04/14/2026

Recent RAC Monitor Article

This edition includes articles on

Decoding Burnout – The Hidden Strain Facing Medical Coders

Last week I read a research letter dealing with family physician burnout published in the Journal of the American Medical Association (JAMA) Internal Medicine. 

It noted 43.5 percent of family physicians reported burnout.  Among those reporting burnout were women, those practicing in nonrural areas and providers over the age of 55.  This survey was conducted between 2016 and 2020, so it did include some of the COVID pandemic. 

This alarming statistic made me think about burnout in the coding world.  In January of this year the American Association of Professional Coders (AAPC) addressed this in an article by Allison Apaza.  It noted coder burnout is a prevalent condition.  I’m confident those of us who code has known someone in our career who had experienced burnout, perhaps we even have felt it ourselves a time or two.  READ MORE

Cutting Through the Fog of Guidance for Incident-to Billing

Given the vast quantity of information published by the federal government, Medicare Administrative Contractors (MACs), consultants, and others, it can be easy to lose track of what is binding, what is informational, and what you can safely ignore.

The regulatory hierarchy has always been important, and the existence of artificial intelligence (AI) may make it even more important to understand what sources are authoritative and which are not, because when you perform an online search, you will often be given a purported answer without the actual original source – or the search results may claim to be quoting from an original source, but actually include fabricated information. READ MORE

One New Form in, Two to Go – And the Delicacy of Handling a Switch from Inpatient to Observation Billing

The Centers for Medicare & Medicaid Services (CMS) has finally released a new version of the Advance Beneficiary Notice of Non-Coverage, the ABN.

As I reported a few weeks ago, the new form is basically the same as the old form, but because the old form is expired, you must transition to the new form by May 12. This is a good opportunity to remind you that an ABN can be given in the emergency department for the Medicare patient who has had their medical screening examination and been found not to require hospital care, but still insists on hospitalization. READ MORE

Giving the Advanced Beneficiary Notice (ABN)

The Centers for Medicare & Medicaid Services (CMS) has released updated instructions for the Advance Beneficiary Notice of Noncoverage (ABN) Form CMS-R-131, extending the form’s expiration date to March 31, 2029 while making only minor clarifications to the accompanying instructions.

While the update does not introduce significant policy changes, it serves as an important reminder about the role the ABN plays when Medicare coverage is uncertain.

The ABN is issued to Medicare fee-for-service beneficiaries when a provider believes that Medicare may deny payment for a particular service. The notice must be presented before the service is provided, allowing the beneficiary to make an informed decision about whether to proceed with care and accept potential financial responsibility if Medicare does not cover the service. READ MORE