In the complex world of healthcare, language is everything – not just in bedside communication, but in the precise documentation that informs coding, billing, compliance,
The shift from fee-for-service to value-based care (VBC) is reshaping how healthcare organizations are reimbursed and evaluated. In this new environment, success hinges not only
Previously neuroendocrine tumors (NETs) were called carcinoid tumors and some clinicians will continue to call them carcinoid tumors. This is a physician query opportunity. They
Our readers know that Hierarchical Condition Categories (HCCs) are groups of diagnoses. Each diagnosis is classified to a payable or non-payable HCC based on whether
Hierarchical Condition Categories (HCCs) and value-based care have been a major focus for healthcare organizations during recent years. As many of you may know, the
Predicting coding patterns using the HCC risk scores can be a valuable endeavor. EDITOR’S NOTE: Longtime RACmonitor contributing correspondent Frank Cohen, a senior healthcare analyst,
The number of conditions a patient has is now going to factor into the risk adjustment score (RAS). EDITOR’S NOTE: Dr. Erica Remer reported this
Emergency release of the new EVALI code by CDC. On Dec. 9, 2019, the Centers for Disease Control and Prevention (CDC) published additional guidance regarding
Today’s coder must embrace APR-DRGs and HCCs in order to stay relevant. At the beginning of the year, Facebook’s “10-year challenge” hit the web, with
HCCs thrive on specificity and ICD-11 will provide a higher level of specificity than in ICD-10. For those of you who are coding for hierarchical
These conditions should be on the radar for coding and clinical documentation integrity. There has been much discussion about healthcare expenses in recent months. The
Diabetes is the leading cause of blindness among workers in the United States. November is National Diabetes Month, as well as Diabetic Eye Disease Awareness
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.
RACmonitor is proud to welcome back Dr. Ronald Hirsch, one of his most requested webcasts. In this highly anticipated session, Dr. Hirsch will break down the complex Two Midnight Rule Medicare regulations, translating them into clear, actionable guidance. He’ll walk you through the basics of the rule, offer expert interpretation, and apply the rule to real-world clinical scenarios—so you leave with greater clarity, confidence, and the tools to ensure compliance.
Bring your questions and join the conversation during this open forum series, live every Wednesday at 10 a.m. EST from June 11–July 30. Hosted by Chuck Buck, these fast-paced 30-minute sessions connect you directly with top healthcare experts tackling today’s most urgent compliance and policy issues.
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.
This third session in our 2026 IPPS Masterclass will feature a review of FY26 changes to the MS-DRG methodology and new technology add-on payments (NTAPs), presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.
This second session in our 2026 IPPS Masterclass will feature a review the FY26 changes to ICD-10-PCS codes. This information will be presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.
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