CMS requires that all total knee replacements performed on fee-for-service Medicare beneficiaries are performed in a hospital. AUTHOR’S NOTE: Since the release of the 2018
Without congressional action, new therapy caps became effective Jan. 1, 2018. Going into 2018, Medicare beneficiaries will have therapy benefits capped at $2,010 for physical
Confusion persists as providers anxiously await facility-specific guidelines from CMS. Did UHC provide to facilities an ED criterion to use when assigning facility ED evaluation
Two key areas the federal review contractors will be targeting next. An MLN Matters article published on Dec. 11 reported on a recent advisement from
The OIG has added specialty drug coverage and reimbursement by Medicaid to its Work Plan. In October, the OIG added specialty drug coverage and reimbursement
Will CMS address the “absurdity” embedded in the rules of outpatient coding? Every once in a while, something comes to my attention that I choose
Two efforts are underway to prevent HHS from cutting Medicare payments to hospitals participating in the 340B drug program. The 340B drug program is under
As use of EHRs increases, so too does the potential for fraud. The use of electronic health records (EHRs) is expanding at a rapid pace,
As it pertains to an important issue first raised in October 2016, CMS last week made a key change, effective Jan. 1, 2018. In a
A low volume appeals settlement and an expanded Settlement Conference Facilitation process are two initiatives to improve the Medicare claims appeal process. On Friday, the
Report offers peek behind the curtain at financial picture. The Centers for Medicare & Medicaid Services (CMS) just released a preliminary report outlining the first-year
More than three dozen advocacy groups appear to sway position of one of the nation’s leading carriers. In the June 2017 UnitedHealthcare (UHC) Bulletin, it
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.
Bring your questions and join the conversation during this open forum series, live every Wednesday at 10 a.m. EST from June 11–July 30. Hosted by Chuck Buck, these fast-paced 30-minute sessions connect you directly with top healthcare experts tackling today’s most urgent compliance and policy issues.
Fraud convictions don’t just punish a few bad claims; they can wipe out years of reimbursements. Don’t wait for an audit to learn the rules. Join Frank Cohen, MPA, for a live Q&A on spotting red flags, avoiding liability, and protecting your practice. Register now and bring your questions!
Substance abuse is everywhere. It’s a complicated diagnosis with wide-ranging implications well beyond acute care. The face of addiction continues to change so it’s important to remember not just the addict but the spectrum of extended victims and the other social determinants and legal ramifications. Join John K. Hall, MD, JD, MBA, FCLM, FRCPC, for a critical Q&A on navigating substance abuse in 2025. Register today and be a part of the conversation!
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.
This first session in our 2026 IPPS Masterclass will feature an in-depth explanation of FY26 changes to ICD-10-CM codes and guidelines, CCs/MCCs, and revisions to the MCE, presented by 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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