This week, as we continue to explore querying for acute (metabolic or toxic) encephalopathy, I want to examine the Glasgow Coma Scale (GCS) as a
I think many have heard me discuss a common scenario with which hospitals are grappling: patients who are medically ready for discharge, but have no
As alluded to on Monitor Mondays, Dr. Ronald Hirsch and I have been enjoying our fall lattes while combing through the Centers for Medicare &
Happy Clinical Documentation Integrity (CDI) Week! We’ve made it another year in a tumultuous healthcare environment. Like many other industries, perhaps one of the biggest
When the 2026 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule takes effect on Oct. 1, coders,
Today we are going to take a look at atrial fibrillation and atrial flutter: the difference between the two, the different types, and how to
The Centers for Medicare & Medicaid Services (CMS) recently published a concise “Hospice Fast Facts,” which provides key insights into hospice utilization in the 2024
It’s virtually axiomatic that if you’re performing a review of your coding, the review should be done under attorney-client privilege. I have said this before
Let’s talk about the mental side of being a coder – and the stress that quietly (or not so quietly) tags along with it. Every
Substance abuse is a pervasive issue with profound implications for hospitals. It’s been estimated that up to 25percent of hospitalized patients have a substance abuse
Condition Code W2 (CCW2), referred to by some as a “Medicare self-denial” or “Medicare Part B rebilling,” has been around for over a decade, since
Hospitals across the United States face mounting financial strain from Medicaid underpayments, but red states – those with Republican-majority legislatures and governors – stand to
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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