The surprise is approval for RACs to audit admissions to inpatient psychiatric hospitals for medical necessity for inpatient psychiatric care. As we all know, all
Senate Republicans will not vote to repeal and replace Obamacare. Congress must still deal with many other healthcare initiatives before Sept. 30. Who doesn’t love
Hospital CDI managers always look for process improvement. Essentia Health’s outpatient CDI operation provides a practical case study. EDITOR’S NOTE: This the final installment in
ICD-10 codes for blindness and low vision are effective Oct. 1, 2017 and reflect parameters from the World Health Organization (WHO). A new set of
New developments in interoperability and mobile health technology were presented at the Translational Medicine Conference in Northern Ireland where the new Patient Buddy app was
Does Medicare have a frequency limit on use of code 94750—pulmonary compliance study (e.g., plethysmography, volume and pressure measurements)?
Last week you said that the new modifier ZC (Merck/Samsung Bioepis) would be effective on July 1, 2017 for the code reporting an injection of the biosimilar drug infliximab. However, I think that is the wrong date. Instead, it should be October 1, 2017, according to transmittal 3850. Can you verify?
Can we charge for the catheter placement for insertion of pacemakers?
The CCI code-pair edits include a column with a modifier indicator—sometimes 0, 1, or 2. What do each of these represent?
On the Medicare outpatient observation notice (MOON), are hospitals and CAHs permitted to use pre-populated check boxes for the free-text field (“You’re a hospital outpatient receiving observation services. You are not an inpatient because:”)?
The patient had a right breast ultrasound, and we billed CPT® code 76641 with modifier –RT. The insurer denied this claim due to the modifier. Doesn’t the breast ultrasound require a modifier?
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.
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
