New procedure codes do not impact the MS-DRG assignment. The Centers for Medicare and Medicaid Services (CMS) released 21 new ICD-10-PCS codes that apply to
CCM appears to be positioned to be effective for improving patient care during the pandemic. Previously, we’ve discussed the numerous benefits of incorporating chronic care
If a patient has COVID-19 and pneumonia, he or she should be admitted to a skilled nursing facility (SNF) at the hospital until the patient
There are some remaining contamination issues and human errors that produce false positives. In previous articles, I discussed the frequency of false positives in COVID-19
New COVID cases reported daily have more than doubled during recent weeks, since a more modest July surge. As the nation’s COVID-19 pandemic continues to
False positives distort various epidemiological statistics. In a previous article (“False Positives in PCR Tests for COVID-19“), I discussed the evidence regarding false-positive rates of
Federal approval of the Pfizer vaccine, believed to be better than 90 percent effective, could occur before the end of the month. When the long-awaited
The prevalence of misinformation coming from the most trusted form of coronavirus test may be more significant than previously thought. Three types of tests are
Part I of the Talk Ten Tuesdays broadcast airs today, with the next two parts to follow on subsequent Tuesdays, 10 a.m. EST. During the
There are false negatives; there are false positives; there are untested individuals with disease. I am in the process of developing a 90-minute COVID-19 webinar
The ICD-10-PCS codes can be found in the XW0 Table for the drug infusions. There were new ICD-10-PCS codes implemented on Aug. 1, involving substances
Sepsis is diagnosed through clinical judgment. One of the forums I monitor recently saw a question about sepsis and SEP-1, which elicited this article. SEP-1
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.
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.
Master the FY 2027 ICD-10-CM changes, including new diagnosis codes, CC/MCC updates, and coding guideline revisions, with practical insights from nationally recognized coding and CDI experts.
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