I believe that part of the answer in last week’s posting is incorrect. You stated that code Q5102 (which describes both currently available versions of infliximab biosimilars) will be discontinued and replaced with codes 5102 and 5014. Although it’s true Q5102 will be discontinued March 31, 2018, I don’t think the replacement codes are correct. Can you provide the right codes?
A patient came in for a whole body thyroid cancer metastases imaging and a SPECT/CT of the neck and chest also was performed. What CPT® code are we to assign here since there is no CPT code for the SPECT/CT?
What kind of documentation does Medicare require when physicians write requisitions or orders for respiratory-assistive devices (RADs)?
Why does the 2018 NCCI Policy Manual state that we can only charge for one venipuncture (36415) per patient encounter, but the MUE limit for 36415 is set at 2 per date-of-service?
If a procedure or service has been assigned a CPT® code, does that mean Medicare will cover it?
What code should be assigned when a battery is replaced for a pacemaker?
Coders are encouraged to learn more about the clinical conditions associated with the patient encounters they are coding. As coders, we often struggle with assigning
The ICD-10 code set is growing, and feedback from the medical community on the changes is needed. This is the first in a series of
This article has been removed pending further editorial review. View Don’t let Type 2 MI give you a heart attack! By Erica E. Remer, MD, FACEP, CCDS
Three key takeaways from this effort by healthcare giant UnitedHealthcare UnitedHealthcare (UHC) is continuing its quest to revamp many facets of our healthcare industry. Last
Questions still linger regarding specifics of implementation. By Mark Spivey Arkansas has become the nation’s third state to implement a work requirement for Medicaid, according
Whatever you do, don’t bring patients back for a procedure another day just for the purposes of billing. Determining when to use Modifier 25 can
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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