Fraud and abuse could soon be spreading like the coronavirus. I had strongly thought about not discussing anything COVID-19-related this week, but it is the
According to the official coding guidelines, ICD-10 code U07.1 for COVID-19 may be reported under the following circumstances: As documented by the provider; Documentation of
ICD-10-CM codes are not robust enough to tell the patient story correctly. I was having a terrible time preparing for my COVID-19 coding webinar,
Ten practical steps to break the COVID-19 spell while spellbound. Most of us are working from home now. That’s quite amazing. In July 2019, a
Managing the after-effects of coding and billing as COVID-19 cases start to move through an organization’s billing cycle, while maintaining up-to-date information, could prove challenging.
The reliability of the current state of health information is extremely limited. EDITOR’S NOTE: Dr. Joseph Nichols is producing a five-part series on healthcare data
Clinical judgment is sufficient for COVID-19 diagnosis. When I was a third-year resident, in 1987, I saw a really sick kid in the ED. He
During quarantine, I look for every chance to be outside. During the fifteen-minute break I have between online classes, I try to get outside; I
Climate-related pre-traumatic stress disorders and other anxieties. Before we get to our next climate-related piece, we have to note that akin to the climate-related condition
Agencies have implemented legislation guaranteeing coverage of COVID-19 diagnostic testing, including antibody testing, and certain related services without cost sharing for enrollees with private health
The Centers for Medicare & Medicaid Services (CMS) released an update to the Coronavirus Aid, Relief, and Economic Security (CARES) Act, which was published on
Capturing the complexity of care with CDI will be more important than ever. The COVID-19 pandemic is “hot-spotting” in places like New York City, New
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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