Quelling the Confusion Over Modifier 25
Monday, March 5, 2018Trending Topic Broadcast10-10:30 a.m. EST; 7-7:30 a.m. PST FEATURINGShannon DeConda, CPC, CPC-I, CEMC, CMSCS, CPMA®;David Glaser, Esq.; Ronald Hirsch, MD, FACP, CHCQM;Angela
Monday, March 5, 2018Trending Topic Broadcast10-10:30 a.m. EST; 7-7:30 a.m. PST FEATURINGShannon DeConda, CPC, CPC-I, CEMC, CMSCS, CPMA®;David Glaser, Esq.; Ronald Hirsch, MD, FACP, CHCQM;Angela
FEATURINGNancy Beckley, MS, MBA, CHC; David Glaser, Esq.;Ronald Hirsch, MD, FACP, CHCQM;Paul Spencer, CPC, CPC-H; Edward Roche, JD, PhD; andAndrew Wachler, Esq. “We have
CDI programs are viewed by most physicians as hospital-led initiatives geared towards increasing reimbursement for the hospital.The majority of clinical documentation improvement (CDI) programs fail
Medical policies are based off of evidence-based medicine. Without proper documentation, however, most providers struggle to get services or procedures covered for patients. Exactly what
For HIM and CDI professionals, 2018 looks to offer a gift of the tremendous opportunity for success. For movie buffs, the film Darkest Hour offers
What code should be reported when an exercise test is done to diagnose bronchospasm?
Cardiology documented the following in a patient progress note on the second hospital day: “Troponins +, highest 6.4, needs cath STAT. + chest pain.” The chart has no further clarification, so what would be the principal diagnosis on discharge?
If a patient has just an abdominal aorta ultrasound, do we use code 76770 or 76775?
Last week you provided information related to billing Medicare for the mixing of commercial products. What are the billing rules for compounding when the drugs are not a mix of commercially available products?
What codes should be reported if a bone biopsy is performed for evaluation of bone matrix structure?
What are the Medicare rules for a situation when two or more diagnoses equally meet the definition for principal diagnosis? For example, we had a patient who was admitted with systolic congestive heart failure exacerbation and aspiration pneumonia. Both are equally worked up (IV antibiotics, speech eval, NPO, IV Lasix, new echo, etc.).
CMS requires that all total knee replacements performed on fee-for-service Medicare beneficiaries are performed in a hospital. AUTHOR’S NOTE: Since the release of the 2018

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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