Talk Ten Tuesdays
ICD10monitor
Subscribe
Get the most up-to-minute news and information on ICD-10. Join Chuck Buck and Erica Remer, MD, FACEP, CCDS, every Tuesday as they welcome ICD10monitor contributing editors and special guests to monitor and report on the progress that all healthcare stakeholders are experiencing in their respective implementations of ICD-10. Register to attend live here: https://event.webcasts.com/starthere.jsp?ei=1236510&tp_key=da0e4c0f76
Available episodes
Newest first
Oldest first
3 days ago
Probing the ICD-10 Impact on CMS-HCC Risk Adjustment
Are there significant risks of potential fraud and abuse with Medicare Advantage (MA) by plans, vendors, and providers, with an emphasis on ICD-10-CM’s impact on Centers for Medicare & Medicaid Services Hierarchical Condition Category (CMS-HCC) risk adjustment?
Evidently, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) believes there are. Recently, Christi A. Grimm, Inspector General, issued a statement in which she addressed the concerns of the federal watchdog agency.
In response to her speech, we invited Dr. James Kennedy, a 20-year veteran in clinical documentation integrity (CDI) consulting and a popular panelist, to share succinct advice on how a compliance plan can best prepare for OIG audits that are sure to come.
Programming note: Invite your compliance teams to hear what promises to be the best four minutes applicable to this challenge, during the next live edition of Talk Ten Tuesdays.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on coding colorectal cancer.
* *SDoH Report: *Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
* *News Desk: *Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
* *TalkBack:* Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.
playlist_add
Mar 14, 2023
First and Foremost: Getting Paid Correctly
It’s all about the money. It’s not only getting paid, but also getting paid the right amount. Little wonder that this is first and foremost on every provider’s mind. Often, though, success or failure lies in the completion and details of medical notes taken.
So, what’s the deal with medical notes? Why are notes so important, and why are they difficult for providers to complete? We’ve invited Kevin Lasser, Co-founder and CEO of TiaTech, to be our special guest and to answer those questions during the next live edition of Talk Ten Tuesdays.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the outcome of the recent Coordination and Maintenance Committee (C&M) meeting.
* *SDoH Report: *Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
* *News Desk: *Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
* *TalkBack:* Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.Emergency Minute
Get an inside look into what healthcare really looks like
Listen on: Apple Podcasts Spotify
playlist_add
Mar 7, 2023
Coordination & Maintenance Meeting: Live Reports and Updates
ICD10monitor correspondent Linda Holtzman, founder of Clarity Coding, will return to the Talk Ten Tuesdays (TTT) broadcast this coming Tuesday, March 7 to report on the activities at the Coordination & Maintenance Committee (C&M) meeting taking place from the headquarters of the Centers for Medicare & Medicaid Services (CMS).
Holtzman, a longtime C&M observer, will bring her knowledge and expertise to her reporting of this important event – an essential meeting for coders and clinical documentation integrity specialists (CDISs).
The two-day meeting will be held on March 7 and 8, virtually. The usual program will begin at 9 a.m. EST until 5 p.m. EST, until the business is finished. The tentative agendas are light this spring, with 18 topics on the diagnosis side and nine proposals for procedure codes. The procedure code information, however, will not be presented during the meeting.
Remember, TTT will be covering this event live!
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will also report on the C&M meeting.
* *The Dunn Report: *Legendary HIM professional Rose Dunn, COO at First Class Solutions, and past president of the American Health Information Management Association (AHIMA), will report on the latest news about hierarchical categories of classification (HCCs).
* *SDoH Report: *Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
* *News Desk: *Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
* *TalkBack:* Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.
playlist_add
Feb 28, 2023
High-Sensitivity Cardiac Troponins: Part II
We will conclude our month-long observance of American Heart Month on the Talk Ten Tuesdays weekly Internet radio broadcast with an upcoming guest appearance of Cardiologist Harry B. Peled, MD with St. Jude Medical Center in Fullerton, Calif.
Last Tuesday, Dr. Mahesh Amin reported on the use of new protocols centered on high-sensitivity troponins for the diagnosis of type 2 myocardial infarction (MI). The response to his appearance was overwhelming; hence the continuation of this timely and critically important topic during the next broadcast.
Our series on the plight of rural hospitals will also continue with Dr. James Kennedy, who will report on an unfolding tragedy facing America’s rural populations as they seek care from facilities faced with drastically dwindling resources.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
* *News Desk: *Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
* *TalkBack:* Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.
playlist_add
Feb 21, 2023
New Protocols for High-Sensitivity Cardiac Troponins
Last year, the Food and Drug Administration (FDA) issued its approval of using new protocols centered on high-sensitivity troponins for the diagnosis of type 2 myocardial infarction (MI).
Reporting our lead story during the next edition of Talk Ten Tuesdays will be Dr. Mahesh Amin, CV Service Line Medical Director for BayCare Health Systems in Clearwater, Fla., a board-certified cardiologist.
This story, along with a Feb. 28 report by Henry Peled, MD at St. Jude Medical Center in Fullerton, Calif., will conclude the monthlong observance of American Heart Month by ICD10monitor and Talk Ten Tuesdays. In previous February broadcasts, the focus has been on the topics of coding and clinical documentation integrity (CDI).
This live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
* *SDoH Report: *Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
* *News Desk: *Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
* *TalkBack:* Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.
playlist_add
Feb 14, 2023
Cardiology: Understanding the Imperative of Pre-Authorizations
In continuing our observance of American Heart Month, during the next live edition of the Talk Ten Tuesdays live Internet radio broadcast we will zero in on the topic of coding and clinical documentation integrity (CDI) issues related to cardiovascular procedures – and, specifically, the importance of obtaining pre-authorizations for cardiology procedures.
Obtaining cardiology procedure pre-authorizations tends to be a time-consuming process, depending on the complexity of the patient’s insurance coverage and staff experience. And that is why we invited Susie Vestevech, the COO for TiaTech USA, to walk you through the process, which can range from several days to several weeks, often requiring multiple phone calls and documentation submissions.
Every year, some 805,000 people in the United States have a heart attack. Basically, someone has a heart attack every 40 seconds. Making certain that your facility is prepared to obtain cardio procedure pre-authorizations is of vital importance every month, not just in February.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
* *SDoH Report: *Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
* *News Desk: *Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
* *TalkBack:* Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.
playlist_add
Feb 7, 2023
Understanding the Pain Points: Coding and Documenting Myocardial Infarction
February is American Heart Month, a time to raise awareness of cardiovascular health and to shine the light on cardiac issues, especially myocardial infarction.
Unfortunately, every year about 805,000 people in the United States have a heart attack. Basically, someone has a heart attack every 40 seconds.
And that is why we invited the Chief Executive Officer for the Innova Revenue Group, Lidiya Ter-Markorova, a clinical documentation integrity expert, to discuss documentation and coding pain points for myocardial infarction during the next live edition of Talk Ten Tuesdays.
The live broadcast will also feature these other segments:
* *Coding Report: *Patricia Chua will report on the latest coding news.
* *SDoH Report: *Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
* *News Desk: *Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
* *TalkBack:* Erica Remer,MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.
playlist_add
Feb 1, 2023
Mary's Bookclub: Respiratory Therapy All Access Pass
Listen to Mary's Bookclub, where Mary summarizes the products you can find at the MedLearn online bookstore!
In this episode, Mary goes over the *Respiratory Therapy All Access Pass*, and why it is an important product for healthcare professionals.
playlist_add
Jan 31, 2023
Exclusive Series: The Plight of Rural Hospitals
As rural hospital closures continue to increase (136 have occurred between 2010 and 2021), health information management (HIM) and clinical documentation improvement (CDI) professionals have key roles in ensuring revenue integrity and optimization essential to sound operations and access.
Even so, small facilities, especially those operating independently, simply do not have the resources that larger chains have to negotiate favorable payer contracts and to implement processes, technologies, and training essential to withstanding payer denials.
In addressing these crucially important issues, Talk Ten Tuesdays, the live Internet radio program produced by ICD10monitor, will begin a new series that will address rigorous revenue integrity solutions that can be developed in a rural environment, while offering tips in creating win-win scenarios with medical/provider staffs.
Join expert coder James S. Kennedy, MD – a native of East Tennessee, which has its own share of rural hospitals – as he offers experience, guidance, and hope essential to success.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
* *SDoH Report: *Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
* *Talk Law:* Healthcare attorney Karen N. George with the Los Angeles-based law firm of Buchalter will resume her popular segment, reporting on healthcare law.
* *News Desk: *Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
* *TalkBack:* Erica Remer,MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.
playlist_add
Jan 24, 2023
Coding Confusion: AMA’s Two-in-One Code Calamity
Who knew that when the venerable American Medical Association’s (AMA’s) combining two hospital encounter service types into one code set of inpatient/observation services – initial and subsequent – consternation would be the outcome. The confusion: what entity can actually bill an inpatient initial code, 99221-99223, and who must default to subsequent codes or report office and other outpatient codes when seeing patients in the observation setting?
The good news: during the next live edition of the long-running and popular Talk Ten Tuesdays Internet broadcast, Terry Fletcher will return to the broadcast and offer her interpretation of the rules, and how multi-specialty practices will handle these changes. Moreover, Fletcher, a nationally recognized professional coder, educator, and auditor, will report on the contrast between CPT® and Medicare when reporting these services.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
* *SDoH Report: *Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
* *Journaling John: *John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, will continue with his journal entries.
* *News Desk: *Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
* *TalkBack:* Erica Remer,MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.
playlist_add
Jan 17, 2023
The Reporting Dilemma: DRG Mismatches (Part II)
The term “DRG mismatches” is most often used to describe situations wherein the working diagnosis-related group (DRG) selected by the clinical documentation improvement specialist (CDIS) differs from the final coded DRG, signaling that the CDIS and the coder have arrived at different principal diagnoses. In other situations, a procedure may have been coded incorrectly by the CDI professional, causing the DRG mismatch.
But here’s good news: there’s a new workflow for resolving inpatient DRG mismatches. With this new workflow, the CDIS and coder no longer have to spend countless hours reconciling DRG mismatches.
During the next live edition of Talk Ten Tuesdays, Patty Chua, president of Innova Revenue Group, will report on the positive coding implications this new workflow has created.
The live broadcast will also feature these other segments:
* *Revenue Cycle Report: *Susan A. Vestevich, JD, chief operations officer for Tia Tech USA, will report on the need for physician c…
playlist_add
Jan 12, 2023
Mary's Bookclub: Nuclear Medicine All Access Pass
Listen to Mary's Bookclub, where Mary summarizes the products you can find at the MedLearn online bookstore!
In this episode, Mary goes over the Nuclear Medicine All Access Pass, and why it is an important product for healthcare professionals.
playlist_add
Jan 10, 2023
Exclusive: The Reporting Dilemma: DRG Mismatches (Part I)
Within the hospital setting, the term “mismatch” is most often used to describe a situation wherein the final working diagnosis-related group (DRG) selected by the clinical documentation improvement (CDISs) specialists from the final coded DRG.
This can be due to many reasons. One of the most frequent reasons is that the CDI professional and coder have arrived at a different principal diagnosis. In other situations, a CC (complication or comorbidity) or MCC (Major CC) may not have been coded by either the CDI professional or the coder. In still other situations, a procedure may have been coded incorrectly by the CDI professional, causing the DRG mismatch.
There are also other reasons for mismatches, as you’ll discover during upcoming editions of the long-running and popular live Internet broadcast Talk Ten Tuesdays. ICD10monitor and Talk Ten Tuesdays are joining forces with Innova Revenue Group to produce a two-part series, debuting next week: “DRG Mismatches.” Reporting ou…
playlist_add
Dec 14, 2022
Mary's Bookclub: Infusion & Injection All Access Pass
Listen to Mary's Bookclub, where Mary summarizes the products you can find at the MedLearn online bookstore!
In this episode, Mary goes over the Infusion & Injection All Access Pass, and why it is an important product for healthcare professionals.
playlist_add
Dec 13, 2022
Crossing State Lines: Telehealth
Telehealth is considered to be rendered at the physical location of the patient, and therefore a provider typically needs to be licensed in the patient’s state. When the public health emergency (PHE) was declared in March of 2020, most states, followed the federal exceptions under the 1135 CARES Act waivers, allowing, an out-of-state provider to render services via telemedicine in a state where they are not located, or allow a clinician to provide services via telehealth in a state if certain conditions are met. However, as of summer 2021, 80 percent of the states implemented telehealth pandemic workarounds. Because these laws were issued under state emergency declarations, they were never meant to be permanent. During the next live edition of Ten Tuesday, healthcare consultant, Terry Fletcher will report on some updates to state rules and what physicians need to do to make sure they are compliant.
The live broadcast will also feature these other segments:
* *Coding Report: *Laur…
playlist_add
Dec 6, 2022
National Coding Roundup
New codes. Old codes. Deleted codes. ICD-10 codes, evaluation and management (E&M) codes, and Z codes.
It’s raining codes, and during the next live edition of Talk Ten Tuesdays, you’ll hear the very latest coding news – along with all you need to know to keep you performing at the top of your game.
The live broadcast will also feature these other segments:
* *CDI Report: *Cheryl Ericson, a recognized clinical documentation integrity (CDI) subject matter expert, will report on the latest CDI news.
* *The Dunn Report: *The legendary Rose Dunn, a nationally recognized professional in health information and former CEO, president, and board member of the American Health Information Management Association (AHIMA), will file her popular Dunn Report. She currently serves as COO of First Class Solutions, Inc.
* *Journaling John: *John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, will continue with his journal entries.
* *TalkBack:* Erica Remer,MD, founde…
playlist_add
Nov 30, 2022
Mary's Bookclub: Comprehensive Cardiology All Access Pass
Listen to Mary's Bookclub, where Mary summarizes the products you can find at the MedLearn online bookstore!
In this episode, Mary goes over the Comprehensive Cardiology All Access Pass, and why it is an important product for healthcare professionals.
playlist_add
Nov 29, 2022
Z Codes: How Mapping Patient Responses Reveals Community Health Disparities
Be sure to join us for the next live edition of Talk Ten Tuesdays, when Karen Bartrom, director of clinical integration and documentation at Cameron Memorial Hospital in Indiana, will report on how Z codes – the social determinants of health (SDoH) and ICD-10-CM codes – can reveal insights related to the health of a community.
With the mapping of patient SDoH responses to Z-codes, valuable aggregate data on a community’s health disparities can be validated and measurable. And the capturing of Z-codes then moves from anecdotal patient stories to strategic analysis, which opens opportunities to identify and develop community programs – as you will learn during the next upcoming edition of the popular weekly Internet broadcast.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
* *Journaling John: *John Zelem, MD, FACS, founder an…
playlist_add
Nov 22, 2022
COVID-19 Public Health Emergency: More to Come in 2023?
Will the United States experience another federal public health emergency (PHE) beyond Jan. 11, 2023? The U.S. Department of Health and Human Services (HHS) on Oct. 13 renewed the PHE for an additional 90 days. Meanwhile, states continue to wait for a 60-day termination warning, as HHS had promised earlier.
Joining the broadcast during the next live edition of the popular Internet radio program Talk Ten Tuesdays will be nationally recognized professional coder, auditor, and consultant Terry Fletcher, who will weigh the pros and cons of continuing the PHE. Also appearing on the program will be Dr. Jennifer Brettler and Kimberly Seery, both from ChristianaCare, a Delaware-based health system; they will give you on a close-up look at Patient Safety Indicators (PSIs).
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
* *The Mental Health…
playlist_add
Nov 16, 2022
Mary's Bookclub: Ultrasound Coder
Listen to Mary's Bookclub, where Mary summarizes the books you can find at the MedLearn online bookstore!
In today's episode, Mary explains the importance of Ultrasound Coder. Listen in to find out why this textbook could be a great addition to add to your essential library.
playlist_add
Nov 15, 2022
Patient Safety Indicators: Under Pressure to Reduce PSI Composite Scores
Our exclusive series on patient safety indicators (PSIs), being produced by ICD10monitor and Talk Ten Tuesdays in association with ChristianaCare, will continue next week.
During the next live edition of Talk Ten Tuesdays, Dr. Jennifer Brettler and Kimberly Seery, both from the Delaware-based health system, will give you on a close-up look at AHRQ Patient Safety Indicator 90 – Patient Safety and Adverse Events Composite. Diving deep into the subject, you will also gain critically important information on PSI 03 – Pressure Ulcer and PSI 09 – Postoperative Hemorrhage or Hematoma Rate.
Both will share with you areas of opportunity and how a multidisciplinary chart review can help reduce your PSI composite score.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
* *The Dunn Report: *Rose Dunn, a nationally recognized professional i…
playlist_add
Nov 8, 2022
2023 Medicare Physician Fee Schedule: Health Equity at the Intersection of Cancer Screening
Long-awaited and highly anticipated, the Centers for Medicare & Medicaid Services (CMS) Medicare Physician Fee Schedule Final Rule for 2023 released this past week supports the expansion of access to behavioral health and cancer screening, while promoting health equity.
The timing of this Final Rule brings to mind the loss of actor Chadwick Boseman of Black Panther fame. Boseman died in 2020, following his battle with colon cancer – an issue addressed in the Final Rule with a focus on cancer screening, as colon and rectal cancers continue to be a leading cause of death in the U.S., with even higher numbers of new cases and death rates for Black Americans, Native Americans, and Alaskan Natives.
Reporting our lead story during the next live edition of Talk Ten Tuesdays will be senior healthcare consultant Sharon Easterling, who is writing a series of articles for ICD10monitor on the experience of Black Americans dealing with the country’s healthcare system.
Other segments during t…
playlist_add
Nov 1, 2022
Medicare Disadvantage: Diagnosis Manipulations, Denying Care
Much like urban legends, the recurring tales of Medicare Advantage (MA) plans being accused of manipulating diagnoses and denying care that otherwise would have been covered under traditional Medicare are gaining traction.
They are now even being referred to as Medicare “Dis-Advantage” plans because of all the manipulation, much related to the fact that a MA patient is more expensive to the Medicare program than a traditional Medicare patient. The government pays MA insurers a set amount for each person who enrolls, with higher rates for sicker patients.
But the Department of Justice (DOJ) recently uncovered irregularities in reporting accurate patient diagnoses, even accusing some insurers of developing elaborate systems to make their patients appear as sick as possible, often without providing additional treatment.
During the next live edition of Talk Ten Tuesdays, nationally recognized healthcare consultant Terry Fletcher will report on the details.
Other segments during the…
playlist_add
Oct 25, 2022
Last Call: An Updated Industry Practice Brief Offers Guidelines for Achieving a Compliant Query
Today is the very last day to comment on the recently posted industry practice brief titled Guidelines to Achieving a Compliant Query Practice, co-authored by the American Health Information Management Association (AHIMA) and the Association of Clinical Documentation Integrity Specialists (ACDIS). The updated brief was released on Oct. 10, 2022 and has been open for comments.
During the next live edition of the popular and long-running Talk Ten Tuesdays broadcast, Karen Carr, an AHIMA CDI practitioner, will explore the next steps in the process of finalizing the practice brief for publication.
Other segments during the live broadcast will include the following:
* *Revenue Cycle Report: *Dr. Ramesh Madhavan, founder and CEO for TiaTech, will discuss the results of the recently deployed survey that asked both Monitor Monday and Talk Ten Tuesday listeners to describe their biggest holdup in the revenue cycle management (RCM) process. Dr. Madhavan, practicing neurologist and program d…
playlist_add
Oct 18, 2022
Do No Harm: A Team Approach to Improve Patient Safety Indicators
It takes a village to raise a child, but it took an integrated, multi-discipled team approach to improve patient safety indicators (PSIs) at ChristianaCare – as you’ll learn more about on Tuesday, Oct. 18, during the next live edition of Talk Ten Tuesdays, the popular, long-running Internet radio program produced by ICD10monitor.
In cooperation with ChristianaCare, Talk Ten Tuesdays and ICD10monitor are beginning a new series on PSIs, with specific focus on how a team approach is helping physicians avoid unwittingly triggering such issues through their documentation. Reporting the lead story will be Varadarajan Subbiah, MD, MBA, FACP, Vice President of Utilization Management and Quality for ChristianaCare, a major nonprofit teaching hospital system headquartered in Wilmington, Delaware. You will hear Dr. Subbiah report that their analysis concluded that documentation and coding represent among the biggest opportunities for improvement, and that externally reported ranking programs…
playlist_add
Oct 12, 2022
Mary's Bookclub: Nuclear Medicine & PET Coder
Listen to Mary's Bookclub, where Mary summarizes the books you can find at the MedLearn online bookstore!
In today's episode, Mary explains the importance of Nuclear Medicine & PET Coder. Listen in to find out why this textbook could be a great addition to add to your essential library.
playlist_add
Oct 11, 2022
Exclusive New Query Practice Brief: What’s New and What’s Out
Long awaited and highly anticipated is the new the Industry Practice Brief Guidelines to Achieving a Compliant Query Practice©, scheduled to released Monday, Oct. 10.
