In June, I wrote that ending the Medicare Inpatient-Only List, which CMS is phasing out through January 1, 2028, would reduce surgical volumes and could
A hospital’s mortality ratio improves. Its case mix index rises. More encounters include complications or comorbidities. Those results deserve attention, but they also deserve a
Hopefully you were listening to Talk Ten Tuesday last week and heard the Karen Davis presentation on the new Myocardial Infarction (MI) definition. She gave
This week, I want to recognize and celebrate the profession of case management. ACMA and the Commission have named this year’s theme “Driving Outcomes,” while
Say a critically ill patient develops a skin lesion even though prevention efforts are documented. The wound team calls it a pressure injury. The physician
The Fifth Universal Definition of Myocardial Infarction (UDMI), released in August 2026, represents a significant change in how myocardial infarction (MI) is clinically classified. Gone
If you are a frequent listener to Talk Ten Tuesdays, and we certainly hope you are, you know we always ask for questions in the
Pressure ulcers are one of the best-known quality-of-care conditions among medical staff, clinical documentation integrity (CDI), and coding professionals. Yet while hospitals often track any
Medicare Advantage has traditionally occupied a familiar space in hospital operations: prior authorization, utilization management, denials, risk adjustment, and reimbursement. With the FY 2027 Inpatient
With October 1 now just days away, it’s a good time to take a quick look back at some of the fast- approaching FY27 inpatient
Dear Doctor, I know how a query can feel. It arrives mid-shift, wrapped in an abundance of misaligned clinical indicators offering a menu of answers
The chart is complete. Every required field is filled out. The dropdowns are selected, the template is populated, and the note is signed. But can
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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