friends could trigger emotional stress. EDITOR’S NOTE: With a presidential election fraught with enormous ramifications and stakes rapidly approaching, RACmonitor/ICD10monitor
Federal healthcare oversight authorities have spent much of the last six months promoting the use of telehealth services. It’s not the first time during
ICD-10-CM Mnemonics are updated for 2020. As the healthcare industry is celebrating the fifth anniversary of the adoption of ICD-10-CM/PCS, an appropriate celebration to mark
Can you report radiologic examination codes 71045 and 71046 with 93503?
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.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
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.
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