Thanks to all our attendees to the IPPS Masterclass this week. We shared a lot of information on the new ICD-10-CM and PCS codes, changes
For some advanced clinical documentation integrity (CDI) programs, Elixhauser comorbidities are hardly unfamiliar territory. Mature programs have spent years examining Elixhauser conditions, mortality risk adjustment,
The practice of medicine encompasses many specialties. Some are organized around specific organ systems—nephrology, cardiology, neurology—while others fall into broader categories, including the familiar divide
Few diagnostic categories draw more denial activity right now than kidney diseases. Acute kidney injury (AKI), acute tubular necrosis (ATN), and chronic kidney disease (CKD)
As this summer comes to an end, we look forward to the cooler weather of fall. Oct. 1 is right around the corner. Before you
A recent question was posed related to “What happens when a hospice enrolled patient returns to the hospital for emergency or hospital care?” Aside from
The Centers for Medicare & Medicaid Services (CMS) finalized adoption of the Advance Care Planning electronic Clinical Quality Measure (eCQM) as a new self-selected electronic
The confusion about when to code severe malnutrition is likely to be back in the spotlight as malnutrition screening becomes a mandatory electronic quality measure
Sepsis has never been a simple diagnosis in healthcare. Ask a bedside clinician, a clinical documentation integrity (CDI) specialist, a coding professional, a quality leader,
As we wait for the fiscal year (FY) 27 Inpatient Prospective Payment System (IPPS) Final Rule, now is a great time to review some new
A few months ago, I argued that clinical documentation integrity (CDI) needed to stop reviewing claims one case at a time because payers have already
Imagine this scenario… A 72-year-old patient is admitted for an elective colectomy to treat colon cancer. The operation proceeds without complication, and the first two
A single CDM error can lead to missed revenue, billing issues, denials, and compliance concerns. Learn the fundamentals of effective Charge Description Master (CDM) management and build a stronger foundation for accurate, consistent charge decisions.
Join Michael Calahan, PA, MBA for this radiation oncology coding and compliance webcast as he explains the fundamentals of coding, billing, reporting, and documentation for hospital outpatient and professional services. Learn how the 2026 radiation therapy coding changes affect current practices, how to distinguish technical and professional services, and how to address bundling, units, frequency, modifiers, and documentation requirements. Michael will also help you identify radiation oncology coding and billing vulnerabilities that could lead to denials, overpayments, repayment demands, or federal audit exposure.
The 2027 CMS policy changes will impact case management, utilization review, reimbursement, and patient status decision-making long before they officially take effect. Join nationally recognized physician advisor Dr. Ronald Hirsch as he explains the finalized and proposed inpatient and outpatient rule changes, expanding bundled payment initiatives, payment updates, and evolving payer expectations. Gain practical guidance to help your organization prepare early, strengthen compliance, reduce reimbursement risk, and confidently navigate the transition to 2027.
The Two-Midnight Rule continues to be one of Medicare’s most closely monitored compliance areas and now the rules are changing again. Join compliance expert Michael Calahan for a practical review of the latest 2026 policy updates, the proposed 2027 OPPS changes affecting inpatient-only procedures, and the best practices hospitals need to reduce audit risk, strengthen admission decisions, and protect reimbursement. Leave with actionable strategies you can immediately apply to improve compliance and confidently prepare for increased federal and Medicare Advantage scrutiny.
Avoid costly inpatient coding errors involving ulcers and gangrene. This practical FY 2027 ICD-10-CM webcast clarifies pressure injury staging, non-pressure ulcer severity, diagnosis sequencing, documentation requirements, and POA reporting. Through real-world cases, gain the confidence to make defensible coding decisions, reduce denials, strengthen compliance, and support accurate reimbursement.
What happens when everyone reviews the same chart, but reaches a different conclusion? In this case-based clinical documentation integrity (CDI) webcast, Penny Jefferson examines how documentation involving clinical support, timing, causation, linkage, and terminology can produce very different outcomes for ICD-10 coding, reimbursement, quality, risk adjustment, medical necessity, denials, and compliance. Using cases involving postoperative respiratory failure, severe malnutrition, and encephalopathy, you’ll learn the practical CLEAR framework to help attendees learn to evaluate whether a diagnosis is codeable, consistent, specific, reportable, and ultimately defensible across the different teams and systems that rely on the medical record.
Spinal fusion cases are among the most complex inpatient procedures to code, where even minor ICD-10-PCS errors can affect MS-DRG assignment, reimbursement, compliance, and audit outcomes. This practical webcast provides a step-by-step framework for interpreting operative reports, assigning accurate ICD-10-PCS codes, recognizing documentation gaps, and confidently coding complex fusion procedures. You’ll leave with practical tools that improve coding accuracy, reduce denials and audit risk, and strengthen documentation-driven reimbursement decisions.
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.
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