Last month, a Phoenix couple pleaded guilty to criminal charges involving healthcare fraud. Unfortunately, this is not remarkable, with approximately 500 annual convictions for healthcare fraud in the United
Today, I want to bring attention to an issue that is once again under scrutiny, how hospitals report patient harm events under the Centers for
The Centers for Disease Control and Prevention (CDC) released its updated stats report in February 2025 on maternal mortality in the United States for 2023,
As with many other physicians of a certain age, I have had the opportunity to practice patient care in both the worlds of paper and
EDITOR’S NOTE: Healthcare attorney David Glaser is a permanent panelist on Monitor Mondays. Hiring is both difficult and important, yet we rarely discuss strategies for
February is American Heart Month. Takotsubo syndrome is also known as broken heart syndrome. According to the American College of Cardiology, it typically occurs following
I’m coding for a patient who underwent CAR-T therapy, and I’m a bit confused about how to report the different steps. I understand that 0537T is for collection and handling, and 0540T is for administration, but I want to clarify a few things. Can we report 0537T more than once per day? Also, if the hospital is facilitating the process but not actually performing the collection or preparation, should the hospital still report any of these codes, or are they strictly for the specialty lab or manufacturer?
A physician performs a medically necessary pulmonary artery angiogram in conjunction with a non-congenital heart catheterization service before pulmonary artery stenting. Which code(s) should be reported for the angiogram?
When performing an MRI on a patient with an implanted cardiac device or neurostimulator, how should code 76018 be reported if the same provider conducting the device evaluation or neurostimulator analysis-programming also prepares the device for MR safe mode?
When billing Medicare for smoking and tobacco-use cessation counseling, how should providers track the 12-month limit of eight sessions to ensure compliance?
What are the key changes introduced in the 2025 ICD-10-CM code update regarding specificity and claim processing?
Despite some uncertainly in light of the Trump administration’s hold placed on all pending federal regulations, it has been confirmed with the Centers for Medicare
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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