Overview of CMS final rules is provided by the author So this is the season for 2019 Medicare facility payment rules. These rules are required
The author comments on proposed E&M changes. Has my entire career been based on a lie? For 33 years, I have been espousing the party
CMS is proposing major changes to overhaul E&M services. As I read through more and more articles and white papers on the new proposed 2019
Change to the inpatient admission order considered to be major. Late last week, the Centers for Medicare & Medicaid Services (CMS) released the Inpatient Prospective
Major overhaul to physician reimbursement is proposed. The Centers for Medicare & Medicaid Services (CMS) revealed the proposed rule for Medicare Physician Fee Schedule (MPFS),
Experts warn of challenges for IRFs in FY 2020. The final rule for fiscal year (FY) 2019 for Inpatient Rehabilitation Facility (IRF) Payment has been
CMS proposes significant changes to E&M services. There has been much confusion over the years regarding documenting for evaluation and management (E&M) services since the
Changes coming with 2019 Official Guidelines for Coding and Reporting of ICD-10-CM The 2019 Official Guidelines for Coding and Reporting of ICD-10-CM have been released,
New codes to be presented at the September Coordination and Maintenance Committee meeting There is a lot of buzz in the industry about the possibility
Major E&M changes on the horizon. Probably the biggest change in healthcare in two decades is the Centers for Medicare & Medicaid Services (CMS) proposal
Major E&M changes on the horizon. Probably the biggest change in healthcare in two decades is the Centers for Medicare & Medicaid Services (CMS) proposal
We have a Coumadin clinic at our facility. The patients are seen by a Coumadin nurse who does a full assessment on the patient she sees every month. During the assessment she also does a PT/INR check on the patient. Is it appropriate to bill the evaluation and management (E & M) level G0463 and the PT/INR check 85610. We have been struggling with this issue for a while and would like some clarifications as soon as possible.
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.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
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.
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