The American Health Information Management Association (AHIMA) and the Association of Clinical Documentation Integrity Specialists (ACDIS) have co-authored an update to the Industry Practice Brief Guidelines to Achieving a Compliant Query Practice©.
Many important elements have been updated and added to the practice brief to meet the demands of the ever-changing landscape of America’s healthcare ecosystem to help ensure all query professionals have the tools necessary to remain compliant. The practice brief was developed with many industry experts to ensure it is all encompassing. Reporting our lead story during the next live edition of Talk Ten Tuesdays will be Melissa Potts, a CDI practitioner of HIM Practice Excellence for AHIMA. She provides clinical documentation (CDI) practice expertise to AHIMA and its member…
playlist_add
Oct 4, 2022
National Healthcare News Roundup
Important healthcare news is happening at a furious rate and that is why the editorial team at ICD10monitor and Talk Ten Tuesdays is producing a national healthcare news roundup to deliver the news you need to know. During this special 60-minute broadcast you learn the latest coding news, as well as news about updates to the 2023 E&M coding and guideline changes, plus discover how one major health system has created a multi-disciplined team to master patient safety indicators. Emergency Minute
Get an inside look into what healthcare really looks like
Listen on: Apple Podcasts Spotify
playlist_add
Sep 27, 2022
Major E&M Changes for 2023: Consultation Services Will Never be the Same
The American Medical Association (AMA) has announced significant revisions to Evaluation and Management (E&M) services for 2023. Consultations, inpatient and outpatient consultations, are two of the E&M categories being revised for Jan. 1, 2023. The revisions made to consultations include code deletions, revision to the criteria for E&M level selection and additions to the guidelines. Reporting our lead story during the next live edition of Talk Ten Tuesdays will be Colleen Deighan, senior consultant with 3M.
Other segments during the live broadcast include the following:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
* *Mental Health Report: *Internationally renowned psychiatrist Dr. H*. *Steven Moffic returns to the broadcast with an update on burnout—this in advance of National Depression Month in October, which follows September’s Suicide Awareness Month.
* *Talk Law: *Healthcar…
playlist_add
Sep 21, 2022
Mary's Bookclub: CT/MR Coder
Listen to Mary's Bookclub, where Mary summarizes the books you can find at the MedLearn online bookstore!
In today's episode, Mary explains the importance of CT/MR Coder. Listen in to find out why this textbook could be a great addition to add to your essential library.
playlist_add
Sep 20, 2022
Claim Denials: Dissecting the Severity of Malnutrition
Hospital inpatient denials continue at a furious pace.
And there is strong evidence of a pattern of denied claims with a principal or secondary diagnosis of sepsis, a principal or secondary diagnosis of acute respiratory failure and denied hospital inpatient claims with the secondary diagnosis of malnutrition. When it comes to denials for a diagnosis of malnutrition, there appears to an additional focus on ICD-10-CM code of E43 Unspecified Severe Protein-Calorie Malnutrition.
Finding the root cause of the denial and then identifying solutions is the direction to improve compliance and obtain accurate patient severity data and reimbursement, as you will learn from national coding expert Gloryanne Bryant during the next live edition of Talk Ten Tuesdays.
Other segments during the live broadcast include the following:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
* *E&M Update: *Senior hea…
playlist_add
Sep 13, 2022
2023 Evaluation and Management Services: Observation and Inpatient Services Revisions Part II
Extensive changes are coming your way for hospital observation and inpatient services. And the time to prepare is now and this upcoming live edition of the long-running Talk Ten Tuesday broadcast is the place to begin to grasp the breadth and depth of these revisions from the American Medical Association.
Colleen Deighan, senior consultant with 3M, will continue the second in her multi-series of reports as she discusses the two evaluation and management (E&M) categories including guideline changes for reporting these services accurately and sharing steps you will need to take for preparing your physicians and your coding staff for success.
Other segments during the live broadcast include the following:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the ongoing Coordination and Maintenance Committee meeting taking place at that hour in the CMS headquarters in Baltimore.
* *Mental Health Report: *Internationally r…
playlist_add
Sep 1, 2022
Mary's Bookclub: Peripheral & Cardiology Coder
Listen to Mary's Bookclub, where Mary summarizes the books you can find at the MedLearn online bookstore!
In today's episode, Mary explains the importance of Peripheral & Cardiology Coder. Listen in to find out why this textbook could be a great addition to add to your essential library.
playlist_add
Aug 30, 2022
2023 Evaluation and Management Services: Preparing for Changes Part I
The American Medical Association (AMA) revised the criteria for evaluation and management (E&M) services for the Office Visit categories of New and Established patients. For 2023, similar revisions have been approved for the remainder of the E&M section. Revisions were also made to services for emergency, observation, inpatient, consultations, nursing, home and residence and prolonged care.
During the next live edition of Talk Ten Tuesday, Colleen Deighan, senior consultant with 3M, will begin her first in a multi-series of reports, sharing key revisions and identifying important steps for preparing physicians and coding staff for success.
Other segments during the live broadcast include the following:
* *Coding Report: *Meg DeVoe, senior product manager for TruCode, and who will be substituting for Laurie Johnson, will report on the latest coding news.
* *Mental Health Report: *Internationally renowned psychiatrist H. Steven Moffic reports on the nation’s state of mental heal…
playlist_add
Aug 23, 2022
Noncompliant Homework: When HIPAA and OSHA Come Knocking at Your Home
Are you a healthcare telecommuter? Is your workspace HIPAA compliant?
While there are advantages of working remotely, there’s a monstrous risk for those who are obligated to comply with HIPAA: keeping patients’ protected health information (PHI) protected.
Not convinced it’s a big deal? The U.S. Department of Health and Human Services (HHS) has the authority to levy hefty financial penalties when entities fail to properly manage their telecommuters’ access and protection of PHI.
During the next live edition of Talk Ten Tuesdays, nationally recognized professional coder, auditor and consultant Terry Fletcher, will give you some “check-lists” to make sure your remote workers, or telecommuters are compliant, along with some examples of violations as well as compliance policies from OSHA.
Other segments during the live broadcast include the following:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC will report on the late…
playlist_add
Aug 16, 2022
While PSI-90 is Suppressed, PSI-04, the Death Rate Payment, Lives On
The Centers for Medicare & Medicaid Services will continue using PSI-04, Death Rate among Surgical Inpatients with Serious Treatable Complications, in its Hospital Inpatient Quality Reporting program. Be advised. This affects your facility’s reputation and reimbursement through fiscal year (FY)2028.
Unlike other PSIs, PSI-04 does not exclude cases based on the Present on Admission indicator of the applicable secondary diagnoses that include shock/cardiac arrest, sepsis, pneumonia, gastrointestinal hemorrhage/acute ulcer, or deep vein thrombosis/pulmonary embolism. Unlike the other PSIs that focus on the prevention of the identified patient event, PSI-04 looks at the success of rescue steps that a facility takes, when presented with severe complications that may already be present on admission, to prevent the patient’s death.
During the next live edition of Talk Ten Tuesday, James S. Kennedy MD, president of CDIMD near Nashville, Tennessee, will outline documentation and coding st…
playlist_add
Aug 9, 2022
OCR Warning: Patient Right of Access to Medical Records Can’t be Denied
The U.S. Department of Health and Human Services (HHS) of the Office of Civil Rights (OCR) is warning healthcare providers about the mandatory compliance with the HIPAA Right of Access promulgated in the 21st Century CURES Act. So far, enforcement actions bring to 38 the number of financial penalties against HIPAA-covered entities for failing to provide patients with timely access to their medical records.
During the next live edition of the long-running Talk Ten Tuesdays, nationally recognized professional coder, auditor and consultant Terry Fletcher, reports on the do’s and don’ts of withholding patient requests for their protected health information. Fletcher will also delve into the penalties and legal exposure that awaits those who are non-compliant.
Other segments during the live broadcast include the following:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC will report on the latest coding news.
* *News Desk: *Timoth…
playlist_add
Aug 3, 2022
Mary's Bookclub: Essentials of Interventional Radiology Coding
Listen to Mary's Bookclub, where Mary summarizes the books you can find at the MedLearn online bookstore!
In today's episode, Mary explains the importance of Essentials of Interventional Radiology Coding. Listen in to find out why this textbook could be a great addition to add to your essential library.
playlist_add
Aug 2, 2022
Sabotaging Your Coding and CDI Reporting
Coders, clinical documentation integrity specialist and revenue cycle professionals will be the beneficiaries next Tuesday during the live edition of Talk Ten Tuesdays when healthcare attorney and litigator Brianna J. Santolli returns to the broadcast and cuts through the legal jargon to warn of tactics deployed by some Medicare Advantage Organizations (MAO) to preserve profits by inappropriately denying prior authorizations. Using a recent case conducted by U.S. Department of Health and Human Services, Office of the Inspector General, Santolli, a litigator at the law firm Kelley Drye & Warren LLP, will explain in clear and simple terms how even though, the coding and documentation was correctly reported for the services provided, MAO will often deny or delay services for medically necessary care.
Other segments during the live broadcast include the following:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC will report on the latest…
playlist_add
Jul 26, 2022
Telehealth: Myths and Truths
Controversy, confusion and contradiction are obfuscating the reporting of telehealth services, especially now during the recently extended public health emergency. There is so much inconsistency with how to report telehealth right now, between what Medicare determines you can do, and what the mix of commercial payers declare is appropriate. And then there are individual state executive orders. What is the reality of telehealth rules like place of service, modifiers, and audio and video versus audio-only options?
In the light of this maelstrom of entanglements, we asked professional coder and consultant Terry Fletcher to return to the broadcast next Tuesday, July 26, 10 a.m. Eastern.
As an added attraction, we are pleased to welcome Ernie Clevenger, the newly elected president of the Health Care Administrators Association to the broadcast.
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC will report on the latest coding news.
* *N…
playlist_add
Jul 19, 2022
Cost Efficiency with the CMS Merit-Based Incentive Payment System
With the recent announcement of the 2023 Physician Fee Schedule, the Centers for Medicare & Medicaid Services (CMS) remains committed to encouraging and incentivizing cost efficiency by providers. Physicians electing to participate in the CMS Merit-Based Incentive Payment System (MIPS) will experience +/-9 percent impact in their traditional Medicare reimbursement based on their performance, 30 percent (2.7 percent of the total) of which is derived from cost efficiency based solely on claims data.
During the next live edition of Talk Ten Tuesday, James S. Kennedy MD, will briefly review these MIPS inpatient and outpatient episode models, including screening colonoscopies, cataract surgery, knee and hip replacements, and many others that are being assessed, all of which make a coder’s and CDI specialist’s job more important than ever.For further information, you can hear Dr. Kennedy speak on this subject at the AAPC Regional HEALTHCON being held in Denver on August 4, 2022; learn m…
playlist_add
Jul 13, 2022
Mary's Bookclub: Cardiac Rhythm Management Coder
Listen to Mary's Bookclub, where Mary summarizes the books you can find at the MedLearn online bookstore!
In today's episode, Mary explains the importance of Cardiac Rhythm Management Coder. Listen in to find out why this textbook could be a great edition to add to your essential library.
playlist_add
Jul 12, 2022
Warning: New CPT® Documentation Guidelines for all E&M Coming 2023!
As expected, the American Medical Association (AMA) has updated the guidelines for E&M services, starting in 2023. These relate to hospital services, emergency department visits, nursing facility services, home visits, and prolonged care services. Just as important, the AMA has deleted some observation care codes, the annual nursing facility assessment code, along with the domiciliary and rest home codes. Some of the existing prolonged services care codes and level one consultation codes will be deleted as well.
To help you sort out what’s in and what’s out, we asked nationally recognized professional coder, auditor and educator Terry Fletcher, to be our sherpa during this exclusive E&M tour on the next live edition of on Talk Ten Tuesdays, July 12 at 10 a.m. Eastern.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC will report on the latest coding news.
* *RegWatch:*…
playlist_add
Jul 6, 2022
Front and Center: 2022 ICD-10-CM/PCS Coding Clinic Update, Spinal Fusion ICD-10-PCS Coding, 2022 Telehealth Tune-up
2022 ICD-10-CM/PCS Coding Clinic Update, Spinal Fusion ICD-10-PCS Coding, 2022 Telehealth Tune-up are discussed by Dr. John Zelem and Chuck Buck who analyze these two essential webcasts produced by ICD10monitor.
playlist_add
Jun 29, 2022
Mary's Bookclub: Coding Essentials for Laboratories
Listen to Mary's Bookclub, where Mary summarizes the books you can find at the MedLearn online bookstore!
In today's episode, Mary explains the importance of Coding Essentials for Laboratories. Listen in to find out why this textbook could be a great edition to add to your essential library.
playlist_add
Jun 28, 2022
“Where’s the Money, Honey?” Medicare Physician Payments at Risk
Gas prices are heading straight to the stratosphere. Inflation is the elephant in the room. And there’s a growing concern in Medicare when it comes to physician payments. Here’s why: Medicare cuts are pending, including the PAYGO 4 percent, starting in 2023.
What’s more, deductions from reinstated sequestrations are on the rise. There’s also an expected lowering of the 2023 conversion factor, the possible ending of the public health emergency (PHE) windfall of telehealth payment parity, as well as MedPac saying that a physician raise generally is not necessary. So, the burning question: where is all the money going from Medicare?
For an exclusive backgrounder on this timely and worrisome topic, register now to listen to the next live edition of Talk Ten Tuesdays. That’s when nationally recognized physician coder, auditor, and consultant Terry Fletcher will have insight and perspective on the potential impact on your practice, moving forward.
The live broadcast will also fe…
playlist_add
Jun 21, 2022
Beware: Modifier 25 Could be DOA
The Current Procedural Terminology ® (CPT) definition of Modifier 25 is that it is used to report an evaluation and management (E&M) service on a day when another service was provided to the patient by the same physician or other qualified healthcare professional. Think of Modifier 25 as a “protective” modifier when minor procedures or services are performed on the same date as an E&M office visit. If both services are medically necessary, both are paid, if the Modifier 25 has been appended to the E&M.
Recently, though, several payers, including Horizon Blue Cross in New Jersey, Horizon Medicare Advantage Plans, and Cigna Healthcare, to name a few, are now scheduled to cut provider payments when a Modifier 25 is used, creating burdensome paperwork to delay claims.
Since this late-breaking news is a developing story, we have asked nationally recognized professional coder, auditor, and consultant Terry Fletcher to report on its impact on physicians during the next live edition of…
playlist_add
Jun 15, 2022
Mary's Bookclub: Coding Essentials for Infusion & Injection Therapy Services
Listen to Mary's Bookclub, where Mary summarizes the books you can find at the MedLearn online bookstore!
In today's episode, Mary explains the importance of Coding Essentials for Infusion & Injection Therapy Services. Listen in to find out why this textbook could be a great edition to add to your essential library.
playlist_add
Jun 14, 2022
Telehealth and Risky Business
Has the U.S. Department of Health and Human Services (HHS) clarified which telehealth services are valid for data submissions for the HHS-operated risk adjustment (RA) program?
Moreover, can Hierarchical Condition Category (HCC) ICD-10-codes – the risk-adjustment model designed to estimate future healthcare costs for patients – be used when the services reported are provided under the public health emergency (PHE) telehealth waivers?
You need to know. And you will, when you listen to the next live edition of Talk-Ten-Tuesdays, coming your way Tuesday, June 14 at 10 a.m. EST. That’s when nationally recognized professional coder, auditor, consultant, and author Terry Fletcher will report on the regulatory guidance from the Centers for Medicare & Medicaid Services (CMS) to help ensure you remain compliant.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on…
playlist_add
Jun 7, 2022
National HIM, Coding, and CDI Roundup
Revenues are trending down. Audits are on the upswing. Experienced revenue cycle professionals are in short supply. And complex coding and documenting issues seem to be an everyday occurrence.
With all the evident Sturm und Drang confronting healthcare professionals of late, ICD10monitor and Talk Ten Tuesdays are producing a special 60-minute edition of the famed Internet broadcast that will air Tuesday, June 7 at 10 a.m. EST.
A wide range of subjects and subject matter experts promises to provide the most comprehensive coverage of contemporary healthcare issues facing America’s healthcare system, with meaningful reporting on coding, clinical documentation integrity (CDI), revenue cycle, patient financial services (PFS), and compliance.
Among those expected to be reporting Tuesday include the following experts:
* Shannon DeConda
* Rose Dunn
* Cheryl Ericson
* Dennis Jones
* Laurie Johnson
* James Kennedy, MD
* Kevin Lasser
* Timothy Powell
* Stanley Nachimson…
playlist_add
Jun 1, 2022
Mary's Bookclub: Coding Essentials for Respiratory Therapy/ Pulmonary Function
Listen to Mary's Bookclub, where Mary summarizes the books you can find at the MedLearn online bookstore!
In today's episode, Mary explains the importance of Coding Essentials for Respiratory Therapy/ Pulmonary Function. Listen in to find out why this textbook could be a great edition to add to your essential library.
playlist_add
May 24, 2022
Behavioral Health – To Screen or Not to Screen?
Behavioral health can be confusing. To screen or not to screen, what are the questions?
Joining us this Tuesday for the lead story is a new panelist, Christine Hall. Christine Hall is the CEO and Senior Consultant for Stirling Global Solutions, LLC. She has 30+ years of healthcare administration and information management experience.
Christine is a subject matter expert in compliance, specialty coding, auditing, risk adjustment, telehealth and reimbursement.
During the next live edition of Talk Ten Tuesdays, Christine will educate us on who can and should provide behavioral health screenings. She will also go over the correct codes to report and the requirements for reimbursement in behavioral health.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
* *Talk Law: *Brianna J. Santolli, Esq., a healthcare and litigation attorney with…
playlist_add
May 17, 2022
US Government Accountability Office: Holding CMS Accountable
With telehealth usage during the pandemic—up from 2.1 million services in 2019, to 32.5 million services from March 2020-February 2021—the GAO (US Government Accountability Office) realized that Medicaid hasn’t collected or assessed any data on the quality-of-care beneficiaries received from telehealth services.
The GAO now recommends that they do so. Given concerns the GAO has raised about the quality of care provided via telehealth, this beneficiary data is crucial. It’s also consistent with how CMS has encouraged states to use data on quality of care to identify disparities in health care and target opportunities for improvement to advance health equity.
During the next live edition of Talk Ten Tuesdays, Terry Fletcher, a healthcare coding expert, will discuss how the GAO is holding CMS accountable for assessing the effect of increased telehealth use by Medicaid Beneficiaries.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson,…
playlist_add
May 10, 2022
Patient Visits: Walking the Indistinguishable Fine Line
Billing and collecting patient visits continue to challenge most healthcare providers and a frequent question often heard is “Can we bill a preventative medicine and new patient visit on the same day?”
As a point of reference, there are circumstances when a preventative visit and a problem-oriented visit could be billed on the same date. The problem: the uncertainty of what those circumstances are and differing policies among payers, including Medicare. Do they all agree with these rules for payment? During the next live edition of Talk Ten Tuesdays, Terry Fletcher, a nationally recognized professional coder, auditor and consultant, will describe the issue and report on the otherwise indistinguishable fine line between preventative and problem-oriented evaluation and management (E&M) visits.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest codi…
playlist_add
May 3, 2022
2023 IPPS Proposed Rule: Important Coding and CDI Implications
The Centers for Medicare & Medicaid Services (CMS) has released the hospital Inpatient Prospective Payment System (IPPS) Proposed Rule for short- and long-term acute-care hospitals. The Proposed Rule not only updates the Medicare approach to Medicare-Severity DRGs (MS-DRGs) reimbursement, but also advocates for the President’s executive orders addressing quality, inequities, and outcomes in healthcare.
While there are no new MS-DRGs, minimal changes to the MS-DRG algorithms, and another one-year delay to implementing a comprehensive complications and comorbidities (CCs) and major CCs (MCCs) restructuring, proposed four years ago, CMS proposes 10 new Inpatient Quality Reporting measures, such as Hospital Commitment to Health Equity, Screening for Social Drivers of Health, Screen Positive Rate for Social Drivers of Health, the Cesarean Birth Electronic Clinical Quality Measure (eCQM), a Severe Obstetric Complications eCQM, a Hospital-Harm/Opioid-Related Adverse Events eCQM, the Global…
playlist_add
Apr 26, 2022
One Million COVID-19 Deaths to Create 360,000 Grievers
A tragic milestone is about to be reached, bringing with it the potential to wreak havoc on America’s crumbling mental health infrastructure: the United States is poised to record one million deaths caused by the deadly coronavirus pandemic.
