Does healthcare IT really improve medical care? Today we present the first in a series of articles that will explore how information technology (IT) is
The final rule on provider-based clinics is expected in early November. To understand changes being made relative to provider-based clinics, both Federal Registers must be
Chapter 8 changes appear to be less fair than ever before. “Life Isn’t Fair, but Government Must Be”— Former Texas Governor Ann Richards, 1991 Everyone
Even a podiatrist may not know for sure. When is a diabetic’s foot ulcer a pressure ulcer? When is a pressure ulcer a diabetic foot
New coding clinic edition offers much to review and follow. Everyone in health information management (HIM), coding, and CDI (clinical documentation improvement) is abuzz about
There is no specific code for this condition at the present time. Acute flaccid myelitis (AFM) is a rare and serious condition that affects the
The biggest holdout to Sepsis-3 is still CMS. UnitedHealthcare has announced that it will be adopting the Third International Consensus Definition for sepsis and septic
I looked up CPT® code 94762—pulse oximetry; continuous overnight determination—in Appendix B of the October 2018 OPPS to find the payment, and I happened to see a SI of Q3 for it. What does this mean?
My question relates to appending modifier -59 to multiple units. CPT® codes 97150 and 97113 X 4 have been charged, and I believe the requirements for the modifier have been met. That is, we should append modifier -59 to each unit of 97113 (i.e., apply -59 four times). Is that correct?
What is the correct way to bill for Q4116—AlloDerm, per square centimeter? I was informed our facility does not charge per square centimeter; they just charge a quantity of 1 for the full piece/sheet. Also, what is the compliant way to handle the waste of these products since modifier JW is not appropriate?
One of our patients had a lung ventilation-perfusion scan with SPECT/CT Imaging. How is this coded?
For our outpatients, we procure blood and blood products from a community blood bank that charges us only the processing and storage costs it has incurred. How do we bill for this?
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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