Leaving 2017 and moving into 2018, three major issues await coders—issues that could be opportunities. As we now come to the end of another year
Health information management professionals are fulfilling roles in numerous healthcare settings. “Revenue integrity” is a relatively new buzz-phrase, but it certainly is a concept that
Dieticians’ findings must find their way into the medical record to achieve proper care and coding. Diagnosing malnutrition is not diving for dollars. Malnutrition –
If a temporary pacemaker lead is inserted during a diagnostic heart cath, is it appropriate to charge for this lead placement if the patient does not leave the procedure room with it (the pacemaker lead)?
Can a biopsy code (i.e., CPT® code 31237 for nasal/sinus endoscopy) be reported with the removal nasal/sinus endoscopy code (i.e., CPT code 31255)?
Is the 2018 ASP file available yet?
Do anatomic considerations enter into CMS’s decision on the number of MUEs?
Is there a good reference regarding what designates deep versus superficial bone biopsy? The code descriptions give some examples but other bones I’m not sure about.
When will CMS make a decision about whether to go ahead with the new, but inadequate, CLFS rates?
Small town physician loses license because she doesn’t use a computer in her practice. Am I the only one who remembers Marcus Welby, MD? For
There are lessons to be learned from challenging the credibility of experts in medical necessity issues. Challenging the qualifications of an individual performing a medical
Will CMS address the “absurdity” embedded in the rules of outpatient coding? Every once in a while, something comes to my attention that I choose
Medicare regulations are complex and even seasoned professionals struggle to apply them consistently. Due to overwhelming demand, Dr. Hirsch returns for Part 2 of Ask Dr. Hirsch: Clarifying Medicare’s Most Misunderstood Rules to answer even more of Medicare’s most misunderstood questions, covering inpatient status, observation, SNF access, Medicare Advantage denials, and more. Join Dr. Hirsch as he provides clear, referenced answers to real-world questions submitted by your peers, helping you navigate Medicare compliance with confidence and clarity.
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.
Artificial intelligence is rapidly transforming healthcare revenue cycle operations, from coding and auditing to compliance and denials. Join industry leaders Pam Warren (MaineHealth) and Raemarie Jimenez (AAPC) for a live fireside chat exploring how AI is changing workflows, workforce roles, payer-provider dynamics, and compliance risk—and what organizations should be doing now to prepare.
Prepare for FY 2027 IPPS changes with a comprehensive 3-part masterclass covering ICD-10-CM/PCS updates, MS-DRG shifts, NTAPs, compliance risks, and reimbursement strategies.
Stay ahead of FY 2027 reimbursement changes with expert analysis of MS-DRG shifts, NTAP updates, Medicare Code Edits, and emerging technologies impacting inpatient payment accuracy.
Stay ahead of FY 2027 ICD-10-PCS changes with expert analysis of new procedure codes, revised guidelines, and high-impact updates affecting reimbursement, compliance, and inpatient coding accuracy.
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