Hello, and a very happy National Case Management Week to all of you! Every case manager out there, nurse or social worker, has had to
As we conclude National Case Management Week 2025 with the theme of “Guiding Journeys,” we are making a point of celebrating case management professionals who
When a patient leaves the hospital against medical advice (AMA), the discharge is not only a clinical concern, but it can also create coding and
Someone recently asked on LinkedIn if they must always sequent a UTI as the principal diagnosis when encephalopathy due to a urinary tract infection (UTI)
September is the annual Suicide Prevention Month which is also a reminder to examine our coding considerations. In March of this year, the Centers for
Mandatory vs. discretionary spending Antideficiency Act “exceptions” Under the Antideficiency Act (which prohibits federal agencies from incurring obligations without appropriations), there are certain exceptions that
If a patient has rheumatoid arthritis and comes in for a methotrexate injection, do we use the chemotherapy injection code?
Is it possible to report biliary stenting codes (47538, 47539, 47540) more than once per session?
What revision was made to the description of CPT code 94640 in 2016?
If a patient is brought to the cardiac cath lab and only bypass grafts were visualized (for example, SVG to the right coronary artery (RCA), and SVG to the circumflex) with no native coronary arteries being injected or imaged, what is the appropriate CPT procedure to code/charge?
What is cytogenetic testing?
As 2026 approaches, interventional radiology teams face mounting pressure from coding overhauls and tightening reimbursement rules—especially for complex procedures like catheter-directed thrombolysis. The storm of
Medicare regulations are complex and even seasoned professionals struggle to apply them consistently. Due to overwhelming demand, Dr. Hirsch returns for Part 2 of Ask Dr. Hirsch: Clarifying Medicare’s Most Misunderstood Rules to answer even more of Medicare’s most misunderstood questions, covering inpatient status, observation, SNF access, Medicare Advantage denials, and more. Join Dr. Hirsch as he provides clear, referenced answers to real-world questions submitted by your peers, helping you navigate Medicare compliance with confidence and clarity.
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.
Artificial intelligence is rapidly transforming healthcare revenue cycle operations, from coding and auditing to compliance and denials. Join industry leaders Pam Warren (MaineHealth) and Raemarie Jimenez (AAPC) for a live fireside chat exploring how AI is changing workflows, workforce roles, payer-provider dynamics, and compliance risk—and what organizations should be doing now to prepare.
Prepare for FY 2027 IPPS changes with a comprehensive 3-part masterclass covering ICD-10-CM/PCS updates, MS-DRG shifts, NTAPs, compliance risks, and reimbursement strategies.
Stay ahead of FY 2027 reimbursement changes with expert analysis of MS-DRG shifts, NTAP updates, Medicare Code Edits, and emerging technologies impacting inpatient payment accuracy.
Stay ahead of FY 2027 ICD-10-PCS changes with expert analysis of new procedure codes, revised guidelines, and high-impact updates affecting reimbursement, compliance, and inpatient coding accuracy.
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