Page 447 – MedLearn Publishing

Cardiology Question for the Week of February 18, 2019

MedLearn Publishing February 18, 2019

A question came from the director of our cardiovascular services (CVS) department today. When a right heart catheterization is done to aid in the placement of a CS lead, is that reported separately? Our dictation only briefly gives findings of RA and LA pressures. We also do an angiogram with the right heart cath. If it is something we can bill for, can you please advise what would need to be included in the dictation? We are not required to add a modifier on the RHC code.

Respiratory Question for the Week of February 18, 2019

MedLearn Publishing February 18, 2019

Is there a CPT code to report when a respiratory therapist provides instruction on how to use incentive spirometry in a physician’s office?

Pharmacy Question for the Week of February 18, 2019

MedLearn Publishing February 18, 2019

What are the criteria for antigen payments?

Laboratory Question for the Week of February 18, 2019

MedLearn Publishing February 18, 2019

Is the performing laboratory required to bill Medicare for the test if all conditions of the new laboratory DOS exception are met?

Radiology Question for the Week of February 18, 2019

MedLearn Publishing February 18, 2019

If the technologist takes right and left lateral images of nasal bones along with a Waters’ view, is this considered the three views necessary for code 70160?

Lawsuit by Policyholders Targets Anthem

Mary Inman, Esq. February 14, 2019

Individual policyholders in Georgia launch a class-action lawsuit against Anthem for deceptive sales. Early last week, Frances Kirby and John David Marks, two individual policyholders

Lawsuit by Policyholders Targets Anthem

Mary Inman, Esq. February 14, 2019

Individual policyholders in Georgia launch a class-action lawsuit against Anthem for deceptive sales. Early last week, Frances Kirby and John David Marks, two individual policyholders

CMS Eliminates Reporting of Functional Limitation Codes

Nancy J. Beckley, MB, MBA, CHC February 14, 2019

CMS also has updated its therapy manuals, making elimination of FLR official. Many therapy providers, at hospital outpatient departments and private-practice clinics alike, were reluctant

The Hard Fact About ABNs in the ED

Juliet Ugarte Hopkins, MD, ACPA-C February 14, 2019

Weighing the difficult decisions being made in the business of healthcare. Medicine has commonly been considered one of the most altruistic professions. From long years

Medicare Advantage Plans Often Decline Authorizations for Long-term Acute Care (LTAC) Transfers

Howard Stein February 14, 2019

Patients “managed” out of benefits on Medicare Advantage programs. Administrative overhead for Medicare fee-for-service operations typically runs at approximately 2-3 percent. Overhead for commercial insurance

Clinical Documentation Integrity Programs Eroding Net Patient Revenue

Glenn Krauss, RHIA, BBA, CCS, CCS-P, CPUR, CCDS, C-CDI, PCS, FC February 12, 2019

CDI professionals can’t mitigate the magnitude of medical necessity denials by third-party payers. Clinical documentation integrity (CDI) programs, combined with the actions of third-party payers,

AHIMA Coding Productivity Study and Preparing for ICD-11

Julie A. Dooling, MSHI, RHIA, CHDA, FAHIMA and Melanie Endicott, MBA/HCM, RHIA, CDIP, CHDA, CPHI, CCS, CCS-P, FAHIMA February 12, 2019

Planning is underway now for ICD-11. The American Health Information Management Association (AHIMA) has been getting involved in the development of ICD-11 through its participation

Compliance for the Inpatient Psychiatric Facility (IPF-PPS): Minimizing Federal Audit Findings by Strengthening Best Practices

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.

April 9, 2026

Mastering MDM for Accurate Professional Fee Coding

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.

March 31, 2026

The PEPPER Returns – Risk and Opportunity at Your Fingertips

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.

March 19, 2026

Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue

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.

January 29, 2026

Featured Webcasts

Mastering OB GYN Coding Accuracy: Precision Coding for Compliance and Reimbursement

Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Sherri L. Clayton, RHIT, CSS. 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.

May 14, 2026

2026 ICD-10-CM/PCS Coding Clinic Update Webcast Series

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.

April 13, 2026

2026 ICD-10-CM/PCS Coding Clinic Update: Fourth Quarter

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.

December 14, 2026

2026 ICD-10-CM/PCS Coding Clinic Update: Third Quarter

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.

October 12, 2026

Cardiology Question for the Week of February 18, 2019

Respiratory Question for the Week of February 18, 2019

Pharmacy Question for the Week of February 18, 2019

Laboratory Question for the Week of February 18, 2019

Radiology Question for the Week of February 18, 2019

Lawsuit by Policyholders Targets Anthem

Lawsuit by Policyholders Targets Anthem

CMS Eliminates Reporting of Functional Limitation Codes

The Hard Fact About ABNs in the ED

Medicare Advantage Plans Often Decline Authorizations for Long-term Acute Care (LTAC) Transfers

Clinical Documentation Integrity Programs Eroding Net Patient Revenue

AHIMA Coding Productivity Study and Preparing for ICD-11

Featured Webcasts

Compliance for the Inpatient Psychiatric Facility (IPF-PPS): Minimizing Federal Audit Findings by Strengthening Best Practices

Mastering MDM for Accurate Professional Fee Coding

The PEPPER Returns – Risk and Opportunity at Your Fingertips

Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue

Trending News

HIP Week Publishers Letter

Questionable Admission Decisions – And When to Report Them

The AbbVie 340B Lawsuit Signals a Shift from Access to Definition

Special Bulletin: How HHH Insulated Medicare Appeals from the Supreme Court Reform

Featured Webcasts

Mastering OB GYN Coding Accuracy: Precision Coding for Compliance and Reimbursement

2026 ICD-10-CM/PCS Coding Clinic Update Webcast Series

2026 ICD-10-CM/PCS Coding Clinic Update: Fourth Quarter

2026 ICD-10-CM/PCS Coding Clinic Update: Third Quarter

Trending News

Fresh Scrutiny of NSA IDR Figures Shows a Program that’s Strained, but Working as Intended

Decoding Burnout – The Hidden Strain Facing Medical Coders

Using AI to Study Clinician Behavior – and the Compliance Risk Hidden Inside It

Why AI Tools Used in the Revenue Cycle Require Human Oversight

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