Facilities have only a limited time in which to respond to a final rule from the Centers for Medicare & Medicaid Services (CMS) that seeks
Last week RACmonitor released a special bulletin on the latest guidance from the Centers for Medicare & Medicaid Services (CMS) on the Medicare Outpatient Observation Notice (MOON).
On Dec. 12, 2016, the Council for Medicare Integrity released its FY 2015 Report To Congress: Recoveries Decline Due to Program Pause, in which it
Although small privacy breaches affecting less than 500 patients per incident are not usually broadcast as widely as large scale cyberattacks, they can be just
Many, many years ago, I was working on a clinical documentation (CDI) implementation project at an acute-care facility when I stumbled on what would be
Mumps has been in the news for several years, but is it really occurring more often these days? Mumps is a viral infection that affects
EDITOR’S NOTE: This article focuses on physician engagement and ICD-10 education. However, the term “physician” includes everyone licensed and credentialed to record a patient diagnosis,
With more than a year of ICD-10-CM/PCS experience under their belts, coding managers have begun to turn their attention toward fine-tuning coder education. They’re using
The patient presents for a diagnostic left heart catheterization (LHC), left ventriculogram and selective coronary angiography. The physician determines that hemodynamic assessment should be performed before and after exercise to assist in the clinical diagnosis. The patient is given a pair of 2.5-pound dumbbell weights then asked to exercise by extending the arms and bringing the arms with the weights to their chest. The patient exercises for three to five minutes. Does this type of exercise meet the criteria for billing code 93464?
How often can preventive screening tests be performed for Medicare patients?
Does Medicare separately pay for drugs used during procedures?
What key words need to be in the radiology report to assign a CTA code?
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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