Collateral damage created by these deaths could likely be compounded by hundreds of thousands grieving the loss of loved ones and suffering from the new DSM-official condition: prolonged grief disorder. The number of potential grievers could be approximately 360,000 individuals – a staggering number, whose grieving could overwhelm an already frail mental health system.
Providing context and commentary to this imminent mental health crisis during the next edition of Talk Ten Tuesdays will be Dr. H. Steven Moffic, an award-winning psychiatrist, prolific writer, and speaker.
The live broadcast will also feature these other segments:
* *Talk Law: *ICD10monitor and Talk Ten Tuesday launch a new segment called, “Talk Law,” featuring Brianna…
playlist_add
Apr 19, 2022
The PHE has been extended; the consequences are unknown
The Public Health Emergency (PHE) was extended, as expected, April 16. But here’s the caveat when it comes to PHE waivers: not all waivers were created equal. For example, does a PHE declaration waive or preempt state licensing requirements for healthcare providers? Are HIPAA protections for virtual care removed?
Reporting this developing story during the next live edition of Talk Ten Tuesdays will be nationally recognized professional auditor, coder, educator and author Terry Fletcher. Listen and learn as Fletcher walks you and your team through the labyrinth of issues associated with the current PHE extension and what those mean for physicians and what assumptions not to make.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
* *The Dunn Report: The Problem with Problem Lists. *Rose Dunn, a nationally recognized professional in…
playlist_add
Apr 12, 2022
Promising New Hope for ICD-11
The World Health Organization (WHO) has released the official version of ICD-11, and the National Committee on Vital Health Statistics (NCVHS), is calling for research to evaluate its use in the U.S.
Reporting the lead story during the next live edition of Talk Ten Tuesdays will be the ICD-11 national correspondent for ICD10monitor, Mary Stanfill, vice president of consulting services for United Audit Systems, Inc. Stanfill will report on promising published research comparing ICD-11 with ICD-10, including early studies exploring the feasibility of replacing the old coding set with the new, noting that the early indications are very promising – and suggesting that America’s healthcare system should invest resources to explore the change. Early ICD-11 content analysis suggests it can represent ICD-10-CM codes much better than ICD-10-CM was able to represent ICD-9-CM codes, at the point the U.S. made that change.
The live broadcast will also feature these other segments:
* *Codi…
playlist_add
Apr 5, 2022
World Health Day Sees New Hope for ICD-11
Thursday, April 7, 2022, is designated as World Health Day by the World Health Organization (WHO). And in a fitting preamble to this annual event, ICD10monitor and Talk Ten Tuesdays will feature a special guest: International Health Information Association (IFMA) President Lorraine Fernandes, who will release an official statement by her organization in support of the implementation of ICD-11.
In her prepared remarks, Fernandes will discuss the importance of ICD-11 relative to an estimated 25,000 petabytes of healthcare data generated worldwide in 2021 – and how, through ICD-11, this data holds tremendous promise for meeting the WHO’s Sustainable Development Goals (SDGs) of better health for all. She will also note that ICD-11 will standardize and structure health data so it can be leveraged by technology to help reduce healthcare costs, improve outcomes, and increase universal access to healthcare.
The live broadcast will also feature these other segments:
* *Coding Report: *…
playlist_add
Apr 4, 2022
Front and Center: Clinical Validation Denials and Critical Care Services
“Clinical Validation Denials: Queries and Strategies for Defending Claims,” and “Critical Care Services: 2022 Coding Update and Major Policy Changes” are discussed by Dr. John Zelem and Chuck Buck who analyze these two essential webcasts produced by ICD10monitor.
Use code FRONTANDCENTER for 15% off your ICD10monitor webcast purchase.
playlist_add
Mar 29, 2022
Automated CDI Queries: Is this the End for CDISs?
Artificial intelligence (AI) is omnipresent — in self-driving cars, manufacturing, and healthcare management. Now, AI is even being deployed in the physician query process. Yet engineering AI to be programmed for physician queries requires understanding the physician’s thought process. And that’s always a challenge, on any level — especially for AI computer scientists.
For the latest update on automated physician queries, we have invited Gerasimos “Gerry” Petratos, CEO for HiTeks, a company that has several installed automated physician query solutions in major healthcare systems, to serve as the special guest during the next edition of Talk-Ten-Tuesdays. Gerry will report on the challenges inherent in these efforts, as well as explain whether automated queries might mark the end of the clinical documentation integrity specialist (CDISs) profession.
Because clinicians require timely and accurate advice to improve patient care and practice management, AI appears to be a ke…
playlist_add
Mar 22, 2022
Welcome to Number 500: Talk Ten Tuesdays Landmark Live Broadcast
Welcome to the 500th live broadcast of Talk Ten Tuesdays.
Ten nationally recognized thought leaders are scheduled to appear during the landmark production. As part of the full 60-minute broadcast, you will hear updates on topics ranging from the deadly coronavirus to the latest healthcare regulatory news, along with updates on ICD-10 coding, clinical documentation integrity (CDI), mental health, and the revenue cycle.
Invited panelists include the following:
* Matthew Albright
* Rose Dunn, MBA, RHIA, CPA, FACHE, FHFMA
* Cheryl Ericson, RN, MS, CCDS, CDIP
* John Foggle, MD, MBA
* Terry A. Fletcher,
BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, ACS-CA
* James Kennedy, RHIT, CCS, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer
* H. Steven Moffic, MD
* Stanley Nachimson, MS
* John Zelem, MD, FACSEmergency Minute
Get an inside look into what healthcare really looks like
Listen on: Apple Podcasts Spotify
playlist_add
Mar 15, 2022
Burnout on the Ides of March: Efforts Stall to Contain a Raging Fire
Two years ago this week, the World Health Organization (WHO) described COVID-19 as a pandemic — about the same time a cruise ship was held at sea off the California coast, with 3,500 people on board ultimately testing positive for the coronavirus.
Today, masks are required. Social distancing is practiced. Countries close and open their borders, schools and public facilities shutter and open, and the embers of burnout explode as the Ides of March arrive. ICD10monitor and Talk Ten Tuesdays continue to report on the growing crisis and also the exposure of widening cracks in America’s health system infrastructure caused by the coronavirus, denying healthcare services to many of America’s disadvantaged communities. Reporting of this unchecked burnout during the next live edition of Talk Ten Tuesdays will be one of America’s foremost psychiatrists, H. Steven Moffic, MD.
The live broadcast will also feature these other segments:
* *Coding Report: Coordination and Maintenance Comm…
playlist_add
Mar 8, 2022
Four New Cost-Efficiency Models from CMS
Only here on Talk Ten Tuesdays will you learn the whole story behind the latest request from the Centers for Medicare & Medicaid Services (CMS). The agency is asking for feedback on four cost-efficiency models as part of the Merit-Based Incentive Payment System (MIPS) program. The deadline is fast approaching: March 25, 2022. The proposed cost-efficiency models for the CY 2023 MIPS cover positions including emergency physician, psychiatrist, and cardiologist/hospitalist.
During the next live broadcast, CDI physician expert Dr. James S. Kennedy of CDIMD in Nashville, Tenn. will report on CMS’s proposed implementation of these cost-efficiency models, which will be effective Jan. 1, 2023, as authorized by the Medicare and CHIP Reauthorization Act of 2015 (MACRA) – as well as the role CDI teams have in ensuring success in avoiding physician financial penalties of up to 2.7 percent.
The live broadcast will also feature these other segments:
* *Coding Report: Coordination and Mainte…
playlist_add
Mar 3, 2022
Front and Center: Clinical Validation Denials & Critical Care Services
“Clinical Validation Denials: Queries and Strategies for Defending Claims,” and “Critical Care Services: 2022 Coding Update and Major Policy Changes” are discussed by Dr. John Zelem and Chuck Buck who analyze these two essential webcasts produced by ICD10monitor.
Use the code FRONTANDCENTER at checkout for 15% off your ICD10monitor webcasts!
https://icd10monitor.com/product-category/webcasts/
playlist_add
Mar 1, 2022
The Top 10 List: Regulatory Rules for Medicare Telehealth
With Medicare audits looming and U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) Work Plan items now relating to telehealth services performed during the COVID-19 public health emergency (PHE), it is time to make certain that your organization is accurately reporting services and claims within the requirements of the 1135 waivers relevant to the Coronavirus Aid, Relief, and Economic Security (CARES) Act of 2020.
Remember, too, that in the world of healthcare auditing, it’s not “if” you get audited, but “when.”
Because of the immediacy of these Medicare telehealth audits, we asked nationally recognized professional auditor, coder, author, and consultant Terry Fletcher to share with you the top 10 regulatory rules for Medicare telehealth.
The live broadcast will also feature these other segments:
* *Tuesday Focus: Outpatient CDI Update: *The Hospital Outpatient Quality Reporting Program evaluates the regularity of treatment known to pr…
playlist_add
Feb 22, 2022
ICD-11 Now Online – But U.S. Adoption on Hold
* *The recent announcement from the Pan American Health Organization (PAHO) that the World Health Organization’s (WHO’s) ICD-11 coding system went online as of Feb. 11 might have been met with measured enthusiasm globally, but not here in the United States. The much-vaunted coding set isn’t expected to reach America’s shores for perhaps as much as a decade.
Nonetheless, ICD-11 continues to be a topic generating interest among America’s coding community. And that is why we have asked Mary Stanfill, our ICD-11 correspondent, to be the special guest during the next live edition of Talk Ten Tuesdays. Stanfill is expected to provide listeners with an update on the new coding set looming on the horizon.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
* *Tuesday Focus:* *Coding Alzheimer’s:* Susan Gatehouse, founder and CEO…
playlist_add
Feb 21, 2022
Front and Center: Brain Disorders and Coding and MS-DRG Compliance
Brain disorders and the accurate selection of the principal diagnosis are two crucially important ICD10monitor webcast topics analyzed by Dr. John Zelem during his conversation with Chuck Buck. Great topics. Great analysis. More great educational opportunities now await you. So now get everyone on your team Front and Center.
playlist_add
Feb 16, 2022
Front and Center: Sepsis & Malnutrition
These complimentary special edition podcast from ICD10monitor features Chuck Buck and John Zelem, MD as they review on-demand webcasts as well as preview upcoming webcasts. Dr. Zelem offers a unique physician perspective as he explains to listeners key learning objectives from these educational webcasts.
playlist_add
Feb 15, 2022
Shared/Split Billing: New Rule Confounding, Confusing, Controversial
The billing rules for shared/split evaluation and management (E&M) visits are changing, as they will again in 2023. But although the Centers for Medicare & Medicaid Services (CMS) considers 2022 a transition year, controversy surrounding the 2022 Medicare Physician Fee Schedule (MPFS) is creating contagious confusion.
If you and your team are suffering from such chronic consternation, relief will be within reach when you log on next Tuesday for another live edition of the Talk Ten Tuesdays Internet broadcast. Because that’s when National Alliance of Medical Auditing Specialists (NAMA) Founder Shannon DeConda will report on how best to implement the new rule.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
* *Tuesday Focus:* *What Was Medicare Thinking*? Nationally recognized professional coder and auditor Terry Fletcher will join…
playlist_add
Feb 8, 2022
New Measures Added to the Hospital Outpatient Quality Reporting Program
To improve care and create transparency, Medicare mandated a pay-for-quality reporting program for hospital outpatient services in 2009. The measures can impact hospital payment if not met, thus creating financial incentives for hospitals to achieve them. The measures are intended to evaluate the regularity of outpatient treatments known to provide the best results for the most patients with a particular condition.
During the next live edition of Talk-Ten-Tuesdays, Colleen Deighan, senior consultant with 3M, will outline the Hospital Outpatient Quality Reporting program and the three new measures adopted as part of the Centers for Medicare & Medicaid Services (CMS) 2022 Outpatient Prospective Payment System/Ambulatory Surgical Center (OPPS/ASC) Final Rule.
The live broadcast will also feature these other segments:
Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
Tuesday Focus: Susan Gatehouse, found…
playlist_add
Feb 1, 2022
New E&M Codes for Principal Care Management
Principal care management is a service that focuses on the medical and/or psychological needs manifested by a single, complex chronic condition that is expected to last at least three months in duration.
During the next live edition of Talk Ten Tuesdays, Colleen Deighan, senior healthcare consultant for 3M HIS Consulting Services, will return to the weekly Internet radio broadcast to report on principal care management and the new CPT® codes for 2022.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
* *RegWatch:* Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington.
* *News Desk: *Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk-Ten-Tues…
playlist_add
Jan 25, 2022
SPECIAL EDITION COVID-19: “With” versus “For”
In today’s supercharged general lexicon, words have enhanced meaning. So as more and more hospitals admit patients, the words “for” and “with” are garnering great significance.
With hospitals filling up with patients who have a COVID-19 diagnosis linked to their stay, what is the actual admission for?
During next week's Talk Ten Tuesdays broadcast, we have asked nationally recognized professional coding expert, educator, and author Terry A. Fletcher to report on the ever-evolving COVID-19 diagnosis capture. Fletcher, in her reporting, is expected to discuss new information from New York and New Jersey, where there is now a distinction that not all COVID-19 hospitalizations are the same. Listen in to find out now how COVID-19 is being reported in many states for added accuracy.
The live broadcast will also feature these other segments:
* *Coronavirus Report:* Former frontline physician Dr. John Foggle will return to the broadcast with an update on the deadly COVID-19 vi…
playlist_add
Jan 18, 2022
SPECIAL EDITION: Overcoming Distrust in Healthcare
ICD10monitor and Talk Ten Tuesdays continue reporting on the social determinants of health (SDoH), as they relate to health equity. On Tuesday, Jan. 18, the day after the national observance of the life of slain civil rights leader Rev. Martin Luther King, Jr., Sharon Easterling, an African-American senior healthcare consultant, will return to the broadcast to report on this timely and crucially important subject.
Many Americans no doubt recall seeing the grainy black-and-white TV news footage of the Rev. King delivering his iconic “I Have a Dream” speech. Fast forward to the present, and Easterling will note that the speech was profoundly rooted in healthcare, with King opining that healthcare is for all, and good healthcare begins with the patient experience in the eyes of many, especially minorities. Easterling is also expected to report on the need for improving the patient care experience, noting that distrust in healthcare is deep-seated, especially in the Black community, b…
playlist_add
Jan 11, 2022
The Social Determinants of Health: An Update by Blue Cross Blue Shield
The health of all Americans is on the line – particularly among the nation’s communities of color, where maternal health issues, behavioral health issues, diabetes, and cardiovascular conditions have a disproportionate impact.
Recognizing this national concern, the Blue Cross Blue Shield Association has devised a national health equity strategy to confront such health disparities. All this follows the release by the National Center for Health Statistics of 2022 ICD-10-CM codes, both new and updated, for education, food insecurity, and housing, with implementation effective beginning Oct. 1, 2021.
During the next live edition of Talk Ten Tuesdays, Lenel James, MBA, an Health Level 7 (HL7) “fellow” and the business lead for Health Information Exchange and Innovation at the Blue Cross Blue Shield Association (BCBSA), will report on the massive effort underway. Lenel has been with BCBSA and has served as its voting representative to HL7 for almost 20 years, and has extensive expe…
playlist_add
Dec 14, 2021
Compliant CDI Technology
There’s never enough time to keep up with the myriad of changes confronting clinical documentation integrity specialists (CDISs). And that is why Talk Ten Tuesdays will reveal important content about a new white paper developed by the American Health Information Management Association (AHIMA) and the Association of Clinical Documentation Integrity Specialist (ACDIS), as part of a featured segment during the next edition of the weekly Internet radio broadcast.
“Compliant Clinical Documentation Integrity Technology Standards,” includes information about the clinical documentation integrity (CDI) technology landscape, recognizing documentation integrity practices, evaluating compliant CDI technology vendors, developing compliant policies and procedures, and the application of technology. It’s just in time for CDI preparation, and just what the doctor ordered. Reporting on the white paper will be Tammy Combs, AHIMA’s Practice Director of CDI and Clinical Foundations.
The live b…
playlist_add
Dec 7, 2021
Reduce Revenue Leakage: An Important Role for Outpatient CDI
Clinical documentation integrity (CDI) programs can have a broad impact in outpatient settings. One key area for outpatient CDI to consider is denials reduction, which begins with understanding what’s contributing to denial risk.
Denial reduction is really about denial prevention. It’s about analyzing denials by category, by payer, and by reason to uncover trends for high-volume or high-dollar denials, then using that discovery to provide education about clinical documentation issues or gaps.
In the next live edition of Talk Ten Tuesdays, outpatient CDI expert Colleen Deighan will return with the final segment of her popular series on a subject that continues to generate listener interest and questions. Deighan will also conduct a listener’s survey during the weekly Internet radio broadcast.
The live broadcast will also feature these other segments:
* *Tuesday Focus: *Susan Gatehouse will report on the potential impacts of the new Edit 20 (Unspecified Code Edit) for inpatient…
playlist_add
Nov 30, 2021
Chronic Care Management: Are You Leaving Money on the Table?
Are you facing a problem with your physcians? They find themselves with patients who have not just one but two or more chronic conditions that need managing? Not just for in-person encounters, but from an ongoing, non-face-to-face perspective?
Many practices have this patient population, but are not capturing care management services correctly, or at all, for work that is already being done.
It’s a huge problem with potentially serious financial impacts. But the answer is close at hand. Listen to the next live edition of Talk Ten Tuesdays for the 411 on care management services, along with the 2022 update, and discover how this is a revenue stream you don't want to miss out on. That’s when nationally recognized physician auditor, coder, and educator Terry Fletcher will return to the broadcast with advice on this ever-daunting challenge.
The live broadcast will also feature these other segments:
* *RegWatch:* Stanley Nachimson, former Centers for Medicare & Medicaid Services (…
playlist_add
Nov 23, 2021
Exclusive ICD-11 Update: Recommendations for Immediate Action
Like the inevitable approach of a slow-moving freight train, ICD-11 is on the horizon, heading this way. It’s coming.
That’s why we asked Margaret Skurka to join us for the next upcoming edition of Talk-Ten-Tuesdays: to give you an exclusive update on the new code set for America’s health system. Skurka, a member of the National Committee of Vital Health Statistics (NCVHS), participated in describing for the Honorable Xavier Becerra, Secretary of the U.S. Department of Health and Human Services (HHS), recommendations regarding adoption of ICD-11 in the United States. Skurka, having served in healthcare for more than 40 years, will be make her farewell appearance during the next live edition of the weekly Internet radio broadcast.
The live broadcast will also feature these other segments:
* *Special Report: Outpatient CDI and E&M: *Outpatient clinical documention integrity (CDI) expert Colleen Deighan will return to continue her popular series on a subject that continues to g…
playlist_add
Nov 16, 2021
An Exclusive Look at Vaccine Mandates: Who Gets the Shot, and Who Doesn’t?
The Omnibus COVID-19 Health Care Staff Vaccination Mandates are out! What entities are included under the regulations, and which are excluded?
Facilities and physician practices have been doing everything they can to get staff and providers vaccinated, in fear of losing their provider status with Medicare and their funds being interrupted. But what organizations really must abide by these requirements under the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoPs)? Hospitals? Physician Offices? Skilled nursing facilites (SNFs)? Home health agencies? Assisted living facilities?
To highlight the correct information on where your organization stands and the impact it will have, please join us for the next edition of Talk Ten Tuesdays on Nov. 16, during which nationally recognized physician coder, auditor, and educator Terry Fletcher will update us on all this and more.
* *
The live broadcast will also feature these other segments:
* *Mental Health Report:…
playlist_add
Nov 9, 2021
Exclusive: Outpatient CDI in the Emergency Department
Is the emergency department (ED) an outpatient CDI priority for your organization? The emergency department is the main source of admissions to a hospital – and the first location patients typically receive care. What should you consider when determining how an outpatient CDI program could support quality patient care, proper payment, and complete and accurate data?
* *
During the next live edition of Talk Ten Tuesdays, outpatient CDI expert Colleen Deighan will return with another installment in her popular series on a subject that continues to generate listener interest and questions. Deighan will also conduct a listener’s survey during the weekly Internet radio broadcast.
The live broadcast will also feature these other segments:
* *Special Series: Maternal Morbidity and Mortality: *Senior healthcare consultant Kristi Pollard, Director of Coding Quality and Education for the Haugen Consulting Group, wraps up her four-part series on the impact of coding on severe maternal morb…
playlist_add
Nov 2, 2021
What in the World is a Medical Assistant?
What can a medical assistant do – and not do?
Medical assistants have a narrow list of tasks they can perform for patients or for a doctor in a doctor's office. It's often difficult to know what's allowed, because there are not strong laws or regulations in place regarding medical assistants.
Since no one really “regulates” them, and they are frighteningly under-monitored by any sort of government agency, what rules should they follow?
