The IRF Nationwide Audit Could Reveal Prime Audit Targets
Recently, I was emailed a question from, presumably, a listener of Monitor Mondays. He wanted to know whether I had commented on the nationwide audits
Recently, I was emailed a question from, presumably, a listener of Monitor Mondays. He wanted to know whether I had commented on the nationwide audits
Federal officials this week announced the rollout of a Final Rule for Medicare Part D prescription drug plans and the rapidly expanding Medicare Advantage (MA)
Today, we’re delving into an exciting and transformative area of healthcare: the personalized medicine revolution, particularly how it intersects with coding, documentation, and reimbursement in
EDITOR’S NOTE: This series is based on the “Developing Facility-Specific Coding Guidelines” which is an AHIMA Practice Brief. This practice brief was updated in December
As the globe prepares to commemorate World Health Day, a renowned expert in health information management, Lorraine Fernandes, is set to deliver valuable insights on
The recent (February 21, 2024) cyberattack on Change Healthcare has caused a shutdown of most of its operations. Change is one of the biggest clearinghouses
What is the typical duration of a polysomnography (PSG) procedure as described by codes 95810 and 95811?
For 2024, which code is associated with assessing the balance of estrogen and progesterone in the vaginal squamous epithelium?
What are the CMS market baskets used for?
What happens when a physician converts an external drainage catheter to
an internal-external drainage catheter. Is this an exchange? What code do we report for this in 2024?
We use 96360 and 96361 for hydration fluids administered in radiology. These codes often edit against the CT procedure code. What modifier would you recommend when coding for services provided in a hospital radiology dept?
Dear Colleagues, One week amid 52 weeks will be dedicated to the tireless work being conducted by medical laboratory professionals and pathologists who continue to
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.
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.
This second session in our 2026 IPPS Masterclass will feature a review the FY26 changes to ICD-10-PCS codes. This information will be 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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