CMS proposes to change physician evaluation and management (E&M) coding with a drastic overhaul. EDITOR’S NOTE: The following report first appeared on RACmonitor on July
Document it right on the front end; avoid fighting a denial on the back end I was recently asked about a post from Hospital Performance
The “right documentation” is the central pivot point to the revenue cycle Physician clinical documentation plays a critical role in any overall healthcare delivery
The WHO’s definitions of gender-related issues continue to cause controversy. The recent news coming out of Geneva, Switzerland and reported here by ICD10monitor that the
Accounting for socioeconomic factors is critical to the sustainability of healthcare. A recent blog headline in the American Council of Science and Health captured the
ICD-10 code I21.A1 identifies Type 2 MI. Over the past two months, I have been making the rounds speaking at regional and national conferences and
“Medical necessity” is a much-used but often-misunderstood concept. After our recent four-part series on the “Pitfalls of an Audit” and our last Talk Ten Tuesdays
WHO team leader to weigh in on the new coding set. The World Health Organization’s (WHO’s) Robert Jakob, MD is scheduled to appear on Talk
U.S. adoption of the new codes is not expected until after 2022. A lot of excitement was generated last week when the World Health Organization
National HIV Testing Day is June 27. Wednesday is National HIV Testing Day—a day designated to highlight the importance of testing in detecting, treating, and
A Pittsburgh-based MD weighs in on an emerging area of focus in the healthcare industry. EDITOR’S NOTE: The following are remarks made by the author
A major shift in the reporting of transgender issues is at hand. They’re here, but it won’t be until sometime until after 2022 that the
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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