In the next live edition of Talk Ten Tuesdays, Terry Fletcher, a nationally recognized professional coder, auditor, and educator, will return to the broadcast with an exclusive report on best practices for medical assistants, but also the imperative admonition: they should not be mistakenly used as nurses.
The live broadcast will also feature these other segments:
* *Special Series: Maternal Morbidity and Mortality: *Senior healthcare consultant Kristi Pollard, Director of Coding Quality and Education for the Haugen Consulting Group, will contin…
playlist_add
Oct 26, 2021
Continuing Series on Outpatient CDI: How to Begin an HCC Program
Outpatient CDI expert Colleen Deighan will return to the next edition of Talk Ten Tuesdays to continue her popular series on a subject that continues to generate listener interest and questions.
Deighan will also conduct a listener’s survey during the weekly Internet radio broadcast. When healthcare organizations are considering, planning, or beginning efforts directed toward documentation integrity in the outpatient setting, Hierarchical Condition Categories (HCCs) are a key focus. Deighan will also discuss what to consider when determining the timing of your HCC review, top HCC category specifics, and best practices for compliant HCC reporting.
The live broadcast will also feature these other segments:
* *Special Series: Maternal Morbidity and Mortality: *Senior healthcare consultant Kristi Pollard, Director of Coding Quality and Education for the Haugen Consulting Group, will continue her four-part series, reporting how coded data is being used by the Alliance for Innovation…
playlist_add
Oct 19, 2021
Taking AIM at Maternal Morbidity and Mortality
We’re taking AIM at reducing maternal morbidity and mortality during an exclusive four-part series on ICD10monitor and Talk Ten Tuesdays. The series will be led by senior healthcare consultant Kristi Pollard, Director of Coding Quality and Education for the Haugen Consulting Group. During her series, Kristi will discuss how coded data is being used by the Alliance for Innovation on Maternal Health (AIM) to improve maternal outcomes.
The live broadcast will also feature these other segments:
* *Special Report: *American Health Information Management Association* (*AHIMA) 2021 President and Chair Katherine Lusk will discuss accomplishments from her term and how the Association continues to advance and advocate for the creation and use of trusted information.
* *The Coding Report:* Laurie Johnson will report on the latest coding news.
* *Tuesday Focus:* *Telemedicine or Telemarketing: *Former special agent for the U.S. Department of Health and Human Services (HHS) Office of…
playlist_add
Oct 12, 2021
Outpatient CDI Risk Adjustment and HCC Capture
Outpatient CDI programs can have real impact with risk adjustment and Hierarchical Condition Categories (HCCs). An important component of the HCC risk adjustment model is accurate and appropriate HCC capture, representing a patient’s disease burden year over year.
HCCs reflect hierarchies within related disease categories. A patient can have multiple HCC categories assigned, and each category, along with patient demographics, is factored into the patient’s overall risk adjustment factor (RAF) score.
The higher the RAF score, the sicker the patient. On the upcoming edition of Talk Ten Tuesdays, we’ll will cover the basics of HCCs and what steps to take in order to begin your outpatient CDI program with a focus on these factors. Broadcast Special Guest Colleen Deighan will also conduct a Talk Ten Tuesdays Listener Survey on this topic.
The live broadcast will also feature these other segments:
* *The Coding Report:* In keeping with the broadcast’s theme, Laurie Johnson will…
playlist_add
Oct 5, 2021
The Dilemma of Coding Mental Health
The COVID-19 pandemic rages on, exposing huge gaps in America’s vulnerable healthcare system, posing life-or-death questions that tear at our collective subconsciousness.
There’s also the constant drumbeat of headline news: vaccination mandates versus personal freedom, for example. Are two shots sufficient, or are three better? Should young children be vaccinated or not? With staff shortages and the rationing of care, who gets an inpatient bed and who doesn’t?
Today, as never before, mental stress is the new norm. And with the pandemic pandemonium comes the annual National Mental Health Awareness Week, sponsored by the National Alliance on Mental Health (NAMI). At this intersection is the tragic reality that millions of Americans are living with some form of mental health condition.
Reporting on mental health during the next edition of Talk Ten Tuesdays will be Dr. H. Steven Moffic, an award-winning author who is considered by many to be among America’s most prominent psychi…
playlist_add
Sep 28, 2021
Outpatient CDI and Getting Back to the Basics
Physician engagement, query productivity, and revenue integrity are some but not all of the activities that encompass today’s outpatient clinical documentation integrity (OP CDI) arena, which continues to gain traction among America’s hospitals and health systems.
During an exclusive broadcast report, CDI expert Colleen Deighan will unveil a Talk Ten Tuesdays listener’s survey on this topic, in which listeners are encouraged to participate. Delving into the survey responses, Colleen will join us on a biweekly basis through the end of the year, and share her knowledge and experience on how hospitals and health systems can determine where and how to focus their efforts to have the biggest impact.
The live broadcast will also feature these other segments:
* *The Coding Report:* Laurie Johnson will report on the latest coding news.
* *News Desk: *Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
* *Tuesd…
playlist_add
Sep 21, 2021
Lessons Learned – A COVID-19 Long Hauler Speaks Out
The National Institutes of Health (NIH) is awarding $470 million to New York University to perform a national study on “tens of thousands of people, to research the long-term effects of COVID-19.”
One such individual who might be included in the study will be the special guest during the next live edition of Talk-Ten-Tuesdays: Deborah Grider, longtime ICD10monitor national correspondent and senior healthcare consultant for Karen Zupko & Associates. Grider will return to the broadcast with an update on her status as a “long hauler,” having contracted the deadly coronavirus more than a year ago.
The live broadcast will also feature these other segments:
* *The Coding Report:* Laurie Johnson will report on the outcome of last week’s Coordination and Maintenance Committee.
* *News Desk: *Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
* *2021 E&M Update: It’s about time:* Nearly everyone thought th…
playlist_add
Sep 14, 2021
COVID-19 Update: Second Surge Underway
The COVID-19 pandemic continues to rage throughout the U.S., fueled by the Delta variant that is driving a new surge of infections of the deadly coronavirus – all this amid growing antagonism about mask mandates and vaccine hesitancy. The U.S. death toll now stands at more than 650,000, with projections indicating more than 750,000 deaths being likely by Dec. 1.
In fact, Idaho, reported to have the nation’s lowest vaccination rate – only 45 percent of its population has received at least one dose of the COVID-19 vaccine – is on the verge on rationing care due to a scarcity of beds and equipment.
For the latest update on COVID-19, the next Talk TenTuesdays broadcast will feature Dr. John Foggle, a former consultant with the World Health Organization (WHO) who designed a course for Project Hope, bringing COVID-19 education to healthcare workers in 23 countries.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare co…
playlist_add
Aug 31, 2021
A Trending Issue: PSI Rates Expected to Increase
Questions and concerns about the recent and significant updates to Patient Safety Indicators (PSI) by the Agency for Healthcare Research and Quality (AHRQ) has prompted the return of Dr. James Kennedy, a subject matter expert on PSIs, to the next live edition of Talk Ten Tuesdays.
The live broadcast will also feature these other segments:
* *Coding Report: *Senior healthcare consultant and well-known national coding and health information management (HIM) leader Gloryanne Bryant will substitute for Laurie Johnson to report the latest coding news.
* *CDI Report: *Nationally recognized clinical documentation improvement (CDI) expert Cheryl Ericson, clinical program manager for Iodine Software, will have the Talk Ten Tuesdays CDI Report.
* *RegWatch:* Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington, D.C.
* *News Desk: *Timothy…
playlist_add
Aug 25, 2021
An Explosive Topic: Rates Expected to Increase for PSIs 8, 11 and 14
The Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs) – which factor greatly into provider success with the Medicare Inpatient Quality Reporting, Leapfrog, and Maryland quality initiatives – were recently significantly updated for the 2021 fiscal year (FY).
During the next live edition of Talk Ten Tuesdays, you’ll learn why PSI 8, Hospital-acquired hip fracture; PSI 11, Postoperative respiratory failure; and PSI 14, Wound dehiscence rates are likely to increase at all facilities. What can you and your quality committees can do to mitigate these increases? What role will ICD-10-CM code Z66, Do not resuscitate, have with PSI 4, Death among surgical inpatients with serious treatable complications?
To be featured during the weekly Internet radio broadcast will be how preoperative documentation workflows that address the newly revised FY 2021 Elixhauser model can go beyond accurately risk-adjusting the PSIs, but also compliantly add net revenue to yo…
playlist_add
Aug 17, 2021
Important News for Coders: Quantifying the Sequelae Following Acute COVID-19
The rapidly expanding surge of COVID-19 infections is triggering a renewed look at the impact the virus is having on long-haulers. The pressing challenge is to understand the findings on the sequelae after recovery from COVID-19 – and what variations are expected to evolve.
Meanwhile, research reveals that about 14 percent of adults who had been infected with the virus developed at least one new clinical sequela requiring medical attention after recovery from COVID-19, although many specifics have yet to be quantified. Reporting our lead story during the next live edition of Talk-Ten-Tuesdays will be Axea Solutions founder and CEO Susan Gatehouse.
The live broadcast will also feature these other segments:
* *Tuesday Focus*: *Fixing Healthcare, Part II*: Rose Dunn, former American Health Information Management Association (AHIMA) CEO, and current COO for First Class Solutions, will return to the broadcast with the final installment in her exclusive two-part series in which she of…
playlist_add
Aug 10, 2021
Pandemic Surge Expected to Add Chaos to HIPAA Claims
Let’s start with a basic question: are you affiliated with a Health Insurance Portability and Accountability Act (HIPAA) covered entity? If so, remember, such entities must comply with standards for electronic transactions, not just privacy.
When you’re asked about your vaccine status, do you claim a HIPAA violation? Is your vaccine status only your business, and no one else’s? If not, whose business is it, really? Is it your employers’ business, or that of the airline or cruise ship company through which you’re booking a trip?
With the recent surge in the coronavirus pandemic, brought about by the new Delta variant, as odd as it may seem to some, more and more people are claiming a HIPAA violation when asked about their vaccine status.
Reporting on this latest coronavirus conundrum during the next edition of Talk Ten Tuesdays will be Terry Fletcher, a nationally recognized professional physician coder and auditor.
The live broadcast will also feature these other segments…
playlist_add
Aug 3, 2021
Could New AHA Advice Raise Surgery Complication Rates?
Surgery doesn't have to be complicated; it shouldn't automatically translate into a misadventure.
Recent American Hospital Association (AHA) advice has the potential to result in artificially elevated complication rates for surgery, however, jeopardizing your safety and performance profiles. Clinical accuracy of diagnoses is king, even in the operating room.
Reporting on this developing story during the next live edition of Talk Ten Tuesdays will be senior healthcare executive Allen Frady, who will reveal important information and provide tips on how to approach this conversation without accidentally veering into forbidden territory.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the Talk-Ten-Tuesdays Coding Report, along with the broadcast’s weekly Listeners Survey.
* *Tuesday Focus*: *Fixing Healthcare, Part I*: Bureaucratic, redundant, labor-intensive, was…
playlist_add
Jul 27, 2021
Where Did All the Money Go?
"Where did all the money go?" It’s a valid question. Join us for the next live edition of Talk Ten Tuesdays, when nationally-recognized professional coder, educator, and auditor Terry Fletcher will provide an answer by discussing a topic not addressed often enough: physician under-coding. The bad habit leads to not getting paid for services provided. Multiply those issues by 20 to 30 patient encounters daily, and it’s little wonder that physicians are missing a ton of money – important and well-earned revenue.
During the pandemic, many physicians just tried to stay afloat with various programs from the U.S. Department of Health and Human Services (HHS): survival programs such as the Paycheck Protection Program (PPP), PPP loans, and the Provider Relief Fund (PRF). But now, the focus is on recovery. During the broadcast, Fletcher will offer examples of those missed revenue opportunities, along with the reasons why under-coding occurs.
The live broadcast will also feature these ot…
playlist_add
Jul 20, 2021
Exclusive: AHIMA Reveals New CDI Brief
The American Health Information Management Association (AHIMA) has just released a new practice brief focused on prospective clinical documentation integrity reviews and query alerts.
Being revealed for the first time during the next edition of Talk Ten Tuesdays, the practice brief was developed by AHIMA through a workgroup of clinical documentation integrity (CDI) industry experts. The free practice brief explores the need for prospective reviews and the impact they have on the CDI industry. The publication also provides information on the provider perspective and how to manage the data obtained in prospective reviews. Every CDI professional will benefit from the practice brief by recognizing the compliance standards that should be followed when performing prospective health record reviews.
The live broadcast will also feature these other segments:
* *CDI Report: *Nationally recognized CDI expert Cheryl Ericson, clinical program manager for Iodine Software, will have the Talk Ten…
playlist_add
Jul 13, 2021
Virtual Care: New Issues for Coders
Lawmakers are lining up to decide what Medicare will pay for after the COVID-19 public health emergency (PHE) is over – and they are looking confident that they have the votes to include it in a must-pass piece of legislation this year.
Congress also seems to be on board with a plan to allow millions of Medicare patients to continue to video-chat with their physicians once the PHE is over. The Medicare advisory committee, MedPAC, has recommended a cautious approach, however, that would temporarily cover some telehealth services for all beneficiaries, but revert to lower reimbursement rates post-crisis for virtual appointments compared to in-person. There's also concern that a rapid expansion could prompt more fraudulent billings: the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) estimates that $4.5 billion in telehealth-related fraud was lost last year, which is why Part B evaluation and management (E&M) services provided during the PHE is on t…
playlist_add
Jun 29, 2021
To Query or Not to Query: That’s the Leading Question
“Querying is the lifeline of clinical documentation integrity (CDI) professionals and many coding professionals,” wrote Cheryl Ericson in a recent edition of ICD10monitor. And yet the query process can be a time-consuming and sometimes arduous activity that often contributes to an inefficient CDI workflow.
One of the biggest hindrances to an efficient query process appears to hinge on misinformation regarding what is considered a leading or non-compliant query, specifically as it pertains to the timing of a query. Ericson, a senior healthcare consultant, will report on this lead story during the next live edition of Talk Ten Tuesdays, sorting through the confusion of the query process while helping you ensure that queries at your facility are compliant and non-leading.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the Talk Ten Tuesdays Coding Report, along…
playlist_add
Jun 22, 2021
OIG Getting Under the Skin of Dermatologists: E&M Services and Modifier 25
Are you monitoring the 2021 U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) Work Plan?
The watchdog agency is watching you. They’re auditing claims for evaluation and management (E&M) services performed on the same day as minor surgical procedures that have been documented with Modifier 25.
The backstory: in 2019, about 56 percent of dermatologists' claims with an E&M service also included minor surgical procedures (such as lesion removals, destructions, and biopsies) on the same day. This may indicate abuse, wherein the provider used Modifier 25 to bill Medicare for a significant and separately identifiable E&M service when only a minor surgical procedure and related preoperative and postoperative services were supported by the beneficiary's medical record. Nationally recognized professional coder, educator, and auditor Terry Fletcher will return to the Talk Ten Tuesdays broadcast for its next edition to report the lead story.
The live broadca…
playlist_add
Jun 15, 2021
The Quest to Improve Quality: Auditing Low-Value Services
The ongoing quest to improve quality includes the auditing of low-value services. During the next episode of Talk Ten Tuesdays, Susan Gatehouse, founder and CEO for Axea Solutions, will report on areas to reduce wasteful spending on services with little to no clinical benefit – all in the name of improving quality of care.
According to most industry definitions, low-value care involves those services that are medically unnecessary and provide no health benefits to patients.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the Talk Ten Tuesdays Coding Report, along with the broadcast’s weekly Listeners Survey.
* *Tuesday Focus*: *HIM Professionals Engaging Physicians (Part IV):* Rose Dunn will continue with her series on how health information management (HIM) professionals, using their existing skill sets, can enhance physician practices in the outpatient e…
playlist_add
Jun 8, 2021
Outsourcing versus Offshoring: Old Issue, New Insights
Outsourcing versus offshoring – a debate long representing a tacit acknowledgment of how many U.S. facilities and physician practices approach coding and billing – has resurfaced as providers grapple with which to choose as the customary way to submit medical claims. Although once considered verboten, today this is more or less becoming mainstream, or the "new normal," with globalization on the horizon.
But should your facility consider outsourcing medical coding and billing – and if you do, how much is actually "off-shored," even if you contract with a U.S.-based company? Do you know who's working for you?
Nationally recognized professional coder, educator, and auditor Terry Fletcher will discuss the good, the bad, and the ugly of outsourcing and offshoring as she busts myths and re-examines the reality of contracting rather than keeping coding and billing in-house during the next live edition of Talk Ten Tuesdays.
The live broadcast will also feature these other segments:…
playlist_add
May 25, 2021
AMA 2021 CPT® Errata and Technical Corrections: Mitigating Shades of Grey
The American Medical Association (AMA) CPT® Errata and Technical Corrections have clarified some grey areas found in the 2021 Evaluation and Management (E&M) Guidelines. But did the updates really help coders and physicians in better understanding how to apply the latest corrections?
Apparently, there’s still confusion, according to Terry Fletcher, a nationally recognized physician auditor and coder. Fletcher will return to the Talk Ten Tuesdays weekly broadcast to offer some working examples, as well as answer listener questions, in an effort to clear up the perplexities while providing insight on how to submit a clean office visit claim.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the Talk Ten Tuesdays Coding Report, along with the broadcast’s weekly Listeners Survey.
* *Tuesday Focus: Hospital at Home versus Hospital to Home: *Are they not one in t…
playlist_add
May 18, 2021
ICD-11 Prep: Examining Prominent Changes in Preparation for the Transition
Healthcare providers nationwide are scanning the horizon for the first signs of ICD-11, which is slowly making its presence seen and felt.
However far in the future you might speculate the transition to ICD-11 to be, the reality is that preparation and planning will take time, and understanding the new concepts being introduced is a key starting point. And that will be where we start during the next live edition of Talk-Ten-Tuesdays; join Chuck Buck and Dr. Erica Remer when they welcome the return of Susan Gatehouse, founder and CEO of Axea Solutions, who will report the lead story.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the Talk Ten Tuesdays Coding Report, along with the broadcast’s weekly Listeners Survey.
* *News Desk: *Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
* *Me…
playlist_add
May 11, 2021
The Pen is Mightier than the EMR
When the Centers for Medicare & Medicaid Services (CMS) began down the path of change that the American Medical Association (AMA) delivered in 2021 for the purpose of administrative burden relief, it was expected that there would be some initial investments of time necessary to create models of efficiency in a new era of documentation.
But most providers have chosen to avoid it. The totality is the patient story. And hasn’t that been the problem since the inception of templates, and one of the other reasons many rallied for changes to the guidelines?
Templates and stern requirements regarding how the patient encounter is documented tend to change – and at times, strangle – the story of the patient. But we must remember that the pen is mightier than the electronic medical record (EMR) – and that the author of the note is, in fact, the ultimate authority of it, and the controller of its destiny. Reporting our lead story during the next live edition of Talk Ten Tuesdays will be…
playlist_add
May 4, 2021
Why it’s important to get a handle on CPT® Errata
It’s vitally important to remember that updates to the American Medical Association (AMA) CPT® code book might not be there when you need them.
But since January of this year, the AMA has been receiving provider feedback: essential information that now been incorporated in the AMA 2021 CPT® Errata and Technical Corrections. Navigating these changes during the next edition of Talk Ten Tuesdays will be nationally recognized physician auditor and coder Terry Fletcher, who will report on significant clarifications – including some evaluation and management (E&M) 2021 Office and Other Outpatient visit clarifications – designed to help practices square their visits with medical decision-making (MDM).
The live broadcast will also feature these other segments:
* *Tuesday Focus*: *HIM Professionals Engaging Physicians (Part II):* Rose Dunn will continue with her series on how health information management (HIM) professionals, using their existing skill sets, can enhance physician p…
playlist_add
Apr 27, 2021
How to Ensure Data Integrity While Protecting Your Organization’s Bottom Line - Part I
There’s a new segment of the healthcare population that represents yet another opportunity for health information management (HIM) professionals to leverage existing staff and processes to improve their organization’s bottom line. That new segment: physicians employed by healthcare systems.
During the next live edition of Talk-Ten-Tuesdays, nationally acclaimed HIM professional Rose T. Dunn, two-term president of the American Health Information Management Association (AHIMA) and chief operations officer for First Class Solutions, will return to the broadcast to report on important strategies to engage physicians – this being the first of a two-part series. Of particular relevance is the fact that now, according to the 21st Century Cures Act, consumers have been empowered to read notes that recap doctor office visits, as well as look at test results electronically. As such, now is the time for everyone at your facility to get on the same page.
