There is a certain not-so-hidden gem ICD-10-PCS: the body-part key. PCS coding can be challenging, so it is vital to take advantage of all the
With the April 1 update, the Centers for Medicare and Medicaid Services (CMS) implemented 80 new PCS codes. To break it down, there are 24
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 Federal Register has published a change to the Sept. 9-10 Coordination and Maintenance Committee Meeting. The Federal Register states that the Centers for Medicare
As coders, we are familiar with the ICD-10 Coordination and Maintenance (C&M) Committee. The Centers for Medicare & Medicaid Services (CMS) describes it as a
I recently came across a denial indicating that a query was noncompliant because it did not include evidence why the query was needed. I was
While we think of Oct. 1 as the date we look for new ICD-10 codes and changes, in the past few years we have seen
Continuing with our discussion of the ICD-10-CM and PCS code updates issued earlier this month, today we will examine an update potpourri of some relevant
The basic foundation for any medical coding or clinical documentation integrity (CDI) professional includes the ICD-10-CM/PCS Official Guidelines for Coding and Reporting, the American Hospital
The ICD-10-CM and PCS codes were released in June 2024. When ICD-10 codes are released, there are files posted on the Centers for Medicare and
The new ICD-10-PCS codes for the 2025 fiscal year (FY) were posted on the Centers for Medicare & Medicaid Services website on June 6. The
As we discuss the Inpatient Prospective Payment System (IPPS) Proposed Rule for the 2025 fiscal year (FY), I want to call attention to the FY
Medicare regulations are complex and even seasoned professionals struggle to apply them consistently. Due to overwhelming demand, Dr. Hirsch returns for Part 2 of Ask Dr. Hirsch: Clarifying Medicare’s Most Misunderstood Rules to answer even more of Medicare’s most misunderstood questions, covering inpatient status, observation, SNF access, Medicare Advantage denials, and more. Join Dr. Hirsch as he provides clear, referenced answers to real-world questions submitted by your peers, helping you navigate Medicare compliance with confidence and clarity.
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.
Artificial intelligence is rapidly transforming healthcare revenue cycle operations, from coding and auditing to compliance and denials. Join industry leaders Pam Warren (MaineHealth) and Raemarie Jimenez (AAPC) for a live fireside chat exploring how AI is changing workflows, workforce roles, payer-provider dynamics, and compliance risk—and what organizations should be doing now to prepare.
Prepare for FY 2027 IPPS changes with a comprehensive 3-part masterclass covering ICD-10-CM/PCS updates, MS-DRG shifts, NTAPs, compliance risks, and reimbursement strategies.
Stay ahead of FY 2027 reimbursement changes with expert analysis of MS-DRG shifts, NTAP updates, Medicare Code Edits, and emerging technologies impacting inpatient payment accuracy.
Stay ahead of FY 2027 ICD-10-PCS changes with expert analysis of new procedure codes, revised guidelines, and high-impact updates affecting reimbursement, compliance, and inpatient coding accuracy.
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