A recent conversation with a vice president of the revenue cycle for a large multi-hospital health system evolved into an active conversation on the merits
Important news recently came from the Centers for Medicare & Medicaid Services (CMS) with the earlier-than-expected July 13 release of the Outpatient Prospective System (OPPS)
The addendum for new codes coming out was recently released with many notable additions and deletions. The next several articles in this series will address
The 2018 Outpatient Prospective Payment System (OPPS) proposed rule arrived Friday from the Centers for Medicare & Medicaid Services (CMS), coming in at 664 pages,
Can a physician’s interpretation of a molecular pathology procedure (such as in the CPT® code range 81161–81408) be reported with CPT code 88291 (cytogenetics and molecular cytogenetics, interpretation and report)?
Can we bill the following code more than once for each additional linear ablation performed, or is there a limit to once per session?
93657 Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (List separately in addition to code for primary procedure).
Can an evaluation and management (E&M) code be reported when a physician in attendance for pulmonary diagnostic testing or therapy obtains a limited history and performs a limited physical examination?
If an eligible provider fails to meet meaningful use (MU) during a participation year in the Medicare Electronic Health Records (EHR) Incentive Program, can he or she continue to participate and earn incentives?
Does Medicare require hospitals to report codes for packaged drugs?
My nuclear medicine tech is being asked to do a procedure for a sestamibi injection without any parathyroid imaging. The intent is to locate the parathyroid prior to surgery so it is similar to a sentinel node injection. Is there a diagnostic nuclear isotope injection code, or should we use an unlisted procedure code?
More than 400 people across the country have been charged in connection with $1.3 billion in healthcare fraud losses as part of what the federal
Cancer is complicated, challenging and creating gaps of health and healthcare in vulnerable communities. Its presence requires more attention, care, funding, supportive healthcare policies and
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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