Is your Electronic Medical Record (EMR) system helping you pass an audit or hurting you? Editor’s Note: This is the third piece in a four-part
Physician documentation issues during an audit go beyond CDI. The issues are the chief complaint and HPI. Editor’s Note: This is the second piece in
Physician documentation issues during an audit go beyond CDI. EDITOR’S NOTE: This is the first in a four-part series that examines physician documentation issues as
Early documentation instruction sorely lacking Last week, during ICD10monitor’s Talk Ten Tuesdays broadcast, Larry Field, DO, treasurer of the American College of Physician Advisors (ACPE),
It is highly recommended to self-audit first, internally, with qualified staff. EDITOR’S NOTE: This is the first in a four-part series on the importance of
Why the Highmark decision—since rescinded—was wrong about medical decision-making relative to medical necessity. When payers and coders downcode evaluation and management (E&M) notes based on
Eight key guidelines for ensuring proper coding. EDITOR’S NOTE: The following is a summary of a presentation by Margaret Skurka during the 2017 American Health
The American Medical Association (AMA) released new current procedural terminology (CPT®) codes during its 2018 CPT and RBRVS symposium held in Chicago Nov. 15-17. Significant
Complexity of medical decision-making is key, but you can’t bill for something you didn’t do. This article was prompted by a Talk Ten Tuesdays listener’s
High degrees of variation abound in areas of coder productivity, certification. In a recent poll, only 80 percent of respondents to a question of how
A Talk Ten Tuesdays listener weighs in on woefully insufficient documentation of a routine visit. EDITOR’S NOTE: During last Tuesday’s Talk Ten Tuesdays broadcast, a
I am a physician who writes and edits guidelines designed to assist in determining appropriate utilization of clinical resources. In a nutshell, the issue that
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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