In a significant move aimed at enhancing healthcare access for Deferred Action for Childhood Arrivals (DACA) recipients, the Biden-Harris Administration has finalized a rule that
I have been performing a lot of chart reviews in my consulting capacity, making clinical validation determinations. Whether I am hired by the payor or
How do the NCCI procedure-to-procedure edits impact the reimbursement and billing process for services involving CPT codes 94640 and 94644/+94645 when performed on the same day?
Can you explain more about what code 88342 actually represents, and what is its primary purpose in diagnosing neoplasms?
How does the OCE help in processing hospital claims related to Ambulatory Payment Classifications (APCs)?
A patient undergoes a PET scan with CT for attenuation correction and anatomic localization. Should the CT imaging be separately charged in this case when reporting 78433?
We’ve heard there is some new guidance regarding 76988 for 2024. Is this true? If so how does it impact which procedures should not be reported in conjunction with the code?
Reimbursement remains in an era of constant threat, making accurate coding more important than ever before. In the complex realm of medical coding for genitourinary
Today’s update touches on a number of healthcare news stories we are seeing at the federal level. Taking lessons learned from the COVID-19 pandemic, the
Last week I wrote about the lack of adoption of the new evaluation and management (E&M) coding rules by physicians and urged all of you
Is there an arms race involving using technology for submitting claims and auditing them? In one example, an electronic health record system was deployed that
Remuneration. It is a weird word. It almost sounds like reMOOneration, which I imagine is when a cow has acid reflux. Or MOONeration, an ideal
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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