The proposal is on the table as part of proposed E&M changes. EDITOR’S NOTE: The following story was published by RACmonitor on Aug. 16, 2018.
Proposed rule will cut by 50% claims submitted with modifier 25. In what is being reported as the biggest change of its kind in more
Proposed E&M code changes would impact specialty physicians. Some physicians are probably not very happy with recently proposed changes to the Medicare Physician Fee Schedule.
Proposed rule on 2019 Physician Fee Schedule offers greater incentives Revisions in the Quality Payment Program (QPP) proposed rule, tucked into the 2019 Physician Fee
Major E&M changes on the horizon. Probably the biggest change in healthcare in two decades is the Centers for Medicare & Medicaid Services (CMS) proposal
CMS proposed major changes to E&M coding but still solicits feedback from stakeholders. The Centers for Medicare & Medicaid Services (CMS) wants to simplify outpatient
More than physician payment rules in the CMS IPPS proposal The physician fee schedule rule is one of many payment system rules that the Centers
The “right documentation” is the central pivot point to the revenue cycle Physician clinical documentation plays a critical role in any overall healthcare delivery
A Pittsburgh-based MD weighs in on an emerging area of focus in the healthcare industry. EDITOR’S NOTE: The following are remarks made by the author
The industry knows that focusing more on SDoH reduces costs. Healthcare costs and coding have been married over 35 years, since the Social Security Act
The importance of an effective outpatient CDI program cannot be overstated When working with a member of the sales force for a previous employer, I
There are now five types of myocardial infarction (MI) code categories, and the author describes these new options and how they will impact reimbursement. For
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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