Treating a heart attack as outpatient may sound ludicrous, but for some hospitals it may be the right choice. The two-midnight rule threw the hospital
As use of EHRs increases, so too does the potential for fraud. The use of electronic health records (EHRs) is expanding at a rapid pace,
Can a right heart catheterization (RHC) be billed on the same claim as a heart biopsy?
Should the CPT® codes be used to bill for mammograms or should the G codes be used?
Can a referring lab bill for clinical laboratory diagnostic tests on the CLFS?
Has CMS made any 2018 changes to the Medicare policy for supervision of hospital outpatient therapeutic services?
In 2018, will 94620 still the code to assign for pulmonary stress testing?
Does the incident-to policy affect Medicare payment for drugs?
Alzheimer’s remains an incurable, fatal disease suffered by more than 5.5 million people. EDITOR’S NOTE: The following article appeared in the RACmonitor on Nov. 16,
Quality coding plays a critical role in protecting revenue and reducing operational costs. Results of the 2nd Annual National Coding Productivity and Accuracy Contest were
Quality of clinical documentation and ICD-10 diagnosis code accuracy and specificity are essential under MACRA. My presentation at the 2017 American Health Information Management (AHIMA)
Predicting the future of MACRA is difficult as goals continue to change, nonetheless, MACRA appears to be here to stay. According to a recent study
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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