CDI is the critical link to quality outcomes. Any healthcare system’s overall performance relies heavily on a strong clinical documentation integrity (CDI) program, and
The aim of documentation is to tell the true story. Last year, I wrote a two-part series on clinical documentation integrity, specifically focusing on the
CMS released the MPFS on Nov. 1, ending months of turmoil. The Centers for Medicaid & Medicare Services (CMS) released the final rule on the
Lack of a SOFA score change does not rule out sepsis. A couple weeks ago, I spoke about how the current definition of sepsis, known
THIS STORY HAS CORRECTED TO REFLECT THE NOV. 2 RELEASE OF THE FINAL FOR 2019 EDITOR’S NOTE: CMS on Thursday released the 2019 Medicare Physician
Release by CMS caps months of debate by stakeholders Long awaited and hotly debated, the 2019 Medicare Physician Fee Schedule (MPFS) and Quality Payment Program
CMS announced on Friday a proposed rule to expand telehealth access for patients. Hospitals, doctors, and other providers seeking an edge in today’s highly competitive
Diabetes could be a contributing factor without being the direct cause. In the first article in this series, I compared pressure ulcers and diabetic foot
The five “Ws” about the flu. It is that time of year again – flu season, which occurs in the fall and winter in the
New classification system noted for granularity. Several of my colleagues recently attended an ICD-11 presentation by Kathy Giannangelo[i] at the American Health Information Management Association
Even a podiatrist may not know for sure. When is a diabetic’s foot ulcer a pressure ulcer? When is a pressure ulcer a diabetic foot
New coding clinic edition offers much to review and follow. Everyone in health information management (HIM), coding, and CDI (clinical documentation improvement) is abuzz about
Get clear, practical answers to Medicare’s most confusing regulations. Join Dr. Ronald Hirsch as he breaks down real-world compliance challenges and shares guidance your team can apply right away.
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.
Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.
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.
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