The live broadcast will also featur…
playlist_add
Apr 20, 2021
When Surgeons Have Had Enough— Modifying PSI-06 Criteria for AHRQ
A key (and occasionally overlooked) role of the physician advisor is advocacy: advocacy for physician partners, advocacy for quality patient outcomes, and advocacy for clinical medicine represented on committees, in board rooms, and to agencies defining national standards.
During the next live edition of Talk Ten Tuesdays, Dr. Drew Updike, medical director of coding at UCHealth, and Dr. Debra Anoff, senior medical director of clinical documentation improvement (CDI) for UCHealth, will offer a blueprint on how they solved a local problem on a national level.
They identified a blind spot in Agency for Healthcare Research and Quality (AHRQ) criteria that was negatively impacting their organization's PSI-06 Quality ranking, as a result of their being a regional referral center for a highly specialized congenital corrective surgery (the “Nuss” procedure).
After collaborating cross-sectionally within their organization, they engaged in advocacy to AHRQ; the result was successful modif…
playlist_add
Apr 15, 2021
HIP Voices
Every day, in facilities ranging from small rural hospitals to large academic teaching facilities and health systems, these dedicated professionals are working to keep patient health information data accurate, secure, and most importantly, personal. Because when it’s personal, it’s relevant.
As part of our recognition of the importance of HIPs, please listen to HIP Voices, a podcast during which you’ll hear the stories of three dedicated professionals:
Laurie Peters, Global privacy officer at Orion Health
Sarah Throop, who describes her journey into telehealth and virtual care.
Shannan Swafford, Manages coding process improvement, BlueCross Blue Shield of Tennessee
playlist_add
Apr 13, 2021
ICD-11: Where in the World is the U.S.?
ICD10monitor and Talk Ten Tuesdays will continue their reporting on the advent of ICD-11 – particularly during April, when attention turns to the World Health Organization (WHO).
A key question that needs answering: where does the United States fall among the countries that are either preparing or even implementing the new update for the standard code set?
For a global perspective on ICD-11 and the nation’s position on the new code set, Margaret Skurka, a member of the International Federation of Health Information Management Associations (IFHIMA) and past president of the American Health Information Management (AHIMA),will share perspective on ICD-11 planning during the next edition of Talk Ten Tuesdays.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the Talk Ten Tuesdays Coding Report, along with the broadcast’s weekly Listeners Survey.
* *RegWatch:*…
playlist_add
Apr 6, 2021
ICD-11: The Journey of Adoption Begins Now—During World Health Week
The World Health Organization (WHO) gave us the International Classification of Diseases (ICD), including several updates over the years, more recently versions 9 and 10.
And now on the horizon is version 11.
Thus, it is only fitting that Talk Ten Tuesdays would focus on the global accomplishments of the WHO this week, with the lead story for this upcoming edition focusing on the looming implementation of the new update for the standard code set. Leading off the reporting will be the broadcast’s special guest, Lorraine Fernandes, president of the International Federation of Health Information Management Associations (IFHIMA). Lorraine will report on the efforts by the organization to further advance the implementation of ICD-11.
The live broadcast will also feature these other segments:
* *CDI Report:* Senior healthcare consultant and physician Alba Kuqi will make her Talk Ten Tuesdays debut with her report on clinical documentation integrity (CDI).
* *Coding Report: *Gloryan…
playlist_add
Mar 30, 2021
Why to Care About the Cures Act
Implementation of the 21st Century Cures Act is set for Monday, April 5. In a nutshell, the legislation directs providers to cease all efforts of information blocking with respect to their electronic health records (EHRs), and to encourage and promote interoperability, allowing for communication and cooperation with third-party application program interfaces.
With respect to portions of clinical notes, there appear to be certain exceptions where physicians can block access, including psychotherapy notes, HIV testing results, and any notes that, in a physician’s judgement, could cause harm to an individual. Reporting our lead story on this topic during the next edition of Talk Ten Tuesdays will be nationally recognized professional auditor and coder Terry Fletcher.
The live broadcast will also feature these other segments:
* *Outpatient CDI Report: * Colleen Deighan, senior consultant with 3M, will conclude her exclusive three-part series for ICD10monitor and Talk Ten Tuesdays on…
playlist_add
Mar 23, 2021
Biannual ICD-10 Implementation Dates Proposed: Weighing the Pros & Cons
The Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention’s National Center for Health Statistics (CDC/NCHS) have announced a proposal for biannual ICD-10-CM and PCS updates.
The impact on business processes would be far-reaching – much of it good, and some possibly not so good, according to Susan Gatehouse, who will report this development as the lead story during the next live edition of Talk Ten Tuesdays. Gatehouse, the founder and CEO for Axea Solutions, will encourage listeners to respond during the public comment period being afforded by both agencies.
The live broadcast will also feature these other segments:
* *Outpatient CDI Report:* Colleen Deighan, senior consultant with 3M, will continue with Part II in her three-part series on outpatient clinical documentation improvement (CDI), reporting on measures that require abstracting.
* *Coding Report:* Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions,…
playlist_add
Mar 16, 2021
A New Look at Outpatient CDI: An Exclusive Three-Part Series
To improve patient care and create transparency, Medicare mandated a pay-for-quality reporting program for hospital outpatient services in 2009. The related measures can impact hospital payment if not met, thus creating financial incentives for hospitals to report them. The measures are intended to evaluate the regularity of outpatient treatments known to provide the best results for most patients with a particular condition.
During the next three broadcasts of Talk-Ten-Tuesdays, listeners will be introduced to these measures and learn how coding and documentation integrity professionals can get involved in reporting and analyzing the data. The exclusive three-part series will include the following:
*Part 1: Hospital outpatient quality reporting program
Part 2: Measures that require abstracting
Part 3: Outcome-based measures*
The live broadcast will also feature these other segments:
* *Coding Report:* Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC…
playlist_add
Mar 9, 2021
Hitting the Reset Button on Revenue Integrity
Whether you work for a full-scale enterprise or a smaller healthcare facility, the importance of revenue integrity programs is gaining increased importance, especially in the light of renewed auditing activities anticipated under the Biden Administration.
Beyond ensuring accurate billing and collection, revenue integrity should strengthen reimbursement performance and provide sound financial practices, according to Susan Gatehouse, founder and CEO for Axea Solutions, who will report on our lead story during the next edition of Talk Ten Tuesdays.
The live broadcast will also feature these other segments:
* *Coding Report: *Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will continue her reporting on proposed codes expected to be discussed during the Coordination and Maintenance Committee meeting, which begins on Tuesday, March 9 and concludes Wednesday, March 10. Johnson will also conduct the Talk Ten Tuesdays Listener Survey.
* *Tuesday Focus:*…
playlist_add
Mar 2, 2021
Exclusive Preview: Coordination and Maintenance Committee Meeting
Will there be an ICD-10 code for post-traumatic visual disturbance? Or for an encounter for PPD test reading and medication review? Or prolonged grief disorder?
In light of COVID-19, the ICD-10 Coordination and Maintenance Committee (C&M) meeting will be online-only, as was the case last spring, at the outset of the pandemic. This year, the two-day meeting begins next Tuesday, March 9, continuing through March 10, bringing together representatives from the Centers for Medicare & Medicaid Services (CMS), the Centers for Disease Control and Prevention's (CDC’s) National Center for Health Statistics (NCHS), various medical societies, medical device vendors, and the general public.
Senior healthcare consultant Laurie Johnson will have an exclusive preview of Day 1 during the next edition of Talk Ten Tuesdays. Joining her will be nationally prominent psychiatrist H. Steven Moffic, MD, who will report on prolonged grief: an ICD-10-CM diagnostic topic expected to be discussed during the C…
playlist_add
Feb 23, 2021
Vaccination Nation, Part IV – The Distribution Bottleneck
Infection rates from the coronavirus are declining. Vaccination rates are increasing. And while that’s good news, word on the ground is anything but good. Vaccination distribution in the U.S. has been, by most accounts, uneven, with reports of supplies not keeping up with demand in many states. And this week, a spate of bad weather, particularly in Texas and states across the Southeast, is hampering vaccination efforts – and in some cases, cancelling mass inoculation events.
During the next live edition of Talk-Ten-Tuesdays Susan Gatehouse, founder and CEO for Axea Solutions, and Deborah Grider, senior healthcare consultant for Karen Zupko and Associates, will report on vaccination rates in their respective states: Georgia and Indiana.
It will mark one of several segments making up Part IV of Vaccination Nation, an exclusive series being produced by ICD10monitor for Talk-Ten-Tuesdays. Also during the program, TTT executive producer Chuck Buck and co-host Erica Remer, MD will answe…
playlist_add
Feb 16, 2021
Exclusive: Vaccination Nation, Part III – The Inoculators
They’re standing in long lines, often in the early morning darkness and in the cold, waiting for access to community vaccination centers all across the country. According to the Centers for Disease Control and Prevention (CDC), more than 1 million doses are being administered daily to grateful recipients.
Yet there’s still the disturbing trend of vaccine hesitancy. Driven by misinformation, lack of trust, and concerns about safety and efficacy, vaccine hesitancy is considered to be one of the top global health threats, according to the World Health Organization (WHO).
During Part III of Vaccination Nation, an exclusive series produced by ICD10monitor for Talk-Ten-Tuesdays, program host and executive producer Chuck Buck and co-host Erica Remer, MD will conduct another live town hall, answering listeners’ questions in real time.
The global COVID-19 pandemic has now resulted in nearly 108 million cases worldwide, as well as 2.37 million deaths. More than 27 million of those cases…
playlist_add
Feb 9, 2021
Exclusive Town Hall: Vaccination Nation – Part II
The Centers for Disease Control and Prevention (CDC) is forecasting that there will be more than 500,000 deaths from the coronavirus in the U.S. by the third week of February. In the meantime, the U.S. vaccine rollout fell short of federal projections, according to Bloomberg News, which noted that the initial round of shots, delivered through early January, was distributed through hospitals.
Then there’s the disturbing trend of vaccine hesitancy. Driven by misinformation, lack of trust, and concerns about safety and efficacy, vaccine hesitancy is considered to be one of the top global health threats, according to the World Health Organization (WHO).
During Part II of Vaccination Nation, an exclusive series produced by ICD10monitor for Talk Ten Tuesdays, program host and executive producer Chuck Buck and co-host Erica Remer, MD will conduct a live town hall, answering listeners’ questions in real time. Remer is a volunteer inoculator with the Medical Reserve Corps of the Cuyahoga…
playlist_add
Feb 2, 2021
Exclusive: Vaccination Nation – Part I
The Centers for Disease Control and Prevention (CDC) is forecasting that there will be more than 500,000 deaths from the coronavirus in the U.S. by the third week of February. In the meantime, there has been a flurry of activity by major pharmaceutical companies to work together to help meet the huge demand for vaccines, all against the backdrop of an emerging trend: vaccine hesitancy. Driven by misinformation, lack of trust, and concerns about safety and efficacy, vaccine hesitancy is considered to be one of the top global health threats, according to the World Health Organization (WHO).
In the first portion of an exclusive series produced by ICD10monitor for Talk Ten Tuesdays, Erica Remer, MD will kick things off with a report on the subject, including a listener survey conducted during the live broadcast. Remer is a volunteer inoculator with the Medical Reserve Corps of the Cuyahoga County Board of Health.
The live broadcast will also feature these other segments:
* *COVID-19 R…
playlist_add
Jan 26, 2021
Exclusive: Improving Documentation for PSI-9
There has long been a focus on improving documentation for the purpose of maximizing the capture of complications and morbidities and major complications and morbidities (CCs and MCCs). As value-based purchasing is becoming more widely adopted, the importance of improving documentation is becoming more relevant. Case in point: the importance of coagulopathy documentation and its impact on perioperative hemorrhage and hematoma, a patient safety indictor (PSI-9).
Reporting our lead story during the next edition of Talk Ten Tuesdays will be Dr.* *Ahmed Abuabdou, Associate Chief Medical Officer and Associate Professor of Medicine at the University of Arkansas for Medical Sciences (UAMS) Medical Center.
The live broadcast will also feature these other segments:
* *Tuesday Focus: Telehealth*: The proliferation of telehealth, now identified in the 2021 U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) Work Plan, means that you will need to be extra dili…
playlist_add
Jan 19, 2021
The Reality of Care Rationing
The U.S. death toll from the coronavirus is approaching the number of Americans killed in World War II, and as America is experiencing another surge of infections, the once-unthinkable subject of rationing care is now being debated.
But how is care to be rationed? Is there a uniform guide for triaging care, as the availability of all beds, ICU beds, ventilators, and other hospital equipment is weighed, based on the acuity of each patient?
As John Zelem, MD wrote recently for RACmonitor, “we have entered a time in which drastic scenarios demand drastic measures (care rationing). We all look forward to the time when we can look back on these challenging times as a unique response to a fairly unique medical emergency.”
Reporting our lead story during the next live edition of Talk Ten Tuesdays will be Dr. Zelem, founder of Streamline Consulting Solutions.
The live broadcast will also feature these other segments:
* *CDI Report:* Cheryl Ericson, clinical program manager for Iodin…
playlist_add
Jan 12, 2021
COVID-19 Relief Bill: Conversion Factor Increases Twice in One Week
The Centers for Medicare & Medicaid Services (CMS) 2021 Final Rule and 2021 Medicare Physician Fee Schedule (MPFS) are effective Jan. 1, 2021, and both affect reimbursement.
But in a rare move, CMS increased the conversion factor (CF) in the MPFS twice in one week as a result of the COVID-19 relief bill, which added a hike of 3.75 percent.
For an update on the major CMS changes for 2021 that will affect your reimbursement under the Part B Physician Fee Schedule, tune in to the next live edition of Talk Ten Tuesdays, coming your way Tuesday, Jan. 12 from 10-10:30 a.m. EST. That’s when nationally recognized professional coder and auditor Terry Fletcher will join the broadcast to report on all the relevant details.
The live broadcast will also feature these other segments:
* *RegWatch:* Stanley Nachimson, former CMS career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington, D.C.
* *SOAP Note: *Shannon DeCon…
playlist_add
Dec 8, 2020
News Update: New Monoclonal Antibody Infusion Underway
Out in the West Texas “town” of El Paso, a number of COVID-19 patients are being treated with a new monoclonal antibody infusion called bamlanivimab. Now in the second week of the operation being conducted in the El Paso Convention Center’s makeshift hospital, Dr. Edward Michelson, Chair of the Department of Emergency Medicine at Texas Tech University Health Sciences Center, reports that while treatments are underway, there hasn’t been enough time to gather data on the effects and outcomes. Dr. Michelson, who appeared on Talk Ten Tuesdays in October 2017, will return to the live broadcast this coming Tuesday with a live update on the new therapy.
Also on tap for the broadcast:
* *Tuesday Focus: New COVID-19 Codes: *The Centers for Disease Control and Prevention (CDC) recently announced further additions to ICD-10-CM related to COVID-19. Additionally, the Centers for Medicare & Medicaid Services (CMS) has posted new guidelines for ICD-10 CM/PCS coding and an updated MS-DRGs…
playlist_add
Dec 1, 2020
COVID Conundrum: Who’s Paying for Personal Protective Equipment?
There’s a recently added CPT® code for personal protective equipment (PPE). But there’s a corresponding catch: who pays and who doesn’t, and what’s the best practice for handling the new normal in physician practices? Could the new code, 99072, although a payable service by Medicare, as well as commercial payers, wind up being a patient’s out-of-pocket expense?
Reporting our lead story during the next live edition of Talk Ten Tuesdays will be nationally recognized professional coder and auditor Terry Fletcher.
Also on tap for the broadcast:
* *News Desk: *Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
* *Tuesday Focus: *Chronic care management (CCM) has taken on new importance in light of the coronavirus pandemic. Continuing his reporting on this topic will be Andrew Dombro, MD, co-founder of Clarity/CCM, LLC.
* *CDI Report: *Senior healthcare consultant Cheryl Ericson will return to the broadc…
playlist_add
Nov 24, 2020
Exclusive Series: In Search of Solutions to COVID-19 False Positives
Thanksgiving, the flu season, and a dramatic surge of the COVID-19 pandemic are converging at a time when the nation’s coronavirus death toll has reportedly exceeded 250,000, with more than 11 million confirmed cases.
With soaring infection rates come more testing, as well as more hospitalizations and deaths.
A focus on COVID-19 testing will come into sharp relief as Talk Ten Tuesdays concludes its exclusive three-part series on false-positive tests. During this episode, co-host Erica Remer, MD will reintroduce Andrew Cohen, PhD, who has been doing groundbreaking work on COVID-19 false positives.
Dr. Cohen will explore possible solutions to this daunting challenge.
Also on tap for the broadcast:* *
* *News Desk: *Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
* *Tuesday Focus: *Shannon DeConda*, *founder of the National Alliance of Medical Auditing Specialists (NAMAS), will return to the broadcast with…
playlist_add
Nov 17, 2020
COVID-19 False Positives and Real-Life Implications for Long-term Care
The global coronavirus pandemic is worsening quickly, and at a time when winter is bearing down, forcing more of us to remain inside. In fact, health experts are predicting that confirmed daily cases of COVID-19 will climb above 200,000 nationally. With soaring infection rates come more testing, as well as more hospitalizations and deaths.
A focus on COVID-19 testing will come into sharp relief as Talk Ten Tuesdays continues with the second portion of its three-part series on false-positive tests. During the next edition of the popular weekly Internet broadcast, Talk Ten Tuesdays co-host Erica Remer, MD will reintroduce Arnold Cohen, PhD, who has been doing groundbreaking work on COVID-19 false positives.
Dr. Cohen will report on the consequences of false positives for patients in long-term care facilities. Putting a human face on the testing dilemma will be Brian Kim, who will report on his real-life experience of false-positive testing results, and how it wreaked havoc on his famil…
playlist_add
Nov 10, 2020
COVID-19 3-Part Series: False Impressions, Real-Life Implications
As the nation is experiencing a dramatic surge in confirmed cases of COVID-19, the terms “false negative” and “false positive” accompany not only medical records, but also news media dispatches.
The public health establishment and the medical world have generally treated positive results of PCR-based tests for the virus that causes COVID-19 as if they are infallible. The evidence shows that this may not be true, and there are real-life implications of false positives – yet to date, there has been little media coverage of false-positive tests.
That is why Talk Ten Tuesdays Co-Host Erica Remer, MD will explore this unchartered territory in an exclusive three-part series on the weekly Internet radio broadcast. Joining Dr. Remer will be Andrew Cohen, PhD, who has been doing groundbreaking work on COVID-19 false positives.
Also on tap for the broadcast:
* *Chronic Care Management:* Andrew H. Dombro, MD will join the broadcast and report on a new segment, Chronic Care Managem…
playlist_add
Nov 3, 2020
Exclusive Live Open-Door Broadcast: Coding and Coping with Stress and Tension
We are all participants in one of the most tumultuous times in the 21st century. A global pandemic rages throughout the United States and Europe, the consequences of which are tangible, but not yet fully quantified. A divisive political environment, exacerbated by 24/7 news and social media, has intensified our feelings about ourselves, our colleagues, neighbors, and family members. Stress and tension abound, of which the consequences are many, with depression and anxiety also taking a physical toll.
In light of all of this, Talk Ten Tuesdays is dedicating its live broadcast to an open-door forum, during which H. Steven Moffic, MD, one of America’s foremost psychiatrists and the broadcast’s resident psychiatrist, will answer your questions while providing strategies for how you can cope during these unsettling (albeit historical) times.
Also on tap for the broadcast:
* *RegWatch:* Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turn…
playlist_add
Oct 27, 2020
Where in the World is ICD-11?
Amid the global COVID-19 pandemic, the 2020 presidential campaign, coding updates, and a tangle of regulatory waivers, it’s important to not to lose sight of the fact that ICD-11 for the United States is on the horizon.
That’s why we asked Margaret Skurka, a voting member of the National Committee on Vital and Health Statistics (NCVHS) in Washington, D.C., who also sits at the table of the World Health Organization’s (WHO’s) Education and Implementation Committee, to report on the latest ICD-11 developments in the U.S. – and also to provide a global perspective on what other countries are doing, and where they are in the implementation process.
The podcast also features these other segments:
* *Tuesday Focus: 2021 E&M Guideline Changes: *Shannon DeConda, founder of the National Alliance of Medical Auditing Specialists (NAMAS), will provide an update on the significant changes in the 2021 evaluation and management (E&M) guidelines.
* *Special Report: Telehealth:* Natio…
playlist_add
Oct 20, 2020
America in the Grip of an Unrelenting COVID-19 Pandemic
In the deadly throes of a global pandemic, Americans are struggling as they adjust to a confusing new normal. Halloween this year will portend an actual frightening threat. And America’s traditional Thanksgiving dinner will have an unwanted guest: COVID-19, the elephant in the room.
