I receive a lot of newsletters every morning to help me stay abreast of what is happening in the healthcare industry. A troubling recent trend
As discussed last week, payments to Medicare Advantage (MA) plans are adjusted to account for expected healthcare resource consumption by enrollees. Higher risk scores increase
As the federal government shutdown drags into its fifth week, the collapse of key safety-net supports such as nutrition benefits, health-insurance subsidies, and the disruption
Chimeric Antigen Receptor T-cell (CAR T-cell) immunotherapy is a topic near to my heart, as a loved one is about to undergo this treatment plan.
The future of healthcare is undeniably intertwined with artificial intelligence (AI). But for all its promise, AI has become a double-edged scalpel – especially when
EDITOR’S NOTE: Sharon Easterling continues her exclusive series on article intelligence (AI) and medical record coding. Let’s be honest: none of us signed up for
I had the pleasure of attending the annual California Health Information Conference in Long Beach, California, as an attendee and as a speaker, last week.
Former President Joe Biden’s recent diagnosis of stage 4 metastatic prostate cancer, marked by a Gleason score of 9, has raised questions about how such
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
This past week, the Centers for Medicare & Medicaid Services (CMS) announced the suspension of eight improvement activities under the Merit-Based Incentive Payment System (MIPS)
EDITOR’S NOTE: To view the full proposed rule or submit a comment, visit https://www.regulations.gov and search for CMS-1833-P. The fiscal year (FY) 2026 Inpatient Prospective
My Dear Esteemed Colleague… You and I are very much aware of the work being accomplished everyday by a team of dedicated healthcare professionals. We
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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