Surgical misadventures versus Complicated Operative Episodes: Conundrums and Smell Tests
Discerning between a more complex operative episode and one in which an unexpected medical misadventure or complication occurred is not as easy as it sounds.
Discerning between a more complex operative episode and one in which an unexpected medical misadventure or complication occurred is not as easy as it sounds.
Overdose deaths up 29 percent over last year. Overdose deaths have been in the news frequently this month. Last year’s overdose deaths in the U.S.
The Centers for Medicare & Medicaid Services (CMS) has issued the Final Rule for inpatient rehabilitation facilities (IRFs) that takes effect Oct. 1. The rule
Medicare payment policies and rates are set to be adjusted for the 2022 fiscal year as a result of the moves. The Centers for Medicare
EDITOR’S NOTE: Sharon Easterling, the newest member of the ICD10monitor editorial board, will be reporting on health equity while also sharing thoughts about her personal
Medical practices are leaving money on the table by under-coding. Are one or more of your physicians under-coding? Missing revenue? Or relying too much on
Physicians and their organizations can expect to see significant changes to the PFS, QPP, and OPPS regulations. The Centers for Medicare & Medicaid Services (CMS)
There is currently a bill in Congress to raise the caps by 17,000. When I was just a young cub in healthcare, Medicare performed audits
By Timothy Powell, CPA, CHCP One of the consulting engagements I once turned down was for a group of “mini” hospitals that provided emergency care
Details will be announced during the Talk Ten Tuesdays broadcast today. By Chuck Buck The American Health Information Management Association (AHIMA) is releasing a new
In an unprecedented move, the Centers for Medicare & Medicaid Services (CMS) has proposed in the 2022 Outpatient Prospective Payment System (OPPS) Rule to put
The Centers for Disease Control and Prevention (CDC) published the ICD-10-CM Official Coding and Reporting Guidelines for the 2022 fiscal year (FY) on July 12.

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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