The U.S. Department of Education’s implementation of President Trump’s One Big Beautiful Bill Act (OBBBA) has triggered one of the most consequential – and controversial
Home Health lives or dies on the quality of its Outcome and Assessment Information Set (OASIS) documentation. OASIS is the standardized assessment tool that every
For decades, clinical documentation integrity (CDI) programs have been synonymous with inpatient care. They evolved from early efforts to improve Diagnosis-Related Group (DRG) accuracy into
Here’s the uncomfortable truth: many hospitals and state Medicaid plans, under pressure from HR1 data analysis needs, are paying eye-watering markups to for-profit CPA and
EDITOR’S NOTE: AI-assisted editing tools were used only for proofreading and language refinement; all analysis, interpretation, and conclusions reflect the author’s original work. Artificial intelligence
Hospitals are about to hit a perfect storm of two powerful climate conditions set both hit in 2026; the One Big Beautiful Bill Act (OBBBA)
Generative artificial intelligence (AI) is reshaping health information management (HIM) at a pace few anticipated. Hospitals and health systems are integrating large language models (LLMs)
Someone recently asked on LinkedIn if they must always sequent a UTI as the principal diagnosis when encephalopathy due to a urinary tract infection (UTI)
Healthcare compliance professionals have long wrestled with the problem of copied-and-pasted notes in medical charts. When clinicians copy-forward prior entries or borrow from templates, auditors
Last week I wrote about querying for the type of acute encephalopathy, and I’d like to continue this week. Please know, when I use the
For decades, armies of medical coders have served as the translators of American healthcare, converting physician notes and hospital encounters into ICD, CPT®, and HCPCS
In 2019, I had an employee health exam, and fortuitously but startlingly discovered I had no sight in my left eye. I rushed my butt
Get clear, practical answers to Medicare’s most confusing regulations. Join Dr. Ronald Hirsch as he breaks down real-world compliance challenges and shares guidance your team can apply right away.
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.
Learn how to navigate the proposed elimination of the Inpatient-Only list. Gain strategies to assess admission status, avoid denials, protect compliance, and address impacts across Medicare and non-Medicare payors. Essential insights for hospitals.
Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY26 IPPS, including new ICD-10-CM/PCS codes, CCs/MCCs, and MS-DRGs, plus insights, analysis and answers to your questions from two of the country’s most respected subject matter experts.
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