EDITOR’S NOTE: The following article was prepared for “Climate Prayer Vigil: City Hall, Milwaukee, Jan. 20, 2017. In the run up to Earth Day, April
The facility ordered CPT code 71021, and the radiologist documented a lateral and apical lordotic view only. Would it be appropriate to bill 71010 and 71035 or modify CPT 71021 with a 52?
For the Medicare program, what is the difference between fraud and abuse?
Last week you mentioned that 94010 and 95070 were part of the mutually exclusive procedure policy. Can you provide a little more information about this policy?
What code is assigned for the following procedure? A patient undergoes a bronchoscopy. Cytology specimens are col¬lected from the left upper and left lower lobes.
Can hospitals bill for a new drug approved by the FDA but with no code assigned yet by CMS?
We explanted the dual-system permanent pacemaker and then we implanted two new leads and attached them to the existing pacemaker on the other side of the chest. I can’t find one CPT code that captures what we did. Can you offer me insight into how you would code this?
The first five years of the Recovery Audit Contractor (RAC) audit program created nightmares for many in the provider community. Deadlines were routinely missed at
When it comes to Medicaid providers in the State of New Mexico, providers looking for relief from auditors looking to recoup dollars can count on
EDITOR’S NOTE: Donna Thiel, former chief compliance officer and now director of the ProviderTrust compliance integrity division, participated in a roundtable conducted by the U.S.
Indeed, it was another “Dantastic” Monday as Inspector General Dan Levinson took the podium to deliver the keynote at the 21st Annual Compliance Institute in
Indeed, it was another “Dantastic” Monday as Inspector General Dan Levinson took the podium to deliver the keynote at the 21st Annual Compliance Institute in
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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