In the current climate of cost containment, commercial payers are increasingly downgrading MS-DRGs after claims are submitted, not disputing the need for inpatient care, but
As I continue to focus on documentation, this week I am turning my attention to a frequently misunderstood Medicare rule: the Three-Day Payment Window. This
In 2025, clinical documentation integrity (CDI) is experiencing a significant evolution. What was once considered a back-office function focused primarily on inpatient coding accuracy has
Last August, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) reported its findings on a review of certain MS-DRGs
While it is not in the news on a daily basis any longer, COVID has not gone away. Since the start of the pandemic, we
Coding in the post-acute care world has taken on a new significance in the past five years. For those of us who are coders, this
Wrapping up our discussion of the ICD-10-CM and PCS code updates released on Oct. 1, in this article we will examine some PCS-related changes. I
The Coordination and Maintenance Committee is scheduled for today —the first of a two-day session by the Centers for Disease Control and Prevention (CDC) and
The clinical documentation integrity (CDI) profession began its heyday in 2008, with the advent of the Medicare Severity Diagnosis-Related Group (MS-DRG) system that built and
As we begin the second half of the year, it is a convenient time to make plans and take stock of our coding operations. There
I attended the 2024 National Physician Advisor Conference (NPAC) hosted by the American College of Physician Advisors (ACPA) in the middle of April. Its theme
Last week I talked about the greater integration needed between clinical documentation integrity (CDI) and utilization review (UR), and with the nudge of Laurie Johnson,
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.
Fraud convictions don’t just punish a few bad claims; they can wipe out years of reimbursements. Don’t wait for an audit to learn the rules. Join Frank Cohen, MPA, for a live Q&A on spotting red flags, avoiding liability, and protecting your practice. Register now and bring your questions!
Substance abuse is everywhere. It’s a complicated diagnosis with wide-ranging implications well beyond acute care. The face of addiction continues to change so it’s important to remember not just the addict but the spectrum of extended victims and the other social determinants and legal ramifications. Join John K. Hall, MD, JD, MBA, FCLM, FRCPC, for a critical Q&A on navigating substance abuse in 2025. Register today and be a part of the conversation!
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.
This first session in our 2026 IPPS Masterclass will feature an in-depth explanation of FY26 changes to ICD-10-CM codes and guidelines, CCs/MCCs, and revisions to the MCE, presented by 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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