Case managers and physicians approach palliative care from different perspectives. There are many staffing models for case managers. A number of years ago, the trend
New policy changes from DOJ will impact False Claims Act cases moving forward. In announcing a significant policy change, the U.S. Department of Justice (DOJ)
CMS has accused Bryan Merrick, MD of wrongful Medicare billings on 10 patients over a span of 20 months. The town’s mayor asks for help
Congress can’t seem to resist tinkering with healthcare through legislation. As we celebrate Halloween, we are seeing healthcare policy “zombies” here in Washington, D.C. –
CDI seen as a key solution to meeting regulatory policy changes. One thing is inevitable this time of year for all of us in healthcare:
Poorly designed EHRs likely the culprit for the proliferation of false medical records. Last week Talk Ten Tuesdays listener “Robert” discussed during the weekly Internet
Nation’s healthcare infrastructure remains fragile following historic storm. San Juan, Puerto Rico – Hurricane María was the strongest storm to slam Puerto Rico in 89
What is the difference between a health plan and a payer?
We are performing intrathecal chemo administration and assigning code 96450. We are also doing fluoro for needle guidance, which would be assigned 77003. However, with the new 2017 CPT® guideline, 96450 is not a primary procedure code to 77003. How should we bill for the fluoro guidance?
Do you know what the payment rate would be for CPT® codes 85025 (CBC) and 80061 (lipid panel) under the new proposed CLFS?
Would modifier 52 be appropriate when the physician orders polysomnography with CPAP titration, and during the phase of the test using the CPAP, the patient is physically unable to complete this portion of the test (e.g., adverse event)?
What code would I use for the second stent if the doctor’s dictation states “MI with culprit lesions in the LAD and RC”? If I can only assign code 92941 one time, what code do I use for the additional artery?
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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