General Question for the Week of April 24, 2017
MedLearn Publishing
April 24, 2017
I have read that CMS will be developing “episode groups.” What are these?
I have read that CMS will be developing “episode groups.” What are these?
What CPT code would you recommend for an ultrasound of the temporal artery for giant-cell arteritis?
One of our cardiologists performed the following: a left heart cath w/ coronaries, then a selective left subclavian angiogram to see whether there was a stenosis in the subclavian, and then a selective left internal mammary artery (LIMA) looking at it for a possible grafting site. How would we code this?
Is there any chance that CMS will change the deadline for reporting the private payer information needed to create the new CLFS?
Monday, April 24, 201710–10:30 a.m. ET; 7–7:30 a.m. PT SPECIAL GUESTCharles Locke, MD, CHCQM-PHYADVSenior Physician Advisor, Care Coordination/Clinical Resource Management, Johns Hopkins Hospital;Assistant Professor, Johns
A powerful U.S. Senator is demanding answers regarding the perceived ineffectiveness of Centers for Medicare & Medicaid Services (CMS) efforts to address apparently sizeable overpayments
With a mission to improve rural healthcare access and outcomes for underserved populations through innovation and promising practices, the role of community health workers (CHWs)
If you’re like me, you had to read through the Skilled Nursing Facility (SNF) Requirements of Participation (ROP) from the Centers for Medicare & Medicaid
One million dollars: that is how much one hospital could have saved had it checked with a well-informed healthcare lawyer before making a voluntary refund.
The Centers for Medicare and Medicaid Services (CMS) has released an update to the ICD-10 and Quality Measures website. The home page covers ambulatory surgical
I am fortunate to work for a company that begins each of its meetings with the reading of its corporate mission statement, setting the tone
EDITOR’S NOTE: This is the second in a two-part series on the subject of secondary diagnosis. Related to last week’s discussion on the Uniform Hospital
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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