There is no need to worry about coding for HCCs or risk adjustment, writes the author. Just follow the coding guidelines. Confusion abounds regarding the
EDITOR’S NOTE: This article originally was published March 1, 2018 in the RACmonitor e-News A look back on the difficult end to a cherished friend’s
The American Hospital Association (AHA) recently announced that notes from social workers and registered nurses will be considered social determinants of health (SDoH). In 1945,
Ronald Hirsch, MD reported on this breaking news story during the Feb. 20 edition of Talk Ten Tuesdays. Here are highlights of that reporting.
What CPT® codes can we use for Medicare claims when we provide high-flow oxygen therapy?
If a record only states “lupus” what would this condition map/code to? I am an auditor at work, and I am in a debate on how to code lupus not otherwise specified (NOS). I say this condition codes to L93.0 but a colleague suggests I am incorrect and that lupus should code/map to M32.9? Do you have any guidance on this particular condition?
We have had many discussions on when it is appropriate to use 76706—ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA). Can we still assign this code if the radiology report does not document screening for AAA for the history and only states patient with abdominal pain but the final impression states no evidence of AAA?
When is 92961 used? If a patient with an implantable cardiac defibrillator (ICD) is cardioverted for atrial fib, is this the appropriate code to use?
What are the correct codes for billing a CBC with and without differential?
When using the JW modifier, should the dollar amount be included on the wastage line or should the line reflect units only?
A look back on the difficult end to a cherished friend’s life. “Larry only has a couple of weeks to live,” read the Facebook message
Guidance on a common unbundling modifier has shifted frequently during the last decade. Anthem Blue Cross Blue Shield (BCBS) were set to implement a new
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.
Bring your questions and join the conversation during this open forum series, live every Wednesday at 10 a.m. EST from June 11–July 30. Hosted by Chuck Buck, these fast-paced 30-minute sessions connect you directly with top healthcare experts tackling today’s most urgent compliance and policy issues.
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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