Increases are expected to become effective in calendar 2024. The Centers for Medicare & Medicaid Services (CMS) have released the Announcement of Calendar Year (CY)
The March 2023 Coordination and Maintenance Committee is the venue for the birthing of new codes. The March Coordination and Maintenance Committee Meeting is over.
Numerous updates from CMS include post-acute transfers to skilled nursing. In the last week there have been a lot of updates that have come from
Our weekly Internet radio broadcast will be bringing you wall-to-wall coverage of the vitally important CMS event. Almost akin to a religious pilgrimage, many of
There appears to be an overlap of messages concerning the social drivers of health in the EMR. The Centers for Medicare & Medicaid Services (CMS)
Predicting coding patterns using the HCC risk scores can be a valuable endeavor. EDITOR’S NOTE: Longtime RACmonitor contributing correspondent Frank Cohen, a senior healthcare analyst,
Coding at the intersection of the social determinants of health (SDoH). Today I will be providing some updates regarding z-codes, specifically Z59.4, Food insecurity, also
New changes are coming for reporting obstetrics. “OB (obstetrics) CDI (clinical documentation integrity) will never be the same,” according to Dr. James S. Kennedy, president
CMS is eliciting comments on MA plans abusing basic Medicare benefits. EDITOR’S NOTE: Patients and healthcare providers can present their personal experiences, devoid of personal
In a recent statement from Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure, she expressed support for the Food and Drug Administration’s (FDA’s)
New deductibles and payment rates lead to new patient financial obligations for 2023. EDITOR’S NOTE: Listen to Dr. Ronald Hirsch’s live reporting Monday on Monitor
There appear to be a number of possibilities where a BOT could be used to provide a service. I admit it, I am a nerd
Stay ahead of Medicare Advantage’s 2025-2026 regulatory changes in this critical webcast featuring expert Tiffany Ferguson, LMSW, CMAC, ACM. Learn how new CMS rules limit MA plan denials, protect hospitals from retroactive claim reopenings, and modify Two-Midnight Rule enforcement—plus key insights on omitted SDoH mandates and heightened readmission scrutiny. Discover actionable strategies to safeguard revenue, ensure compliance, and adapt to evolving health equity priorities before the June 2025 deadline. Essential for hospitals, revenue cycle teams, and compliance professionals navigating MA’s shifting landscape.
Struggling with CMS’s 3-Day Payment Window? Join compliance expert Michael G. Calahan, PA, MBA, CCO, to master billing restrictions for pre-admission and inter-facility services. Learn how to avoid audit risks, optimize revenue cycle workflows, and ensure compliance across departments. Critical for C-suite leaders, providers, coders, revenue cycle teams, and compliance teams—this webcast delivers actionable strategies to protect reimbursements and meet federal regulations.
Providers face increasing Medicare audits when using skin substitute grafts, leaving many unprepared for claim denials and financial liabilities. Join veteran healthcare attorney Andrew B. Wachler, Esq., in this essential webcast and master the Medicare audit process, learn best practices for compliant billing and documentation, and mitigate fraud and abuse risks. With actionable insights and a live Q&A session, you’ll gain the tools to defend your practice and ensure compliance in this rapidly evolving landscape.
Dr. Ronald Hirsch dives into the basics of Medicare for clinicians to be successful as utilization review professionals. He’ll break down what Medicare does and doesn’t pay for, what services it provides and how hospitals get paid for providing those services – including both inpatient and outpatient. Learn how claims are prepared and how much patients must pay for their care. By attending our webcast, you will gain a new understanding of these issues and be better equipped to talk to patients, to their medical staff, and to their administrative team.
Stop revenue leakage and boost hospital performance by mastering risk adjustment and HCCs. This essential webcast with expert Cheryl Ericson, RN, MS, CCDS, CDIP, will reveal how inaccurate patient acuity documentation leads to lost reimbursements through penalties from poor quality scores. Learn the critical differences between HCCs and traditional CCs/MCCs, adapt your CDI workflows, and ensure accurate payments in Medicare Advantage and value-based care models. Perfect for HIM leaders, coders, and CDI professionals. Don’t miss this chance to protect your hospital’s revenue and reputation!
Struggling with ICD-10-CM coding for diabetes and complications? This expert-led webcast clarifies complex combination codes, documentation gaps, and sequencing rules to reduce denials and ensure compliance. Dr. Angela Comfort will provide actionable strategies to accurately link diabetes to complications, improve provider documentation, and optimize reimbursement—helping coders, CDI specialists, and HIM leaders minimize audit risks and strengthen revenue integrity. Don’t miss this chance to master diabetes coding with real-world case studies, key takeaways, and live Q&A!
Uncover critical guidance. HIM coding expert, Kay Piper, RHIA, CDIP, CCS, provides an interactive review on important information in each of the AHA’s 2025 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.
Uncover critical guidance. Kay Piper provides an interactive review on coding guidelines and more in the AHA’s fourth quarter 2025 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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