Last week I mused about how clinical validation queries do not appear to be keeping up with the volume of clinical validation denials. Perhaps one
Today, I want to continue to talk about something we have heard a lot about in 2024 and 2025. This is truly transformative and is
Recent studies have shown a troubling increase in cancer rates among women under 50; beyond the genetic factors, more research is exposing the role of
The announcement recently by Chinese’s DeepSeek of a low-cost, open-source large language model (LLM) akin to ChatGPT marks a significant milestone in the development of
A cardiologist performs a medically necessary pulmonary artery angiogram in conjunction with a non-congenital heart catheterization procedure. This angiogram is conducted prior to the placement of a pulmonary artery stent. Which add-on code(s) should be reported to accurately capture this service?
Do you have any more tips for reporting the JZ modifier?
A patient with an implant requires an MR procedure. The implant must be placed into a protective mode, and detailed documentation of this process is required. Additionally, a medical physicist is involved in customizing the implant settings to ensure MR compatibility. Which CPT® code(s) should be reported for this service?
What evidence is needed to bill for codes 94667 and 94668?
A laboratory is implementing a new HPV assay that uses in vitro PCR technology to simultaneously test both high-risk pooled and individual results. As of 2025, which CPT® code should be reported for this service, and which Category III code has been deleted in conjunction with this update?
Evaluation and Management (E/M) coding has undergone significant changes in recent years, creating new challenges for medical coders, a real risk to reimbursement, and the
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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