One category of denials where outpatient CDI can help is medical necessity denials. EDITOR’S NOTE: Colleen Deighan will conduct the Talk Ten Tuesdays Listener Survey
The list of unspecified diagnosis codes subject to the new edit will require targeted training for your billing staff to avoid reimbursement issues and provide
Cluster coding is a new feature for coding professionals. The World Health Organization (WHO) began developing the International Classification of Diseases, Eleventh Version (ICD-11), in
The concern of “note bloat” is gaining traction. Is it your perception that clinical notes have grown longer, and yet less informative? A recent study
Providers are increasingly using chronic care management (CCM) codes to address care fragmentation issues for patients with multiple chronic conditions. However, until last year, only patients
The transition to the new international coding set is all but inevitable, in light of its utility in documenting new medical advances and technology –
Implementing an effective strategy begins with an assessment of E&M claims data by specialty. Evaluation and management (E&M) services are cognitive services of physicians and
The volume of Medicare beneficiaries has been slowing growing while the distribution of Medicare plans is quickly changing. Medicare provides federal healthcare coverage for Americans
Margaret Skurka, an iconic healthcare leader, is stepping aside after 40 years of dedicated service to AHIMA and the World Health Organization. She served on
The implementation of the new codes is April 1, 2022. The new ICD-10-CM/PCS codes for implementation on April 1, 2022, were recently released by the
The deadly coronavirus has been the impetus for these new codes. ICD-10-CM has significantly changed in that we are now getting updates, albeit limited ones,
The implementation date for the new code remains uncertain at this time. EDITOR’S NOTE: Skurka, who is stepping down after 40 years of voluntary services
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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