Help: What Do I Do Now?
Tiffany Ferguson, LMSW, CMAC, ACM
May 22, 2023
The PHE has ended and the three-day SNF rule has returned. Following up on my previous article posted in April regarding the return of the
The PHE has ended and the three-day SNF rule has returned. Following up on my previous article posted in April regarding the return of the
On April 2, my 92-year-old father sustained a fall in his assisted living facility (ALF), which resulted in an emergency department evaluation. Fortunately, he hadn’t
The end of the public health emergency (PHE) brings new challenges regarding the old Three-Day rule. The three-day stay for Medicare patients is the requirement
Delays in transitions to post-acute care are a vexing issue. I am continuing to see a significant number of healthcare organizations dealing with denials and
Numerous updates from CMS include post-acute transfers to skilled nursing. In the last week there have been a lot of updates that have come from
The unwinding of Medicaid coverage is something to look for. During the COVID-19 pandemic, our health system saw significant benefits under the federal public health
Recently, the Centers for Medicare & Medicaid Services (CMS) announced that it was cracking down on poorly performing skilled nursing facilities (SNFs) by making changes
This category of E&M services will have three subcategories instead of the current four. EDITOR’S NOTE: The American Medical Association (AMA) announced major revisions to Evaluation
Comments on these proposed rules are due by June 7. Hospice payment rates, as well as those for skilled nursing facilities (SNFs), constitute the subjects
Alexander v. Azar Reappears; Condition Code 44 appeals could be back in court. Author’s Note: Thanks to the Center for Medicare Advocacy for alerting me
The move comes amid localized spikes in COVID-19 cases occurring nationwide. Federal officials said Friday that they are ending an emergency blanket waiver intended to
March 23, 2020—The Centers for Medicare & Medicaid Services (CMS) has clarified its position on the use of swing beds, saying that swing beds can
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.
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.
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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