Pharmacy Question for the Week of July 22, 2019
MedLearn Publishing
July 22, 2019
Can you provide details on the RAC audit for prophylactic and diagnostic injections?
Can you provide details on the RAC audit for prophylactic and diagnostic injections?
Wrapping your brain around Cerebral Edema You may be noticing an uptick in clinical validation denials for cerebral edema. Here’s my take on this. There
Author finds fault with WPS policy. You might think that you could rely on the accuracy of a Medicare Administrative Contractor (MAC) policy, but apparently,
President Trump issues an executive order on kidney disease and a new payment model for radiation therapy. As reported by Dr. Ronald Hirsch on the
An interview with a subject matter expert sheds light on one of healthcare’s trendiest topics. Editor’s Note: Ellen Fink-Samnick is a member of the RACmonitor
Hot topics come and go – and healthcare is no exception. A few years ago, predictive analytics (PA) was making its rounds, and I remember
Coverage would include those suffering from chronic lower back pain who are also enrolled in approved studies. The Centers for Medicare & Medicaid Services (CMS)
With the reimbursement so complex and antiquated, should Congress investigate? Medicare reimbursement payments to hospitals for graduate medical education are based on calculations so complicated,
Guidance and advice effective with discharges occurring on and after June 21, 2019. The American Hospital Association (AHA) Coding Clinic for ICD-10-CM/PCS for the second quarter
“Let me count the ways.” EDITOR’S NOTE: Dr. Remer reported on this topic during the most recent edition of Talk Ten Tuesdays. I have been
All bad documentation is based on lies – the lies doctors (and all human beings) tell themselves. We always believe our lies, because they are
The Gravity Project will be the editorial focus on tomorrow’s Talk Ten Tuesdays. The latest big development associated with the oft-discussed social determinants of health
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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