CMS sets up virtual participation for rural healthcare providers in the government’s MIPS program. New announcements from the Centers for Medicare & Medicaid Services (CMS)
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)?
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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