The coronavirus continues to dominate headlines, family dinner conversations, political debates, congressional hearings, and the news media. During this edition of Talk Ten Tuesdays, providing a physician’s perspective on the novel coronavirus, the disease that causes COVID-19, will be Dr. John Foggle, who returns to the broadcast to share his perspective. It’s a perspective earned from his consulting with the World Health Organization (WHO) in the South Pacific in January and February, then returning to the U.S. to treat COVID patients in the Northeast.
The live broadcast will also feature these other segments:
* *Mental Health Report:* H. Steven Moffic, MD, an award-winning psychiatrist who has…
playlist_add
Oct 13, 2020
Coding Sequela to COVID-19: Part II
Once a frequent flyer with all the attendant privileges, senior healthcare consultant Deborah Grider was abruptly grounded when COVID-19 curtailed her coast-to-coast consulting.
She first reported on her sequela from the coronavirus infection, the disease that causes COVID-19, for Talk Ten Tuesdays listeners in July. Now, she will return to the long-running broadcast to report on several other conditions that have arisen. About one in six people who have survived COVID-19 are expected to have long-lasting complications, including some that are life-threatening.
The live broadcast will also feature these other segments:
* *Tuesday Focus: *Shannon DeConda, founder of the National Alliance of Medical Auditing Specialists (NAMAS), will provide an update on the significant changes in the 2021 evaluation and management (E&M) guidelines.
* *Tuesday Special Report: *Julia K. Brodt, PhD, an educator and former epidemiologist, will provide a layperson’s background on antibodies, which…
playlist_add
Oct 6, 2020
Exclusive: Auditors Are Back with a Vengeance
Given the importance of medical review activities relative to the program integrity efforts of the Centers for Medicare & Medicaid Services (CMS), and regardless of the status of the current federal public health emergency (PHE), providers can expect imminent pre- and post-payment reviews, plus audits by Supplemental Medical Review Contractors (SMRCs) and the Recovery Audit Contractors (RACs).
Reporting our lead story during this edition of Talk Ten Tuesdays will be nationally recognized professional coder and auditor Terry Fletcher.
The live broadcast will also feature these other segments:
* *Tuesday Focus: COVID-19 Update: *Dr. John Foggle, Adjunct Associate Professor of Emergency Medicine at the Alpert Medical School of Brown University, provides an update on the pandemic that has claimed the lives of more than 205,000 in the U.S.
* *RegWatch:* Stanley Nachimson, former CMS career professional-turned-well-known healthcare IT authority, reports on the latest regulatory news…
playlist_add
Sep 29, 2020
Dealing with Coding and Clinical Validation Denials with Medicare Advantage Organizations
The Centers for Medicare & Medicaid Services (CMS) has ordered Medicare Advantage Organization (MAO), -hired subcontractors, to stop issuing “pseudo-denials” that require pseudo-appeals before the MAO considers the denial formalized.
Reporting our lead story during this edition of Talk Ten Tuesdays will be Dr. Edward Hu, system executive director of physician advisor services for UNC Health in North Carolina. Dr. Hu was one of several healthcare executives who convinced CMS to issue a recent memo outlining this change. Dr. Hu will explain the coding significance of this new directive, particularly as it relates to coding and clinical validation denials, which by definition occur retrospectively, and often after a claim was initially paid.
The live broadcast will also feature these other segments:
* *The Dunn Report: *National health information management (HIM) expert and past president of the American Health Information Management Association (AHIMA), Rose Dunn, returns to th…
playlist_add
Sep 22, 2020
Site-Neutral Payments Expected to Trigger a Court Battle
Battle lines in a budding court battle could be drawn soon.
A federal appeals court has reversed the decision of a lower court and upheld the action by the U.S. Department of Health and Human Services (HHS) to pay formerly grandfathered off-campus outpatient departments run by hospitals at the same, lower rate of physician clinics.
Experts believe that could mean a potential loss of $800 million to these already struggling hospitals, the finances of which have been especially hit hard during the COVD-19 pandemic. There is clearly a legal battle ahead. Reporting our lead story during the next edition of Talk Ten Tuesdays will be nationally recognized professional coder and auditor Terry Fletcher.
The live broadcast will also feature these other segments:
* *Tuesday Focus: *Shannon DeConda, founder of the National Alliance of Medical Auditing Specialists and a partner of DoctorsManagement, will continue her series for ICD10monitor and Talk Ten Tuesdays in which she delves into the…
playlist_add
Sep 15, 2020
The Impact of COVID-19 on the Social Determinants of Health
COVID-19 is disrupting the stability of food, shelter, and sleep. Stress levels are unthinkable.
The continuing pandemic, along with unemployment, racial injustice, and social isolation, is raising anxiety and depression to high levels as well. Moreover, it’s been reported that ongoing stress can decrease the body’s lymphocyte levels, making infection more likely. This cycle is evident among COVID patients.
Reporting on this untenable situation during the next edition of Talk Ten Tuesdays will be Sheryl Markowitz, senior vice president of clinical operations at Healthfirst of New York City, one of the largest Medicare and Medicaid providers in the greater metro area of the Big Apple. Ms. Markowitz will be reporting on how Healthfirst is responding to a significant increase in calls from members experiencing anxiety and depression by increasing outreach and availability of help.
The live broadcast will also feature these other segments:
* *Tuesday Focus: Vaccinating Kids: *Sep…
playlist_add
Sep 10, 2020
Dateline Washington: IPPS Final Rule: Comment and Analysis
The long-awaited and highly anticipated Inpatient Prospective Payment System Final rule was released late Tuesday afternoon, September 2nd. Due to the rule being published Tuesday, Sept. 2, you and your team have precious little time to prepare for these changes since the IPPS becomes effective Oct. 1, 2020.
Joining us today for this special Talk Ten Tuesdays is Stanley Nachimson is a former CMS career professional and is the founder of Nachimson Advisors, LLC; and Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC.
playlist_add
Sep 1, 2020
CMS Requires Positive COVID-19 Test Results for 20% Medicare Add-on Payment
The Centers for Medicare & Medicaid Services (CMS) started rolling out post-payment audits again, as of Aug. 3, but now – after finding inconsistencies in the accuracy of some COVID-19 tests, and considering the fact that CMS has been paying an additional 20 percent to providers and facilities “treating patients with COVID or testing for COVID” – the agency has enacted a new mandate to qualify for the increased reimbursement.
During the next live edition of Talk Ten Tuesdays, Terry Fletcher, a nationally recognized professional coder and auditor, reports on the controversy surrounding our lead story.
The podcast also features these other segments:
* *RegWatch:* Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, reports on the latest regulatory news coming out of Washington, D.C.
* *Tuesday Focus: *2021 E&M Guideline Changes: Grant Huang, a consultant and auditor for DoctorsManagement, w…
playlist_add
Aug 25, 2020
EXCLUSIVE: Sleeping Patterns Gone Awry Amid the COVID-19 Pandemic
Plenty of time at home. Self-isolation. Binge-watching television shows. No commuting. Working remotely.
You would think that with all the time spent at home these days, folks would be getting more and better sleep, right? Wrong!
The truth is, according to Dr. Nick van Terheyden, that there are daunting obstacles to getting a good night’s sleep, with all the additional worries and fear induced by the COVID-19 pandemic and associated challenges in our economy and society. Reporting our lead story during this edition of the long-running Talk Ten Tuesdays weekly Internet radio broadcast will be “Dr. Nick the Incrementalist,” founder of Incremental Health, who has previously reported here that sleep is “this amazing new treatment that allows you to live longer, improves your memory, makes you more creative and slimmer, (and) decreases (risk of) cancer, dementia, infections, heart disease, strokes, and diabetes.” Now, if only there were a vaccine for sleep disorder.
The live br…
playlist_add
Aug 18, 2020
EXCLUSIVE: Dissecting the 2021 OPPS Proposed Rule
It’s out and it’s already creating controversy: the Centers for Medicare & Medicaid Services (CMS) Outpatient Prospective Payment System (OPPS) proposed rule, which becomes effective January 2021. The rule, issued Aug. 4, would eliminate the Medicare inpatient-only list of services while increasing the number of Ambulatory Surgical Center (ASC)-eligible procedures. The rule would also increase 340B payment cuts, and it looks to overhaul the hospital star-rating system.
It’s an interesting time for such changes, amid the impact of COVID-19. Dissecting the OPPS proposed rule during the next edition of Talk Ten Tuesdays will be Susan Gatehouse, founder and CEO of Axea Solutions.
The live broadcast will also feature these other segments:
* *CDI Report: *Senior healthcare consultant Glenn Krauss, founder and creator of Core-CDI.com, files the CDI report, in which he’s expected to discuss what he calls the stagnation of clinical documentation integrity (CDI) as a result of visio…
playlist_add
Aug 11, 2020
COVID Counseling: Now a Payable Compliance Risk
The Centers for Medicare & Medicaid Services (CMS) has announced two new payment initiatives, with one being the use of "counseling" to help stop the spread of COVID-19.
CMS will make payment available to physicians and providers to counsel patients at the time of COVID-19 testing about the importance of self-isolation after they are tested, and prior to the onset of symptoms. However, to get reimbursed for these services, there are protocols to follow, eligible providers to consider, and place-of-service rules. During the next live edition of Talk Ten Tuesdays, Terry Fletcher, nationally recognized professional coder and auditor, will report our lead story.
The live broadcast will also feature these other segments:
* *Tuesday Focus: COVID and Caregiver Parents:* With schools opening, healthcare workers face a daunting dilemma as they plan for their children to return to class. The impact to healthcare workers, specifically those who are unable to work remotely while they home-sch…
playlist_add
Aug 4, 2020
E&M: The Good. The Bad and the Ugly
COVID-19 is a disruptor of giant proportions. Case in point: The lead story for tomorrow’s Talk-Ten-Tuesdays was the ongoing COVID-19 pandemic, featuring Dr. John Foggle, who has spent the last three months working on the front lines in an urban, academic medical emergency department, treating COVID patients. Dr. Foggle had to cancel because he was asked to lecture on the deadly virus at Walter Reed National Medical Center.
So, given the attention being given to the coronavirus, it’s not surprising that evaluation and management (E&M) guideline changes for 2021 could be overlooked. That’s why we asked Shannon DeConda to share additional insight on these changes taking place in four short months.
The live broadcast will also feature these other segments:
* *Mental Health Report:* Nationally renowned psychiatrist H. Steven Moffic, MD will report on burnout among frontline nurses caring for hospitalized patients suffering from the coronavirus, recognizing that more often than n…
playlist_add
Jul 28, 2020
EXCLUSIVE: Coding Sequela to COVID-19
One day she’s consulting in Los Angeles. The next day she’s back in Indiana, with upcoming client calls scheduled at hospitals and physician practices in nearly every U.S. city and small town. Her frequent flyer miles would qualify for a round-trip to Mars.
High-flying and always in demand as a speaker, Deborah Grider came crashing down, diagnosed with COVID-19 earlier this year. She’s recovering now – enough so that she wrote a personal account of her COVID ordeal for ICD10monitor. Grider will report on coding sequelae of COVID-19.
The podcast also feature these other segments:
* *CDI, Past, Present, and Future: The Series:* Nationally recognized clinical documentation integrity (CDI) expert Cheryl Ericson, clinical program manager for Iodine Software, launches an exclusive new series for ICD10monitor and Talk Ten Tuesdays that traces the evolution of CDI, noting that although the practice has evolved, the metrics haven’t.
* *The Coding Report:* Laurie Johnson report…
playlist_add
Jul 21, 2020
Preventative Care vs E/M Problem-Oriented Services
Choosing the proper office visit code can be confusing unless you fully understand rules between preventative medicine and evaluation and management (E&M) coding. Knowing the difference between preventive visits, with its many procedural services and bundled service codes, and E&M visits with its complicated coding and documentation guidelines, is imperative to correct office visit coding.
This week on Talk Ten Tuesdays we are joined by Healthcare Coding and Reimbursement Consultant and coding auditor Terry Fletcher, who reports on Preventative Medicine vs. E&M codes
The live broadcast will also feature these other segments:
* *The Coding Report:* Laurie Johnson reports the OIG update for coding sever malnutrition.
* *News Desk: *Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
* *Tuesday Focus:* Beth Wolf reports the latest on managed care denials for malnutrition.
* *TalkBack:* Erica Remer,* *MD, founder and…
playlist_add
Jul 14, 2020
Telehealth: Could this be the New Normal?
The use of telehealth has surged during the coronavirus pandemic, with the technology spreading far and fast. Doctors and patients alike must be wondering, 'is the beginning of a whole new kind of doctor–patient relationship'? One that will transform health care systems? With the uptick in the use of telehealth the Office of Inspector General (OIG) and Center of Medicare and Medicaid Services (CMS) has added Telehealth to the list of audits due to data analysis and non-compliance.
Joining us this week for Talk Ten Tuesdays will be Terry Fletcher who discuss the downfalls and keeping Telehealth compliant and in perspective.
The the podcast features these other segments:
* *The Coding Report:* Laurie Johnson reports on FY21 ICD-10-CM new codes and updated diagnosis guidelines.
* *News Desk: *Timothy Powell, anchors the Talk Ten Tuesdays News Desk.
* *RegWatch: *Stanley Nachimson has the latest regulatory news and reports on the recently published CMS rules on payments for ES…
playlist_add
Jun 30, 2020
The Ins and Outs of Outpatient CDI Programs
Outpatient clinical documentation improvement (CDI) programs have moved into the mainstream, as hospitals and healthcare systems continue to embrace consulting companies’ push into the outpatient arena. As the CDI profession matures and the market for CDI consulting becomes more competitive and less lucrative, these companies have identified a new long-term revenue stream associated with consulting engagements, in addition to software.
Joining us this week onTalk Ten Tuesdays will be Glenn Krauss, CEO and Founder of Core- CDI, to discuss the effectiveness of outpatient clinical documentation improvement (CDI) programs.
The live broadcast will also feature these other segments:
* *Tuesday Focus: *Gloryanne Bryant, reports on CPT codes for Remote Patient Monitoring in relation to COVID19.
* *The Coding Report:* Laurie Johnson reports on coding obesity 3.
* *News Desk: *Timothy Powell, anchors the Talk Ten Tuesdays News Desk.
* *TalkBack:* Erica Remer,* *MD, founder and pr…
playlist_add
Jun 23, 2020
Let’s Talk Data - HHS Issues Requirements of Additional Data and Timely Submission for COVID-19 Testing
As the country begins to reopen, it is essential to have clear and accurate data for leadership to make informed decisions during the phased reopening. The U.S. Department of Health and Human Services (HHS) has recently announced guidelines for additional data to be reported to HHS by laboratories along with COVID-19 test results. These guidelines allow for standardization of reporting and ensure comprehensive and nearly real-time data for COVID-19 decision-makers.
During this episode of Talk Ten Tuesdays, Susan Gatehouse will discuss the disproportionate impact of COVID-19 on specific individuals, such as minorities and the elderly, and the need to provide more detailed data to public health experts on a real-time basis.
The podcast will also feature:
* *Tuesday Focus: *Terry Fletcher, nationally recognized professional physician coder and auditor gives us tips and tricks on how to avoid an audit.
* *The Coding Report:* June is Alzheimer's and brain awareness month, and Laurie…
playlist_add
Jun 16, 2020
EXCLUSIVE: Treating ICU COVID-19 Patients: Lessons Learned About Teamwork
umbersome yet secure, your PPE is firmly in place as you shadow Dr. David Jury, similarly attired, as he makes his rounds in the ICU, explaining to you the handoff from his overnight telemedicine colleague…
Join for a remarkable, albeit virtual, journey into an ICU unit at the famed Cleveland Clinic, as our Talk Ten Tuesdays special guest Dr. David Jury describes his role as an anesthesiologist and critical care physician dealing with COVID-19 patients.
“I love what I do,” Jury wrote in a recent essay for FrontLine Friday, published by RACmonitor. “I'm intellectually stimulated, emotionally rewarded, and challenged at the same time nearly every day. COVID-19 brings a new set of challenges to my occupation, but I can't imagine doing anything else.”
The live broadcast will also feature these other segments:
* *Tuesday Focus:Codes that Spark Interest:* Gloryanne Bryant, nationally recognized health information management (HIM) authority, will report on two ICD-10-CM codes…
playlist_add
Jun 9, 2020
EXCLUSIVE: Post-Pandemic Payer Contracting
When your team comes to the negotiating table with commercial payers this year, they’ll be doing so in the new normal: the coronavirus pandemic.
Whether contract negotiations come during or toward the end of this country’s most devasting healthcare crisis in a century, this will be a whole new ballgame. Having wreaked havoc on institutions, policies, and procedures, the lingering effect of the pandemic is expected to bring to the forefront unprecedented financial and public health challenges for both payers and providers, affecting the types of agreements both parties can strike.
Reporting our lead story is Terry Fletcher, nationally recognized professional physician coder and auditor. Fletcher will discuss points of negotiation and trends that could impact payor-provider negotiations.
The live broadcast will also feature these other segments:
* *Tuesday Focus:* Susan Gatehouse reports on the need to focus on your compliance plan and isolate key areas related to COVID-19 to e…
playlist_add
Jun 2, 2020
Physician Queries Pending COVID-19 Test Results
“In my opinion, as a physician and an ex-physician advisor, I can categorically assure you that it would irritate a provider to get queried to confirm a diagnosis they had already made clinically and documented in a codable format,” writes Erica Remer, MD, Talk Ten Tuesdays program host-turned-correspondent, who will be reporting our lead story during this edition of Talk Ten Tuesdays. “I agree with developing facility-specific coding guidelines, but they should be sensible and reasonable,” Remer added.
The podcast also feature these other segments:
* *Tuesday Focus:* Holly Louie reports on how coders are encountering inadequate physician documentation, flawed facility policies, and misinterpretations of guidelines, all of which are creating barriers, errors, and problems for accurate diagnosis reporting.
* *RegWatch: *Stanley Nachimson reports on the latest regulatory news coming out of Washington, D.C.
* *The Coding Report:* Laurie Johnson has an update on the deadl…
playlist_add
May 19, 2020
EXCLUSIVE: Missing in Action: Addendums to the Record
If physician documentation is missing or does not support the level or evaluation and management (E&M) service billed, surgery performed, or durable medical equipment (DME) issued, an addendum should be requested from the physician. A valid addendum must be received before the claim is submitted.
Reporting our lead story during this of Talk Ten Tuesdays will be Terry Fletcher, nationally recognized professional physician coder and auditor. Fletcher reports on the need to know how to correctly make these changes, but also, to know the difference between a "late entry" and an addendum to a medical record – and how Medicare's Program Integrity Manual relates it to reimbursement, compliance, and best practices.
The podcast also feature these other segments:
* *CDI Report:* Robert Kopec, MD, reports on when physician queries are appropriate during the current coronavirus pandemic. Dr. Kopec is the medical director of infection prevention and control at Morton Plant Mease in Florida.…
playlist_add
May 12, 2020
EXCLUSIVE: Safeguarding COVID-19 Reimbursement
Waivers, modifiers, lab tests, multiple diagnosis codes: they constitute layer upon layer of intricacies that could get in way of your reimbursement. That is why accurate COVID-19 coding cannot be overlooked when ensuring appropriate compensation and safeguarding claims against third-party payer audits.
Reporting our lead story during this edition of Talk Ten Tuesdays is Susan Gatehouse, founder and CEO of Axea Solutions.
The live broadcast will also feature these other segments:
* *COVID-19 Telehealth Update: *CMS has issued two interim final rules, including expansion and relaxation of guidelines for telehealth services. The first was issued on March 30, the second on April 30. Kathy Pride, executive vice president of coding and documentation services for Panacea Health, will report on what has changed and where to look for guidance.
* *Mental Health Report:* H. Steven Moffic, MD, returns to the broadcast to report on the impact of climate change on mental health – part of…
playlist_add
May 5, 2020
EXCLUSIVE: COVID-19 Report: Post-Pandemic Fraud and Abuse Coming Soon
It’s coming. And it could soon be spreading, as is the coronavirus: healthcare fraud and abuse. After all, there’s lots of money involved, at a time when waivers have been issued and rules relaxed, as the nation’s healthcare system focuses on fending off COVID-19. These changes include FaceTime, Skype, and telephone calls being reimbursed as telehealth and telemedicine services: a factor that can lead to fraud and abuse on scale not likely to be seen ever before the deadly virus upended processes, practices, and lives.
The live broadcast will also feature these other segments:
* *RegWatch: *Stanley Nachimson, reports on the latest regulatory news coming out of Washington, D.C.
* *Mental Health Report:* H. Steven Moffic, MD, reports on the disparities in the delivery of mental healthcare, evoking the memory of late jazz legend Billie Holiday’s eerily prescient version of the song “Strange Fruit.”
