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
For years, the triad model, comprised of nurse case managers, social workers, and utilization review nurses, served as the three-legged stool supporting the model for
The role of physician advisors has evolved into an absolute necessity in hospitals of all sizes around the country. As the healthcare landscape rapidly evolves,
I’ve spent much of my time over the last few months interviewing current and former employees of clients, as part of either internal or external
The educational content and schedule for the upcoming Open Door Forum Webcast series produced by RACmonitor and ICD10monitor have been unveiled. The announcement was made
Amid a crowded galaxy of well-known regulatory and process subject-matter experts, five extraordinary respected and renowned healthcare professionals are poised to lead a new series
A new series of educational webcasts for both RACmonitor and ICD10monitor are being launched. The announcement was made by Chuck Buck, Publisher of RACmonitor and
The Centers for Medicare & Medicaid Services (CMS) has released the Inpatient Prospective Payment System (IPPS) Proposed Rule for the 2026 fiscal year (FY). Among
Hospitals nationwide are preparing for significant regulatory shifts driven by the Centers for Medicare & Medicaid Services (CMS). The FY 2026 Inpatient Prospective Payment System
MedLearn Media is launching an online resource believed to be useful for professional coders, charge capture, compliance, and revenue integrity specialists alike. DrugCode Pro is
Effective communication is critical in navigating clinical and non-clinical interactions, addressing generational and gender-specific differences, and fostering collaboration. By understanding how poor communication can affect
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.
Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.
Breast biopsy procedures may be clinically straightforward but accurately translating them into compliant billing can be anything but. In this focused webcast, Shawn Blackburn, CPC, CPMA, CIC, CRC, CCS-P breaks down how imaging guidance, lesion count, laterality, and payer expectations all impact how these procedures should be reported. Through clear explanations and real-world scenarios, you’ll gain practical insight into aligning clinical workflows with billing requirements, avoiding common pitfalls, and ensuring your documentation supports accurate reimbursement and compliance.
Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Sherri L. Clayton, RHIT, CSS. You’ll learn how to apply global maternity package rules accurately, select the right CPT codes for procedures and visits, and identify documentation gaps that lead to denials. With practical guidance and real examples, this session helps you strengthen compliance, reduce audit risk, and ensure accurate reimbursement for women’s health services.
Uncover essential coding insights with nationally recognized coding authority Kay Piper, RHIA, CDIP, CCS. Through ICD10monitor’s interactive, on‑demand webcast series, Kay walks you through the AHA’s 2026 ICD‑10‑CM/PCS Quarterly Coding Clinics, translating each update into practical, easy‑to‑apply guidance designed to sharpen precision, ensure compliance, and strengthen day‑to‑day decision‑making. Available shortly after each official release.
Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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