My question relates to the Medicare 70/30 rule for referral testing. In the definitions and examples provided by the Centers for Medicare & Medicaid Services (CMS), the terms “related” and “non-related” laboratories are used. Is a joint venture partner’s laboratory a related or non-related laboratory?
Complicated coding of type 2 myocardial infarctions. Advancing technology often leads to evolution of medicine. As our laboratory studies become more sensitive, we need to
Frustrations arise over inconsistent guidance from MACs and CMS. Every single day, I get numerous email notices from the Centers for Medicare & Medicaid Services
The main burden for this change is on healthcare providers such as physicians, clinics, hospitals. The Centers for Medicare & Medicaid Services (CMS) will start
The ICD-10 code set is growing, and feedback from the medical community on the changes is needed. This is the second piece in a series
OIG audits device credit reporting. The confluence of two major healthcare news stories is creating confusion among providers. News of changes to the national coverage
The main burden for this change is on healthcare providers such as physicians, clinics, hospitals. The Centers for Medicare & Medicaid Services (CMS) will start
The DOJ has focused particularly on the payment of kickbacks that induce physicians to prescribe more, or more expensive, opioids. Last week, President Trump unveiled
For one health system, staying the 340B drug program makes financial sense. Working at a large teaching hospital in Pennsylvania recently, I was able to
Orthopedic surgeons are upset with various interpretations of regulations on total knee replacement coming from CMS. The saga of determining the proper status for Medicare
I believe that part of the answer in last week’s posting is incorrect. You stated that code Q5102 (which describes both currently available versions of infliximab biosimilars) will be discontinued and replaced with codes 5102 and 5014. Although it’s true Q5102 will be discontinued March 31, 2018, I don’t think the replacement codes are correct. Can you provide the right codes?
A patient came in for a whole body thyroid cancer metastases imaging and a SPECT/CT of the neck and chest also was performed. What CPT® code are we to assign here since there is no CPT code for the SPECT/CT?
Federal auditors are intensifying their focus on inpatient psychiatric facilities, using advanced data analytics to spotlight outliers and pursue high‑dollar repayments. In this high‑impact webcast, Michael Calahan, PA, MBA, Compliance Officer and V.P., Hospital & Physician Compliance, breaks down what regulators are really targeting in IPF-PPS admissions, documentation, treatment and discharge planning. Attendees will learn practical steps to tighten processes, avoid common audit triggers and protect reimbursement and reduce the risk of multimillion-dollar repayment demands.
In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.
Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.
Stay ahead of the 2026-2027 audit surge with “Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue,” a high-impact webcast led by Michael Calahan, PA, MBA. This concise session gives hospitals and physicians clear insight into the most likely federal audit targets, such as E/M services, split/shared and critical care, observation and admissions, device credits, and Two-Midnight Rule changes, and shows how to tighten documentation, coding, and internal processes to reduce denials, recoupments, and penalties. Attendees walk away with practical best practices to protect revenue, strengthen compliance, and better prepare their teams for inevitable audits.
Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Stacey Shillito, CDIP, CPMA, CCS, CCS‑P, CPEDC, COPC. You’ll learn how to apply global maternity package rules accurately, select the right CPT codes for procedures and visits, and identify documentation gaps that lead to denials. With practical guidance and real examples, this session helps you strengthen compliance, reduce audit risk, and ensure accurate reimbursement for women’s health services.
Uncover essential coding insights with nationally recognized coding authority Kay Piper, RHIA, CDIP, CCS. Through ICD10monitor’s interactive, on‑demand webcast series, Kay walks you through the AHA’s 2026 ICD‑10‑CM/PCS Quarterly Coding Clinics, translating each update into practical, easy‑to‑apply guidance designed to sharpen precision, ensure compliance, and strengthen day‑to‑day decision‑making. Available shortly after each official release.
Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s third quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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