General Question for the Week of March 26, 2018
MedLearn Publishing
March 26, 2018
If a procedure or service has been assigned a CPT® code, does that mean Medicare will cover it?
If a procedure or service has been assigned a CPT® code, does that mean Medicare will cover it?
What code should be assigned when a battery is replaced for a pacemaker?
Coders are encouraged to learn more about the clinical conditions associated with the patient encounters they are coding. As coders, we often struggle with assigning
The ICD-10 code set is growing, and feedback from the medical community on the changes is needed. This is the first in a series of
This article has been removed pending further editorial review. View Don’t let Type 2 MI give you a heart attack! By Erica E. Remer, MD, FACEP, CCDS
Three key takeaways from this effort by healthcare giant UnitedHealthcare UnitedHealthcare (UHC) is continuing its quest to revamp many facets of our healthcare industry. Last
Questions still linger regarding specifics of implementation. By Mark Spivey Arkansas has become the nation’s third state to implement a work requirement for Medicaid, according
Whatever you do, don’t bring patients back for a procedure another day just for the purposes of billing. Determining when to use Modifier 25 can
Expect denials as the healthcare giant is cracking down on Levels 4 and Level 5 UnitedHealthcare (UHC) will reportedly review and possibly adjust or deny
Hospitals must perform medical screening evaluations to patients presenting at emergency departments. Anthem Blue Cross Blue Shield, the nation’s largest health insurer, instituted a policy
AHIMA is recognizing the contributions being made by healthcare information professionals throughout the country this week. The American Health Information Association (AHIMA) is celebrating health
Amid confusion over New Technology codes, much attention was focused on partial knee joint replacements during the recent ICD-10 Coordination and Maintenance Committee meeting, March
Traditional utilization management models can no longer keep pace with regulatory shifts, payer scrutiny, and operational pressures. In this webcast, Tiffany Ferguson, LMSW, CMAC, ACM, ACPA-C, introduces an Adaptive Model strategy that modernizes UM through role specialization, technology-driven workflows, and proactive, team-based processes. Attendees will learn how to restructure programs to improve efficiency, strengthen clinical collaboration, and enhance financial performance in a rapidly changing healthcare environment.
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.
Breast biopsy procedures may be clinically straightforward but accurately translating them into compliant billing can be anything but. In this focused webcast, Shawn Blackburn, CPC, CPMA, CIC, CRC, CCS-P breaks down how imaging guidance, lesion count, laterality, and payer expectations all impact how these procedures should be reported. Through clear explanations and real-world scenarios, you’ll gain practical insight into aligning clinical workflows with billing requirements, avoiding common pitfalls, and ensuring your documentation supports accurate reimbursement and compliance.
Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Sherri L. Clayton, RHIT, CSS. 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.
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