Clarity is badly needed for the quarterly health data report. Every quarter, the quality representatives at most hospitals receive their Program for Evaluating Payment Patterns
For implanted cardioverter defibrillators, (ICDs) there is no national coverage determination (NCD), nor is there an implementation date. As we have reported in past
For implanted cardioverter defibrillators, (ICDs) there is no national coverage determination (NCD), nor is there an implementation date. As we have reported in past editions
“Ebony and ivory live together in perfect harmony Side by side on my piano keyboard, oh Lord, why don’t we?”— Sir Paul McCartney and Stevie Wonder,
Communication, collaboration, and coding exemplify the tone of last week’s C & M meeting. “Communication, collaboration, and coding” are three words that describe the March
Recently I reviewed a case that triggered an exposition. As a clinician, I am always trying to wrap my head around a coding-clinical disconnect in
Can you explain Medicare’s policy regarding when an inpatient admission changes to outpatient?
Are there any new drugs with pass-through status for the next quarter?
In the urgent care setting, would we bill a J code for the appropriate drug in addition to the CPT® procedure code 94640?
Are there any restrictions on the types of specimens that can be assigned CPT® codes for drug-analysis procedures?
If a patient is having a computed tomography (CT) abdomen/pelvis without contrast (CPT® 74176) and the physician orders two doses of Omnipaque 3,000 mg (Q9967) in 500 ml of sterile water to be administered orally 30 minutes before the exam, can we bill separately for the contrast? If so, is the contrast billed per ml? (I understand that whether intravenous contrast was injected determines coding for CT. Only intravenous administration of contrast changes the code sets. Oral and/or rectal contrast is not billable as a “with contrast” study.)
Can we bill separately for the oral contrast if the test is ordered as a CT abdomen/pelvis with and without contrast (CPT 74178)? I would think we cannot bill separately for the oral contrast in this situation because the IV contrast would already be billed.
What codes can be assigned for extremity arterial non-imaging Doppler studies?
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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