* *The Coding Report: *Laurie Johnson has an update on the deadly cor…
playlist_add
Apr 28, 2020
EXCLUSIVE BROADCAST: Under the COVID Spell: New Definition for PHI
Most of us are working from home now. That’s quite amazing. During the month of July 2019, an estimated total of 4.7 million folks telecommuted, either full or part-time.
Fast forward to the national stay-at-home edict, and now, according to Global Workplace Analytics, those working at home could possibly number 75 million.
So, what new privacy concerns are emerging, with healthcare professionals now working remotely as a result of the lockdown? How is it possible to stay alert, fit, and nimble, while at the same time, being conscious of your work product?
Reporting our lead story during this edition of Talk Ten Tuesdays, while remaining in self-isolation, is Rose Dunn, past president of the American Health Information Management Association (AHIMA) and the chief operating officer for First Class Solutions.
The live broadcast will also feature these other segments:
* *Healthcare Data Report:* Amid the coronavirus pandemic, the need for reliable health information has never bee…
playlist_add
Apr 21, 2020
EXCLUSIVE BROADCAST: CDI Increasing in Importance During the COVID-19 Pandemic
The costs of managing prolonged ICU stays for COVID-19 patients, combined with lost revenue from decreased ambulatory visits and the cancellation of elective procedures, will have health systems and provider groups emerging from the ongoing pandemic with significant financial challenges.
It will be more important than ever to ensure that clinical documentation reflects the true complexity of care being delivered. Reporting our lead story during this edition of Talk Ten Tuesdays will be Matt Lambert, MD, an emergency medicine physician and the chief medical officer for Curation Health.
The live broadcast will also feature these other segments:
* *Mental Health Report:* H. Steven Moffic, MD, one of America’s foremost psychiatrists, returns to the broadcast to report on the impact of climate change on mental health – part of an exclusive series he is authoring for ICD10monitor.
* *Tuesday Focus: *The Centers for Medicare & Medicaid Services (CMS) recently announced expanded co…
playlist_add
Apr 14, 2020
Medical Necessity versus Medical Decision-Making
Medical decision-making (MDM) and medical necessity are not the same thing. MDM specifically refers to the complexity of establishing a diagnosis and/or selecting a management option. Medical necessity refers to the appropriateness of the service provided for a certain condition. But which determines how you get reimbursed, when many healthcare professionals use these terms interchangeably?
The live broadcast will also feature these other segments:
* *Mental Health Report:* H. Steven Moffic, MD, one of America’s foremost psychiatrists, returns to the broadcast to report on how best to test your survival skills during this challenging time in our daily lives.
* *Tuesday Focus: *Susan Gatehouse, founder and CEO of Axea Solutions, reports on the Families First Coronavirus Response Act enacted on March 18, the Act was passed in response to the COVID-19 pandemic.
* *The Coding Report:* Laurie Johnson has an update on the deadly coronavirus that continues to dominate internationa…
playlist_add
Apr 7, 2020
EXCLUSIVE: World Health Day in the Midst of COVID-19
The confluence of the global COVID-19 pandemic and the World Health Organization (WHO) designation of April 7 as World Health Day is fast approaching.
Nonetheless, the organization is asking its global partners to take the time to recognize the work of nurses and midwives, acknowledging the “critical role they play in keeping the world healthy,” marking the raison d'être for the International Year of the Nurse and Midwife.
Reporting our lead story during this edition of Talk Ten Tuesdays Lorraine Fernandes, president of the International Federation of Health Information Management Association (IFHIMA), who says that “World Health Day gives us a unique opportunity to explore the ways IFHIMA supports their 23 member nations and other members, including individuals, corporate and educational institutions.” Fernandes will also report on initiatives to advance the IFHIMA mission: “a healthy world enabled by quality health information.”
The live broadcast will also feature th…
playlist_add
Mar 31, 2020
EXCLUSIVE: Social Determinants of Health and 2021 E&M Codes
Eighty percent of what influences a person’s health is related to non-medical issues such as food, housing, upbringing, social support, and income. These socioeconomic and psychosocial circumstances are known as the social determinants of health (SdoH). With the goal of allowing physicians more time with their patients, the American Medical Association (AMA) has made significant revisions to the Office and Other Outpatient Services New and Established Evaluation & Management (E&M) categories for 2021.
During the next live edition of Talk Ten Tuesdays, Collen Deighan will report on what you need to know about this unique coding topic, and how the SDoH are addressed in the medical decision-making component of these revisions to drive proper payment and impact all patients’ health and well-being.
The live broadcast will also feature these other segments:
* *The Coding Report:* Laurie Johnson will have an update on the deadly coronavirus that continues to dominate international as…
playlist_add
Mar 25, 2020
Capturing Revenue for Care Management Services
What are care management services, and are you capturing revenue associated with them?
Transitional care management (TCM), chronic care management (CCM), advance care planning (ACP), and behavioral health integration are among services you may already be providing for your patients. Good news: you can be paid for those services, as you’ll discover during the next live edition of Talk Ten Tuesdays when nationally-recognized professional physician coder and auditor Terry Fletcher reports our lead story.
The live broadcast will also feature these other segments:
* *The Coding Report:* Laurie Johnson will have an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
* *News Desk: *Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
* *Special Report*: Amid the global pandemic of COVID-19, Dennis Jones of Montefiore Nyack Hospital gives us an update of the…
playlist_add
Mar 17, 2020
C&M Virtual Meeting: Will there be an Official Code for EVALI?
Will there be a code for EVALI? Or the use of e-cigarettes? Or one for the deadly coronavirus that the World Health Organization has now declared as a pandemic?
In light of the coronavirus outbreak, the ICD-10 Coordination and Maintenance Committee (C&M) meeting will be online only and convene Tuesday, March 17. The virtual meeting brings together representatives from the Centers for Medicare and Medicaid Services (CMS), the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS), various medical societies, medical device vendors, and the general public.
The live broadcast will also feature these other segments:
* *Tuesday Focus:* Dr. Moffic, one of America’s foremost psychiatrists, continues his reporting on the rising world temperature and its impact on mental health.
* *Special Report: *The World Health Organization has declared that the global coronavirus outbreak is now a pandemic. Given the international scope of the crisis and th…
playlist_add
Mar 10, 2020
Helping Transgender Patients Understand their Coverage and Rights
There are HIPAA privacy rights that reach farther than those of the average patient. And there are privacy provisions in the Patient Protection and Affordable Care Act (PPACA) that prohibit discrimination against this population of patients.
But do these prevent discrimination against transgender patients? During this edition of Talk Ten Tuesdays, we asked nationally-recognized professional physician coder and auditor Terry Fletcher to report on the insurance policies from state to state on what cannot be automatically excluded.
The podcast also includes these other segments:
* *Special Report: *Nationally prominent psychiatrist and author H. Steven Moffic, MD, returns to the broadcast to report on the intersection of the coronavirus and the rise of racism directed toward Asians and Asian-Americans.
* *The Coding Report:* Laurie Johnson has an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
* *Tuesday Focus: Data…
playlist_add
Mar 3, 2020
Patient Privacy and the International Response to Coronavirus
With more cases of the novel coronavirus (COVID-19) being reported in countries outside of China, where the deadly virus has claimed the lives of a reported 2,771, world health leaders are preparing for a global pandemic that will provide a tsunami of health information for use by governments, world health agencies, and researchers, to hopefully control the future spread of the disease, develop vaccines, and share new learning to prevent future outbreaks.
That’s a good thing. But what about the privacy of that health information? Even in a crisis, health practitioners have a responsibility to protect privacy, which is a matter of trust between health professionals and the patient/consumer. And that is why we asked Lorraine Fernandes, president of the International Federation of Health Information Associates (IFHIMA), to report on this crucially important healthcare issue.
The live broadcast will also feature these other segments:
* *RegWatch:* Stanley Nachimson reports on the la…
playlist_add
Feb 25, 2020
Price Transparency is Coming to a Chargemaster Near You
The Trump Administration has grand plans to make healthcare prices more transparent, hoping a little bit of light will help lower the high costs of U.S. healthcare.
In new regulations, the administration is requiring hospitals to disclose, for the first time, the prices they negotiated with health insurers for a wide range of services, as well as the prices they charge patients who are paying with their own money.
But is it going to make any difference? We ask nationally-recognized professional physician coder and auditor Terry Fletcher to check with some health policy experts for their opinions about the new price transparency regimes. Terry gives you the best and worst-case scenarios, as well as the more realistic predictions, as this new rule is enforced during 2020.
The podcast also features other segments:
* *Tuesday Focus:* Is it extravasation or infiltration? Knowing the difference is important for coders – and, actually, all healthcare professionals. Susan Gatehouse, fo…
playlist_add
Feb 18, 2020
Analyze This: Healthcare Data and Solastalgia on Mental Health
Dr. Nichols, who is authoring an exclusive four-part series on healthcare data for ICD10monitor, reports on the crucial search for reliable health information, noting that without it, all stakeholders are at significant financial and/or personal health risks.
Dr. Moffic, one of America’s foremost psychiatrists, reports on the intriguing subject of solastalgia – the rising world temperature, and its impact on mental health. Dr. Moffic is writing an exclusive series on the topic for ICD10monitor, and Tuesday’s report will be his second in his remarkable series.
The podcast also features these other segments:
* *RegWatch:* Stanley Nachimson reports on the latest Medicare Advantage news coming out of Washington, D.C.
* *The Coding Report:* Laurie Johnson has an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
* *News Desk: *Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Tal…
playlist_add
Feb 11, 2020
Million-Dollar Coding Mistakes – and How to Avoid Costly Errors
While facilities and practices are concentrating on making critical changes in 2020 and 2021, it is important not to lose focus on the basics of correct coding. CPT® and ICD-10-CM coding errors can cost healthcare providers millions of dollars in lost revenue, but also, those errors can trigger compliance issues that could lead to audits.
Reporting our lead story during this edition of Talk Ten Tuesdays is a nationally recognized professional physician coder and auditor Terry Fletcher.
The podcast also features these other segments:
* *Special Report: The EHR Source of Truth: *Is your organization’s electronic health record (EHR) the source of clinical truth? Exploring that question is Susan Gatehouse, founder and CEO of Axea Solutions, who reports on how documentation and coding audits can uncover deficits within an EHR.
* *Tuesday Focus*: How does one avoid compromising on quality when faced with reimbursement cuts? It’s an issue that we hear about frequently, and that i…
playlist_add
Feb 4, 2020
The Coding Dilemma: Reporting Deep-Tissue Pressure Injuries
The release of the fiscal year (FY) 2020 Official Guidelines for Coding and Reporting (OCG) has resulted in confusion and apprehension surrounding the intent of the new guideline related to the new ICD-10-CM codes for pressure-induced deep-tissue damage or deep-tissue pressure injury (L89.-6).
The ambiguity stems from what appears to be conflicting advice found within the coding guidelines (I.C.12.a) regarding pressure ulcer stage codes, as you’ll learn when Lisa Baris, Director of Health Information Management (HIM) and Healthcare Clinical Documentation Improvement (CDI) for Nuance Communications reports our lead story during this edition of Talk Ten Tuesdays.
The podcast will also feature these other segments:
* *CDI Report*: In order to effectively challenge DRG reassignments, facilities should retain a team of physicians that can review the cases and generate clinically robust appeal letters that adhere to the Official Guidelines for Coding and Reporting for ICD-10-CM/PCS an…
playlist_add
Jan 28, 2020
Prior Authorization Headaches: A Pain Point for Providers and Practices
With prior authorization (PA) posing a significant pain point for healthcare providers and a major headache for most practices, Talk Ten Tuesdays asked Terry Fletcher to report on this troubling issue, especially in light of the WEDI survey results posted this week, revealing that 84 percent of providers reported that the number of medical services requiring PA has increased.
The PA process, heavily dependent on manual tasks, has grown to become one of the biggest frustrations for physicians in group practices. During this Tuesday’s edition, you and your team will receive the latest update on how the Centers for Medicare & Medicaid Services (CMS), commercial payors, and other organizations are tackling this process to better serve patients.
The podcast will also feature these other segments:
* *Special Report:* As organizations continue to evaluate the most efficient and cost-effective ways to streamline operations, there is increasing movement towards single-source physician an…
playlist_add
Jan 21, 2020
The Coding World in 2020: Part II
Talk Ten Tuesdays is continuing its reporting on the unprecedented changes occurring this decade in the world of healthcare coding.
Coders and health information management (HIM) professionals need to retool in order to meet new challenges brought about by artificial intelligence, as well as by social and political changes already underway. With profound healthcare upheaval taking place here and globally, we asked Ginna Evans, the new president and board chair of the American Health Information Management Association (AHIMA), to share her 2020 agenda for the group, which represents more than 103,000 HIM specialists in the United States and around the world.
The live broadcast will also feature these other segments:
* *Special Report: *Appropriate Use Criteria (AUC), a Medicare program becoming effective January 2021, is expected to be a huge undertaking for organizations reported by Susan Gatehouse, founder and CEO of Axea Solutions.
* *The Coding Report:* Holly Louie, will rep…
playlist_add
Jan 14, 2020
The Coding World in 2020: Look Ahead to ICD-10-CM Clinical Coding Challenges
The coding world in 2020 will be a new landscape of challenges for coders as well as health information management (HIM) professionals. And to help you and your team prepare for what lies ahead in the New Year, Gloryanne Bryant, a well-known, national coding and HIM leader, returns to the Talk Ten Tuesdays broadcast with her report on six major issues confronting coders this year and beyond.
The podcast will also feature these other segments:
* *Tuesday Focus: *Nationally recognized professional physician coder and auditor Terry Fletcher, a member of the ICD10monitor editorial board, reports how why “incident-to billing” is under siege – and could go the way of Google Glass.
* *The Coding Report:* Laurie Johnson reports on the latest coding news that has been making headlines. Johnson is a nationally recognized coding authority and senior healthcare consultant at Revenue Cycle Solutions, LLC.
* *Mental Health and Climate Change: *Nationally renowned psychiatrist and aut…
playlist_add
Dec 10, 2019
In the Holiday Spirit of Giving: Free Advice to Avoid Claim Denials
In the true holiday spirit of giving, during this edition of Talk Ten Tuesdays weekly broadcast will provide you and your team with some free advice on how to avoid claim denials – especially if you don’t have a robust claim denials management process.
Unfortunately, the majority of healthcare organizations encounter claim denials on a regular basis, often habitually. Though some claim denials may be unavoidable, ineffective claim denials management can result in even more lost revenue, as you’ll learn when Susan Gatehouse, founder and CEO of Axea Solutions, returns to the broadcast.
The live broadcast will also feature these other segments:
* *The Coding Report:* Laurie Johnson reports on the latest coding news that has been making headlines. Johnson is a nationally recognized coding authority and senior healthcare consultant at Revenue Cycle Solutions, LLC.
* *Tuesday Focus: Mental Health: *During this holiday season, you and others are likely looking forward to festivi…
playlist_add
Dec 3, 2019
Beyond CCs and MCCs: Say Hello to HCCs and APR-DRGs
There was a time when the coin of the realm in the world of coding was knowledge of complications or comorbidities (CCs) and major complications or comorbidities (MCCs).
But 10 years later, the industry has changed rapidly, and to avoid going the way of the dinosaur, coders today need to embrace all patients’ refined diagnosis-related groups (APR-DRGs) and hierarchical condition categories (HCCs). A coder’s staying power lies beyond MS-DRGs, according to Kristi Pollard, who reports our lead story during this edition of Talk Ten Tuesdays.
The live broadcast will also feature these other segments:
* *The Coding Report:* Laurie Johnson reports on the latest coding news that has been making headlines. Johnson is a nationally recognized coding authority and senior healthcare consultant at Revenue Cycle Solutions, LLC.
* *Tuesday Focus:* A recent meta-analysis of studies published by the Journal of the American Medical Association (JAMA) on the effects of nutritional support on c…
playlist_add
Nov 26, 2019
Ten Going on Eleven: Help is Here
As we conclude our month-long Talk Ten Tuesdays series, “Ten Going on Eleven,” we do so with a special appearance by Valerie Watzlaf, board president and chair of the American Health Information Management Association (AHIMA).
Valerie, vice chair of education and associate professor within the Department of Health Information Management in the School of Health and Rehabilitation Sciences at the University of Pittsburgh, will discuss how AHIMA is helping the health information management (HIM) profession prepare for the implementation of ICD-11.
The live broadcast will also feature these other segments:
* *The Coding Report: Ten Going on Eleven:* Laurie Johnson will report on the need to be conversant with the new code changes, especially if there is no physical coding book. Johnson is a nationally recognized coding authority and senior healthcare consultant at Revenue Cycle Solutions, LLC.
* *Ten Going on Eleven: *George Vancore, a system consultant for Florida Blue (Blue C…
playlist_add
Nov 19, 2019
Ten Going on Eleven: The Role of HCC Coding
Exclusive reporting on ICD-11 and the need for early preparation for the new code set continues at ICD10monitor and Talk Ten Tuesdays.
Among those skills that will need to be honed is hierarchical classification category (HCC) coding. HCCs thrive on specificity. Although it was thought that ICD-10 delivered the ultimate level of specificity, ICD-11 is expected to surpass ICD-10 in that area. But HCCs require documentation, and the key looming question remains, at this time, unanswered: will the documentation rise to meet the specificity level needed under ICD-11?
Nationally recognized health information management (HIM) expert and past American Health Information Management Association (AHIMA) President Rose Dunn, the chief operating officer for First Class Solutions, will explore that issue during the next edition of Talk Ten Tuesdays.
The live broadcast will also feature these other segments:
* *Mental Health Report: *Although the industry hasn’t turned the corner on reducing…
playlist_add
Nov 12, 2019
Ten Going on Eleven: Data Mining: A Must-Have Skill for Coders
Data mining is the next frontier in healthcare – and it’s here.
The creation of revenue management and data management educational tracks in health information technology (HIT) associate degree programs, plus the use of artificial intelligence (AI) to assign ICD-11 codes, means that data mining skills are a must-have for coding specialists, requiring extensive education.
To help assist this major educational initiative, ICD10monitor and Talk Ten Tuesdays are producing a series of articles and broadcast segments on medical coding data mining. Published by ICD10monitor, in association with the author, educator, and consultant Lolita Jones, this exclusive series will tackle the topic of data mining in an easy-to-understand format that will also include real-life medical coding data mining examples.
The goal is simple. We want coding specialists to embrace data mining, so they can excel in their new roles as coding validators when ICD-11 is implemented. Launching this new series dur…
playlist_add
Nov 5, 2019
Ten Going on Eleven: The Train Has Left the Station
ICD-11 is on track to arrive here in the U.S. sooner than most expected – 2022. In fact, global experts convened in Switzerland to create a roadmap to advance the digital health ecosystem.
For the very latest update on ICD-11, the World Health Organization’s (WHO’s) Robert Jakob, MD, team leader of classifications and terminologies (ICD, ICF, ICHI), is today's Talk Ten Tuesdays special guest. Also joining the broadcast is Margaret Skurka, who has just returned from the WHO Family of International Classifications (WHO-FIC) meeting in Banff, Calgary, Canada, and discusses the latest on ICD-11 from both the U.S. perspective and a global perspective.
Skurka is past president of the International Federation of Health Information Management Associations, IFHIMA, and serves as the current IFHIMA/AHIMA representative to the WHO Family of International Classifications Education and Implementation Committee. That committee does work on ICD-11, as well as on improving the quality of coded…
playlist_add
Oct 29, 2019
Reasons Not to Believe DRG Denials
“In the hospital setting, we see multiple insurance denials on a weekly basis,” Lamon Willis recently wrote in an article for ICD10monitor.
“Teams of people route them to various departments for analysis and review. I have staff members who review the APC and/or DRG, along with coding criteria, to determine if we have properly fulfilled our duties as coders and to support the appeals process for the organization,” he continued. “My staff and I agree on one thing at the very beginning, and that is: don’t believe the denial.”
During this edition of Talk Ten Tuesdays, Willis, director of coding for Velocity Healthcare Collaborative, explains valid reasons for not necessarily believing in DRG denials by auditors.
The live broadcast will also feature these other segments:
* *The Coding Report: *Laurie Johnson, a senior healthcare consultant at Revenue Cycle Solutions, LLC, continues her exclusive reporting on the coding of e-cigarette lung injuries (vaping).* *
* *Tue…
playlist_add
Oct 22, 2019
Five Looking at Ten: Lessons Learned
Five Looking at Ten, the month-long series on ICD10monitor and Talk Ten Tuesdays that examines lessons learned since the nation’s healthcare system adopted ICD-10, will continue with a special guest appearance of Robert Tennant of the Medical Group Management Association (MGMA).
The broadcast also feature these other segments:
* *Five Looking at Ten: *Clinical Audits: Nationally recognized health information management (HIM) authority Gloryanne Bryant reports on lessons learned from clinical coding audits and selecting a coding vendor. *
*
* *Five Looking at Ten: *The Coding Report: Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on lessons learned as the nation prepares for the transition from ICD-10 to ICD-11, as well as the prerequisite training.
