Hierarchical Condition Categories: It’s Not Just for Inpatients
The number of conditions a patient has is now going to factor into the risk adjustment score (RAS). EDITOR’S NOTE: Dr. Erica Remer reported this
The number of conditions a patient has is now going to factor into the risk adjustment score (RAS). EDITOR’S NOTE: Dr. Erica Remer reported this
Prior authorization is mostly a manual process. Prior authorizations are not going anywhere anytime soon, but drastic changes on how they are handled may finally
In the continuous pursuit of improved efficiencies, can single-source coding be a solution? As organizations continue to evaluate the most efficient and cost-effective ways to
Coronavirus is spreading. EDITOR’S NOTE: This is a developing story and ICD10monitor will continue to update you on the latest development on this global health crisis.
More than 4,000 cases were coded in the 2019 contest focused on outpatient coding. ICD-10 is well-established, and we are already discussing and planning for
Success can cost you more than you thought it would. You might have heard the phrase, “everyone wants to be successful until they see what
Tackling processes and departmental integration requirements for AUC will be key this year. The testing phase for the Appropriate Use Criteria (AUC) Program officially began
EDITOR’S NOTE: Dr. Erica Remer reported this story live during the January 14 edition of Talk Ten Tuesday. The following is an edited transcript of her
Incident-to billing for advanced practice providers or APPs (nurse practitioners, physician assistants, clinical nurse practitioners, nurse midwives, etc.) has been available to limited-license practitioners since
Seven coding challenges reveal a new compliance landscape in 2020. It’s here: 2020! This past year in healthcare, as in many years before, was full
Improper DRG payments in 2019 demonstrate the urgency for CDI leadership to address issues. The 2019 Medicare Fee-for-Service Supplemental Improper Payment Data Report was recently
EDITOR’S NOTE: Anyone who has viewed the wildfires in Australia knows why it has been called the “canary in the coal mine” of climate change.
Michelle Wieczorek explores challenges, strategies, and best practices to AI implementation and ongoing monitoring in the middle revenue cycle through real-world use cases. She addresses critical issues such as the validation of AI algorithms, the importance of human validation in machine learning, and the delineation of responsibilities between buyers and vendors.
Frank Cohen shows you how to leverage the Comprehensive Error Rate Testing Program (CERT) to create your own internal coding and billing risk assessment plan, including granular identification of risk areas and prioritizing audit tasks and functions resulting in decreased claim submission errors, reduced risk of audit-related damages, and a smoother, more efficient reimbursement process from Medicare.
Dr. Ronald Hirsch presents an essential “A to Z” review of Observation, including proper use for Medicare, Medicare Advantage, and commercial payers. He addresses the correct use of Observation in medical patients and surgical patients, and how to deal with the billing of unnecessary Observation services, professional fee billing, and more.
Explore the top-10 federal audit targets for 2024 in our webcast, “Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets,” featuring Certified Compliance Officer Michael G. Calahan, PA, MBA. Gain insights and best practices to proactively address risks, enhance compliance, and ensure financial well-being for your healthcare facility or practice. Join us for a comprehensive guide to successfully navigating the federal audit landscape.
Join industry expert, Kathy Pride, RHIT, CPC, CPMA, CCS-P, for an in-depth exploration of Evaluation and Management (E/M) coding, tailored for healthcare professionals navigating recent guideline changes. Dive into advanced topics beyond mere code selection, including shared visits, criteria for selecting E/M levels, and documentation best practices. Gain clarity on complex guideline terminology and ensure compliance with regulatory standards. This comprehensive session is essential for coders, auditors, educators, and practitioners seeking to enhance their proficiency in E/M coding and maximize revenue capture.
This third session in the ICD10monitor 2025 IPPS Masterclass will feature a review of FY25 changes to the MS-DRG methodology and new technology add-on payments (NTAPs), presented by senior healthcare consultant Laurie Johnson, with bonus insights and analysis from CDI expert Dr. Erica Remer.
This second session in the ICD10monitor 2025 IPPS Masterclass will feature a review of the FY25 changes to ICD-10-PCS codes, presented by senior healthcare consultant Laurie Johnson, with bonus insights and analysis from CDI expert Dr. Erica Remer.
This first session in the ICD10monitor 2025 IPPS Masterclass will feature a review of FY25 changes to ICD-10-CM codes and guidelines, SDoH, CCs/MCCs and revisions to the MCE, presented by senior healthcare consultant Laurie Johnson, with bonus insights and analysis from Dr. Erica Remer.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY25 Inpatient Prospective Payment System (IPPS) Final Rule, including new ICD-10-CM/PCS codes, plus insights, analysis and answers to questions from the country’s most respected subject matter experts.
Dive deep into the world of Social Determinants of Health (SDoH) coding with our comprehensive webcast. Explore the latest OPPS codes for 2024, understand SDoH assessments, and discover effective strategies for integrating coding seamlessly into healthcare practices. Gain invaluable insights and practical knowledge to navigate the complexities of SDoH coding confidently. Join us to unlock the potential of coding in promoting holistic patient care.
HIM coding expert, Kay Piper, RHIA, CDIP, CCS, reviews the guidance and updates coders and CDIs on important information in each of the AHA’s 2024 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.
Kay Piper reviews the guidance and updates coders and CDISs on important information in the AHA’s fourth quarter 2024 ICD-10-CM/PCS Quarterly Coding Clinic in an easy to access on-demand webcast.
Join healthcare attorney David Glaser, as he debunks refund myths, clarifies compliance essentials, and empowers healthcare professionals to safeguard facility finances. Uncover the secrets behind when to refund and why it matters. Don’t miss this crucial insight into strategic refund management.
Hospital staff continue to grapple with the complexities of Medicare notices. In this webcast, Tiffany Ferguson, LMSW, CMAC, ACM, will present the latest requirements for preparation and delivery of CMS-mandated forms, including the Advance Beneficiary Notice (ABN), Hospital-Issued Notices of Noncoverage (HINNs), Important Message from Medicare (IMM) and Medicare Outpatient Observation Notice (MOON), and practical solutions through foolproof workflows and compliance auditing.
Unlock the keys to bridging the clinical-finance disconnect by transforming your approach to revenue cycle collaboration for superior patient care and financial prosperity!
Join Dr. Ronald Hirsch as he delves into the pivotal connection between case management, utilization review, and hospital revenue cycles, unveiling strategies to enhance communication and align goals effectively. Discover how to overcome hidden challenges hindering seamless collaboration and gain insights imperative for success
During this webcast Dr. Hirsch will breakdown the CMS-4201-F rule and the new federal regulations, how and when they will apply to Medicare Advantages plans.
Happy World Health Day! Our exclusive webcast, ‘2024 SDoH Update: Navigating Coding and Screening Assessment,’ is just $99 for a limited time! Use code WorldHealth24 at checkout.