Severe Protein Calories Malnutrition in the OIG Crosshairs
The OIG continues to review cases of malnutrition. The diagnosis of severe protein calorie malnutrition is under high scrutiny from the Centers for Medicare &
The OIG continues to review cases of malnutrition. The diagnosis of severe protein calorie malnutrition is under high scrutiny from the Centers for Medicare &
In addition to CTE, head trauma could also lead to Parkinson’s and ALS. The National Football League (NFL) signed an agreement in January 2017 covering
It’s not the credentials, but knowledge of the clinical validator that counts. Clinical documentation integrity (CDI) professionals come from a variety of backgrounds and skill
I am looking for the correct codes to assign when our provider documents that bilateral selective carotid artery angiogram and intracerebral artery angiogram were performed followed by selective left subclavian artery and left vertebral artery angiogram. Would the correct coding be CPT® 36223-50 and 36226-LT? Or would it be 36223-50 and 36225-LT?
When does the new laboratory DOS policy take effect?
For medications used from Canada that have only a DIN and not an NDC, are you aware if there is a generic NDC that can be used or if CMS and other payers ever recognize the DIN on claims?
How would the CMS site-neutral payment policy work?
There is no CPT® code for MRA (magnetic resonance angiography) bilateral extremity run-off, and a colleague says that we should only bill a MRA of the abdomen and MRA of both extremities. A separate code for the pelvis should not be assigned for MRA pelvis because this overlaps the abdomen and extremities. Is this correct?
How is oxygen billed to Medicare?
Condition 44 is one of three perplexing issues reviewed by the author. Last week was a boring regulatory week, other than the continuing talk about
Practices need to get a handle on both their financial and RVU impacts. Recently, the Centers for Medicare & Medicaid Services (CMS) released a proposed
The proposal is on the table as part of proposed E&M changes. By now I am sure that everyone is well aware that the Centers
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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