One of our physicians sent a patient to the outpatient department to have a PICC line inserted (36568 or 36569) and have the first round of therapeutic medications (96365, 96366, 96367, 96368) on the same day. Can you please tell us if the insertion of a PICC line and the administration of the antibiotic drug can be charged on the same day with a modifier of 59 or XU?
When it is appropriate to bill 77073—bone length studies (orthoroentgenogram, scanogram)—with the following codes?
73562 Radiologic examination, knee; 3 views
73564 Radiologic examination, knee; complete, 4 or more views
Is the coding of a diagnostic cardiac catheterization different based on the access into the body (for example: radial versus femoral artery)?
Does Medicare allow labs to bill for a molecular pathology interpretation done by a PhD or geneticist?
Are modifiers required when billing biosimilar products?
All audits are questionable, contends the author, so appeal all audit results. Providers ask me all the time – how will you legally prove that
Taking a look at whether approaches that yield results in other fields could do so in healthcare, too. Sometime around August of last year, I
CMS guidance about medical review changes for inpatient rehabilitation facilities (IRF): Bonus or baggage? There has been lots of buzz about Medicare’s most recent clarifications
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,
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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