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
Federal officials are taking a TEAM approach to saving federal dollars on certain high-volume, high-cost surgical procedures with a new program embedded in the recent
The Children’s Health Insurance Program (CHIP) was created as part of the Balanced Budget Act of 1997 (BBA 97) to provide health insurance to children
The Centers for Medicare & Medicaid Services (CMS) just issued the above proposed rule—Managed Care Access, Finance and Quality. Before digging into the rule, I
This is the season for reporting proposed and final payment rules for FY 2024. After a brief pause during the winter months, the Centers for
Editor’s Note: The unofficial, unpublished FY 2023 Physician Fee Schedule Proposed Rule (CMS-1770-P) was posted on July 7, 2022. Comments will be taken at www.regulations.gov
The proposed rule includes expansions to the Physician Payment Schedule as well as a focus on access to high-quality care. The Calendar Year 2023 Physician
The final rule is expected to be posted on the first Friday in August. The Centers for Medicare & Medicaid Services (CMS) has released the
Physicians and their organizations can expect to see significant changes to the PFS, QPP, and OPPS regulations. The Centers for Medicare & Medicaid Services (CMS)
New substances and devices are cited in technology proposals. The Inpatient Prospective Payment System (IPPS) Proposed Rule for the 2022 fiscal year (FY), which was
The IPPS proposed rule is dense reading. The Centers for Medicare & Medicaid Services (CMS) released its Inpatient Prospective Payment System (IPPS) Proposed Rule for
CMS says the proposed rule is intended to enhance medical workforce in rural and underserved communities. Long-awaited and eagerly anticipated the Centers for Medicare &
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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