Last week during Talk Ten Tuesdays, there were several questions about the Coordination and Maintenance Committee, as well as the CPT® Editorial Panel meetings. As
I am currently performing a fraud assessment, and since I can’t go back and educate the provider in question, I am going to share my
This report includes a collection of topics. Compliance, CPT® Panel Meeting, and new CPT codes for respiratory syncytial virus (RSV) vaccine administration are included in
In the 2023 Fourth Quarter of the American Hospital Association (AHA) Coding Clinic, there is discussion of two types of short-term external heart assist systems.
Back in September 2023, the Centers for Medicare & Medicaid Services (CMS) announced release of an MLN to better equip providers with documentation guidelines in
EDITOR’S NOTE: As you may know, Dr. Erica Remer is a consultant, in addition to serving as co-host of the long-running Talk Ten Tuesdays weekly
EDITOR’S NOTE: This story was first reported by Mr. Frank Cohen during the live Monitor Monday broadcast, Monday, Jan. 8, 2024. In 2021, the Centers
The Centers for Medicare & Medicaid Services (CMS) has released 41 new procedure codes, which are effective April 1, 2024. The new codes were posted
It’s hard to believe that we are at the end of the year. I thought that I would review the year end check to help
The 2023-2024 flu season is upon us. This year the egg-based flu vaccines have been created for the following: • Virus A/Victoria/4897/2022 HIN;• Virus A/Darwin/9/2021
There should be a strong and healthy relationship between health information management (HIM) and case management and/or utilization review (UR) in every healthcare setting. These
If your laboratory performs toxicology procedures to test for drugs of abuse, you have most likely become aware of the new Procedure-to-Procedure (PTP) edits effective
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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