It’s a move sure to stir up controversy. Under a recently passed Centers for Medicare & Medicaid Services (CMS) Final Rule, your Medicare enrollments will
Conduct coding audits in all settings and check vendors’ coding credentials are among lessons learned under ICD-10. When we left ICD-9-CM, there were around 14,000
Expanding clinical conversations to involve all players can only benefit the entire organization. EDITOR’S NOTE: This article is based upon Dr. Erica Remer’s remarks during
The actual go-live of ICD-10-CM/PCS was generally smooth, with no major problems. For health information management (HIM) coding and clinical documentation improvement/integrity (CDI) professionals, the
The risks of using the Internet to self-diagnose and code. A majority of us turn to the Internet for health-related information. According to the Pew
If there is no organ dysfunction, it is not sepsis. EDITOR’S NOTE: Dr. Erica Remer reported this story live during the Sept. 10 edition of Talk
The CDI is more than diagnosis capture through the query process. The Association for Clinical Documentation Improvement Specialists (ACDIS) recently released a paper titled Proactive
Artificial intelligence (AI) solutions are designed to support CDI teams in their quests for efficiency. The concept of “doing more with less” is far from
Fall ICD-10-CM/PCS Coordination and Maintenance Committee Meeting kicks off today. Today and tomorrow mark the dates for the next ICD-10 Coordination and Maintenance Committee meeting.
Moving from the inpatient to the outpatient setting is gaining momentum. Outpatient clinical documentation improvement (CDI) programs are becoming more prevalent in the healthcare sector,
Data for clinical and business intelligence can uncover significant opportunities within clinical documentation improvement. In my previous article, I discussed the process of how transformational
Where CDI went awry: missing an opportunity for safety. In last week’s ICD10monitor news edition, I authored an article titled “How a Texas Health System
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.
Get two essential perspectives on CMS compliance for $199.
The Two-Midnight Rule helps you navigate short-stay admissions, patient status, and evolving 2026-2027 requirements, while CMS CRUSH explores the next wave of program integrity, payment oversight, and data-driven scrutiny.
Two RACmonitor webcasts. One practical approach to preparing for increased CMS oversight.
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.
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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Prepare for FY 2027 IPPS changes with a comprehensive 3-part masterclass covering ICD-10-CM/PCS updates, MS-DRG shifts, NTAPs, compliance risks, and reimbursement strategies.
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