Coded data represents the foundational elements for healthcare decision-making, research, quality of care, monitoring of population health, pay for performance, payment, disease management, clinical registries,
Documentation should paint a picture of the patient’s condition. Medical necessity drives every patient encounter. In fact, the Comprehensive Error Rate Testing Program (CERT) states
EDITOR’S NOTE: What follows is the first of a two-part series examining how health risk, severity, and complexity impact healthcare policy, payment, and quality assessment.
First, let me say that I understand. My nursing life was spent in busy emergency departments as a trauma nurse. I understand distracting injuries. I
The Medicare Access & CHIP Reauthorization Act (MACRA) became effective Jan. 1, 2017, making it imperative that rural providers and hospitals leverage some practical application
What is the performance period for the value modifier in 2017 and 2018?
Can you provide guidance on use of the new K code for CPAPs?
In the 2/13/17 question you said 77063 could be billed with G0202 because it was digital and not with 77067 because it was analog. Those descriptions are no longer part of the code. I have been told by multiple sources to use CPT 77063 for ALL screening mammograms except Medicare which is the G0202 until 2018. Is this not correct?
If several pharmacies, each with their own national provider identifier (NPI), are owned by the same covered organization health care provider (payee), may the X12 835 payment and remittance advice for these pharmacies be consolidated and sent to the covered organization health care provider (i.e., the “parent”)?
For the new lab payments, what codes will we use to identify the new and existing ADLTs?
Can we bill codes 93620 and 93656 (both relate to comprehensive electrophysiologic evaluation) together? Are there any other codes that may be billed with 93656, or is it all encompassing?
HCPro’s HIM Briefings published its first release of information (ROI) benchmarking survey of 2017 last month. The survey, conducted in December 2016, explored health information
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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