* *Revenue Cycle Report: *Tim Bavosi, vice president of consulting for RevSpring, reports on the root causes linked to claim denials.
* *News Desk: *Timothy Powell, compliance expert and…
playlist_add
Oct 15, 2019
Do EHRs Contribute to Patient Deaths?
There is ongoing concern that electronic health record (EHR) systems are one of the top contributing causes to patient deaths, complications, and erroneous care plans. During this edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher, a member of the ICD10monitor editorial board, reports on the growing issue of EHR-related errors.
The live broadcast will also feature these other segments:
* *The Coding Report:* Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on coding for influenza since flu season officially started Oct. 1.
* *Tuesday Focus: *Mortality versus Morbidity: The terms “mortality” and “morbidity,” along with “severity of illness (SOI),” are often interwoven. That’s wrong, as you’ll learn when Susan Gatehouse, CEO of Axea Solution, returns to the broadcast.
* *Five Looking at Ten: Out of the Blue (Early Payer Adoption): *Join us for this month-long series on…
playlist_add
Oct 8, 2019
Searching for Codes on Facebook
There’s growing concern in the healthcare industry regarding offshore and untrained staff getting their CPT® and ICD-10 codes from non-verified Internet sites such as Facebook, Twitter, and other social media platforms.
This practice aligns with another troubling trend: the use of Google by folks leveraging the Internet for self-diagnosis, doing so with a misdirected sense of trust in all things online while hoping to reach their own conclusions about their illness.
During this edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher reports on how, in this day and age of limited time with doctors, this practice can undermine the role of the physician.
The episode will also feature these other segments:
* *The Coding Report: *Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on the 2020 fiscal year’s proposed CC/MCC designation changes that did not happen in the Final Rule, but will be dis…
playlist_add
Oct 1, 2019
Five Looking at Ten: Lessons Learned
Five Looking at Ten is an upcoming month-long series on ICD10monitor and Talk Ten Tuesdays, through which we will examine what lessons have been learned since the nation’s healthcare system adopted ICD-10, which became effective Oct. 1, 2014. Each week, we will report on lessons learned as we approach year five – while at the same time, looking ahead to the implementation of ICD-11.
Joining us during this broadcast is our special guest is Denise Buenning, who, during the run-up to ICD-10, was the deputy director for the Centers for Medicare & Medicaid Services (CMS) Office of E-health Standards & Services.
The broadcast will also feature these other segments:
* *Five Looking at Ten - Coding Report: *Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on lessons learned as the nation prepares for the transition from ICD-10 to ICD-11, as well as the prerequisite training.
* FY20 IPPS Proposed Rule: https://www.govinfo.gov/content/pkg/FR-2019-…
playlist_add
Sep 24, 2019
Late Signatures for Medical Services: Can You Still Bill and Get Paid?
The Centers for Medicare & Medicaid Services (CMS) has published rules and guidance on the topic of a "completed medical record." But what if the provider didn't sign off on the note or authenticate it in the electronic health record (EHR) until after the fact? Is the record still considered complete, for billing and reporting purposes?
During this edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher reports on the need for complete medical records, including the proper documentation and a dated physician signature.
This podcast also features the following segments:
* *The Coding Report: *Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, hasTalk Ten Tuesdays coding report.
* *The CDI Report: *Susan Gatehouse, CEO of Axea Solutions, returns to the broadcast to report on the challenges associated with the proper reporting and documenting of the social determinants of health (SdoH).
* *News Desk:…
playlist_add
Sep 17, 2019
New ICD-10 Codes Coming Your Way
What new codes are coming your way? The ICD-10 Coordination and Maintenance Committee (C&M) met for two days this past week to discuss requests for ICD-10 code changes.
Laurie Johnson, an ICD10monitor editorial member and senior healthcare consultant for Revenue Cycle Solutions, LLC, reports on the public forum held Monday and Tuesday at the headquarters of the Centers for Medicare & Medicaid Services (CMS).
This episode also features these other segments:
* *Tuesday Focus:* Addicted Nation—Two major news stories this week underscored a nation whose citizens are caught in the grip of addiction: the tentative settlement agreement involving Purdue Pharma, makers of OxyContin, and the announcement that the federal government is considering a ban of flavors used in e-cigarettes in response to a surge in underage vaping. Six vaping deaths and some 450 possible cases of lung infection related to vaping have been reported nationwide. Nick van Terheyden, MD, AKA, “The Incrementalist,…
playlist_add
Sep 10, 2019
Smoking Cessation Programs: Coding for Reimbursement
Is your facility currently providing smoking cessation counseling and treatment? Did you know you can bill and get reimbursed for your services? It isn't just part of your standard evaluation and management (E&M) encounter. But who is covered? What are the CPT® and ICD-10-CM codes? What is the reimbursement and rules for payment?
Nationally recognized professional physician coder and auditor Terry Fletcher reports on the latest information about revenue opportunities for all specialty providers involved in smoking cessation programs.
The broadcast will also feature these other segments:
* *RegWatch: *Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, reports on the latest regulatory news coming out of Washington, D.C.
* *The CDI Report: *Mel Tully, vice president of clinical services and education at Nuance Communications’ health division, reports on the benefits of artificial intelligence (…
playlist_add
Aug 27, 2019
Time-Based E&M Coding and Reporting
There are rules to follow when you are using "time" as your element of support for any evaluation and management (E&M) encounter. If a physician elects to report the level of care based on counseling and/or coordination of care, then a number of factors must be in the patient's medical record.
During this edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher discusses the American Medical Association’s (AMA’s) rules, the position taken by Medicare, and how the electronic medical record (EMR) can actually assist you in your efforts.
But should time really be the new standard for supporting your patient encounters?
The broadcast also features these other segments:
* *Coding Report: *Speaking of E&M coding, 2020 proposed Medicare Physician Fee Schedule (MPFS) shows a significant shift from the 2019 version. Sally Streiber, president of Practical Coding Solutions, explores the changes, including removal of 99201, how levels of…
playlist_add
Aug 20, 2019
ICD-10-CM Coding for Transgender Patients
Gender dysphoria is quickly moving into America’s healthcare lexicon as LGBTQ+ families are rising in number at historic rates, prompting the emergence of alternative medical clinics that are providing services for the transgender patient community. As a result, coders have questions – specifically, about ICD-10-CM diagnosis codes.
During this edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher explains what codes to choose, how to understand them, and how to apply them to this new population of patient encounters.
The live broadcast will also feature these other segments:
* *Coding Report:* Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on the latest development in the baffling condition known as acute flaccid myelitis (AFM).
* *CDI Report: *Gloryanne Bryant, nationally recognized health information management leader, author, and clinical coding and documentation expert, reports…
playlist_add
Aug 13, 2019
The Art of the Physician Query
So how do you as a coding professional ensure your physician queries are effective and compliant? First, it’s important to understand when to query a physician, how to submit a query and the best way to get a reply from your provider.
During the next edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher will provide insight into this important and powerful communication tool.
The live broadcast will also feature these other segments:
* *The Coding Report:* Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, will have the Talk Ten Tuesdays coding report.
* *Tuesday Focus:* Rhonda Buckholtz, chief compliance officer for Century Vision Global, will report on the use of evidence-based medicine to influence CDI improvements.
* *News Desk:* Timothy Powell, compliance expert, and ICD10monitor national correspondent will anchor the Talk Ten Tuesdays News Desk.
* *TalkBack:* Erica Remer, MD, FACEP, C…
playlist_add
Aug 6, 2019
Burnout: Information for Coders and CDI Specialists
As reported by ICD10monitor, the World Health Organization (WHO) has classified physician burnout as an occupational phenomenon, while noting that it is not a medical diagnosis.
There are some estimates that more than half of physicians have experienced burnout. But what do coders and clinical documentation integrity specialists (CDISs) need to know about burnout among their physicians?
Reporting our lead story during this edition of Talk Ten Tuesdays will be Megan Cortazzo, MD, Medical Director for Clinical Documentation Improvement and Health Information Management at UPMC and Assistant Professor of Physical Medicine and Rehabilitation. Joining the conversation on burnout will be nationally prominent psychiatrist H. Steven Moffic, MD.
The live broadcast will also feature these other segments:
* *The Coding Report: *Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, has the Talk Ten Tuesdays coding report.
* *RegWatch: *Stanley Nachimson, former Cen…
playlist_add
Jul 30, 2019
Patient-Focused Coding: Using Codes to Tell the Patient’s Story
Has the art of telling the patient’s story through coding been lost?
So ponders Kristi Pollard, a senior coding consultant for the Haugen Group, who reports this intriguing story in this edition of Talk Ten Tuesdays. Pollard is expected to explain that, first and foremost, coders are storytellers who convey each patient’s medical story through codes.
The podcast also features these other segments:
* *The Coding Report: *Laurie Johnson, a senior healthcare consultant at Revenue Cycle Solutions, LLC, discusses World Hepatitis day on the Talk Ten Tuesday coding report.
* *The Dunn Report: *National health information management (HIM) expert and past American Health Information Management Association (AHIMA) President Rose Dunn returns to the broadcast with the sixth installment in her series on how HIM can play a role in other areas of the revenue cycle.
* *Tuesday Focus: *Rhonda Buckholtz, chief compliance officer for Century Vision Global, reports on a mystery code – ac…
playlist_add
Jul 23, 2019
Avoiding Confusion over Critical Care Services
What may seem relatively straightforward to some coders has been a headache, presenting confusion and ambiguity, for others, when it comes to charging for critical care services. During this edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher will focus not only on coding but also documentation compliance when reporting such services.
The broadcast also features these other segments:
* *The Revenue Cycle Report:* Bonnie S. Cassidy, nationally renowned health information management (HIM) authority, reports on the importance of ICD-10 coding in the revenue cycle.
* *Dateline Washington:* Leslie Krigstein, vice president of congressional affairs for the College of Health Information Management Executives (CHIME), reports on the latest healthcare news coming out of Washington, D.C.
* *News Desk: *Timothy Powell, compliance expert, and ICD10monitor national correspondent anchors the Talk Ten Tuesdays News Desk.
* *TalkBack…
playlist_add
Jul 16, 2019
2019 ICD-10-CM/PCS Coding Clinic Update
The ICD-10-CM/PCS update to the American Hospital Association’s (AHA’s) Coding Clinic for the second quarter of 2019 has been published, and there is plenty of news to report.
Each quarter, new advice and guidance are published by the AHA to address questions and challenges associated with clinical coding. The AHA Coding Clinic on ICD-10-CM/PCS is an “official” coding resource, and as such, it is recognized by regulators and auditors alike.
Reporting our lead story during thisTalk Ten Tuesdays is nationally recognized health information management leader, author, and clinical coding and documentation expert Gloryanne Bryant.
The broadcast also features these other segments:
* *Tuesday Focus:* A new national collaborative to advance interoperable social risk and protective factor documentation, titled The Gravity Project, was launched May 2, 2019. The Robert Wood Johnson Foundation has funded this partnering with the SIREN: the University of California San Francisco’s So…
playlist_add
Jul 9, 2019
Are HIM Coding Professionals Qualified to Query for Clinical Validity? Part III
During the sultry summer of 2018, a Talk Ten Tuesday listener asked if whether seasoned coding professionals were sufficiently trained and competent to interpret clinical terms and concepts from medical records. So the editorial team here at ICD10monitor published a story on the topic on July 17, 2018. Debra Beisel Benton, who at the time was working at Maricopa Integrated Health System as the HIM System Coding Educator, wrote the story. The topic solicited many comments, creating a contentious debate.
Now, one year later Talk Ten Tuesday checks in with Anny Pang Yuen who wrote a follow-up article for ICD10monitor in August of last year. Returning to the broadcast will be Debra Beisel Benton.
What changes have taken place since last year? How are AHIMA and AAPC responding to this debate? During the next edition of Talk Ten Tuesday, you’ll hear the very latest on this contentious issue when both Yuen and Beisel Benton report our lead story.
The live broadcast will also feature thes…
playlist_add
Jul 2, 2019
Serious Issues with Cloning Around
The dangers of cloned documentation can damage the perceived trustworthiness and integrity of the medical record for patient care. The current use of copy-and-paste functions in electronic medical record/health record (EMR/EHR) systems is a growing area of focus for government auditors. In fact, the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) has weighed in on this topic, as well as The Joint Commission and several of the Centers for Medicare & Medicaid Services (CMS) Medicare Administrative Contractor (MAC) payers. Reporting on this, our lead story during this edition of Talk Ten Tuesdays is a nationally recognized professional physician coder and auditor Terry Fletcher.
The live broadcast also features these other segments:
*The Coding Report:* Laurie Johnson reports on the latest ICD-10 coding news. Johnson is a senior healthcare consultant at Revenue Cycle Solutions, LLC.
*CDI Report: *Continually monitoring the clinical documentation improv…
playlist_add
Jun 25, 2019
A Physician’s Prescription for Avoiding ICD-10 Codes for Sleep Disorders
There are a plethora of ICD-10 codes for sleep disorders – as many codes for these diagnoses as sheep jumping over a fence. And with the approach of summer, there is the concordant expectation of summer insomnia.
“Sleep is not just a pillar of health, it is the foundation to health,” writes Nick van Terheyden, aka “Dr. Nick the Incrementalist,” founder of Incremental Healthcare, who reports our lead story.
Dr. Nick discusses the importance of sleep, which he describes as offering “the incredible benefits of this amazing new treatment that allows you to live longer, improves your memory, makes you more creative and slimmer, (and) decreases (risk of) cancer, dementia, infections, heart disease, strokes, and diabetes.”
The live broadcast will also feature these other segments:
* *The Coding Report: *Laurie Johnson report on ICD-10 coding for sleep disorders. Sleep disorders can be coded based on interruption in sleep patterns to substances that interrupt sleep. Johnson…
playlist_add
Jun 18, 2019
States Receive Low Scores in the 2019 Scorecard on State Health System Performance
The grades for America’s healthcare system are out, and the results are dismal, according to The Commonwealth Fund’s 2019 Scorecard on State Health System Performance, released Wednesday.
The Scorecard, according to The Commonwealth Fund, reveals that most states are losing ground on key measures related to life expectancy as premature deaths from suicide, alcohol, and drug overdose continue to increase. Among other findings, the Scorecard found that healthcare costs are placing an increasing financial burden on families across the nation.
Reporting our lead story during the next edition of Talk Ten Tuesdays will be David C. Radley, a senior scientist for The Commonwealth Fund's Tracking Health System Performance program. Dr. Radley and his team develop the national, state, and sub-state regional analyses on healthcare system performance and related insurance and care system market structure. He is also a senior study director at Westat, a research firm that supports the Scorecar…
playlist_add
Jun 11, 2019
Coding and Documenting Anticoagulation Management
Along with one of the most common blood-thinning medications in the world, taken daily to prevent blood clots, comes frequent checks called “pro-times” or international normalized ratio (INR) monitoring.
This has been taken for granted in the past, as the work involved for the physician to monitor such patients at least monthly (and sometimes more often) can be costly for a medical practice. However, in 2018, as Medicare continues to reinforce support for primary care and certain medical specialties like cardiology, anticoagulation management is now a payable service, which may be available for work that is already being done in your practice.
During this edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher reports on the importance of documentation to capture the new CPT® codes for home and outpatient INR monitoring services.
This broadcast will also feature:
* *The Coding Report: *The Centers for Medicare & Medicaid Se…
playlist_add
Jun 4, 2019
Coding Accuracy Assessment: Part II
The cascading implications of inaccurate ICD-10 coding are explored during this edition of Talk Ten Tuesdays. We are revisiting this timely and important subject, featured during the May 21 edition of the broadcast. Guest co-host Holly Louie returns to continue her reporting on how coding inaccuracies impact compliance and payment issues.
The live broadcast will also feature these other segments:
* *Tuesday Focus:* The trend of mobile monitoring and moving the intensive care monitoring unit out into the community to improve care, thus allowing people to age safely and gracefully in their homes, will be reported on when Nick van Terheyden, MD, AKA, “The Incrementalist,” returns to the broadcast.
* *RegWatch:* Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional turned well-known healthcare IT authority, reports on the latest regulatory news coming out of Washington, D.C.
* *News at 11:* Rhonda Buckholtz, chief compliance officer for…
playlist_add
May 21, 2019
Coding Accuracy Assessment: The News not Good
Central Learning is a web-based coding assessment and education application. Since 2016, the company has conducted an annual national coding review to measure ICD-10 coding accuracy and production.
The initial intent was to evaluate how coding accuracy and production fared using ICD-10, as compared to ICD-9. The common industry accuracy benchmark under ICD-9 was 95 percent.
The findings in 2018 indicated that the industry at large still lags far behind past expectations. In addition, as production under ICD-10 increases, accuracy decreases. Reporting our lead story during the next edition of Talk Ten Tuesdays will be Holly Louie, past president of the Healthcare Business and Management Association (HBMA) and guest co-host.
The live broadcast will also feature these other segments:
* *Tuesday Focus:* Justin Hammerling, president of Kapios Health and vice president of ProMedica, reports on the disconnect between doctors and coders when scheduling inpatient surgeries.
* *The CDI…
playlist_add
May 14, 2019
Advanced Care Planning: Now is Always a Good Time to Plan
Physicians and mid-level providers are having some serious conversations with patients regarding advanced care planning (ACP) – meaning the discussion of a serious illness and the next steps they need to take regarding advanced directives, hospice, skilled nursing, pre, and post-death arrangements, and more.
These discussions are now payable under most health insurance plans, including Medicare, but you need to be walked through the steps of these important conversations first, then consider the options, for coding, billing, and reimbursement. Most practices have been providing this important service for years, but have never charged for it.
Nationally recognized professional physician coder and auditor Terry Fletcher will be reporting our lead story during this edition of Talk Ten Tuesdays, she will discuss ACP directives and regulatory insight you need to get started.
The live broadcast will also feature these other segments:
* *Tuesday Focus: *The American Hospital Associati…
playlist_add
May 7, 2019
Computer-Assisted Coding and Artificial Intelligence: The Same, or Different?
If there’s an industry buzzword that is heard most often in today’s healthcare discourse, it might be “artificial intelligence” (AI).
And just as the advent of the computer presaged concerns about job loss, the same could be said today about AI, especially when it comes to coding. But before AI came into vogue, computer-assisted coding (CAC) and the use of natural language processing (NLP) appeared to be a potential job killer.
Reporting on AI and CAC during this edition of Talk Ten Tuesdays is Lamon Willis, Director of Coding for Velocity Healthcare Collaborative in central Georgia.
The live broadcast will also feature these other segments:
* *The Coding Report*: Laurie Johnson continues her reporting on the proposed 2020 Inpatient Prospective Payment System, proposed procedure codes and also has an update on the dramatic surge in the outbreak of measles in the U.S. Johnson is a senior healthcare consultant at Revenue Cycle Solutions, LLC.
* *Tuesday Focus: *Death by…
playlist_add
Apr 30, 2019
2020 IPPS Proposed Rule: Context, Perspective, and Analysis
Proposed changes to the Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System were posted late Tuesday by the Centers for Medicare & Medicaid Services (CMS).
And while the dust has yet to settle, the proposals are sending shockwaves through the coding and clinical documentation integrity (CDI) communities. Context, perspective, and analysis of the proposed IPPS rule will be provided during the next edition of Talk Ten Tuesdays.
The live broadcast will also feature these other segments:
* *The Coding Report:* Laurie Johnson reports on the proposed coding changes outlined in the IPPS rule. Johnson is a senior healthcare consultant at Revenue Cycle Solutions, LLC.
* *RegWatch: *Stanley Nachimson, former CMS career professional turned well-known healthcare IT authority, provides much-needed context on the proposed rule.
* *News Desk: *Timothy Powell, compliance expert, and ICD10monitor national correspondent anchors the Talk Ten…
playlist_add
Apr 23, 2019
Peer-to-Peer Reviews: Virtually Speaking
The patient’s physician requests the treatment advice of another physician consultant, but without a face-to-face encounter with the patient and that consultant. Is this a billable situation? Traditionally No. But since 2018 and even now, more specifically, CPT® codes in 2019, "virtual" peer reviews are a covered benefit for most payers. This is new territory when it comes to insurance coverage, especially since these services are not subject to telehealth rules or restrictions Medicare has put on other telemedicine services. What’s the solution? Nationally recognized professional physician coder and auditor Terry Fletcher will be analyzing this situation when she reports our lead story during this edition of Talk Ten Tuesdays.
The broadcast will also feature these other segments:
* *Tuesday Focus:* Rhonda Buckholtz, chief compliance officer for Century Vision Global, reports why the need for creating a culture of compliance in coding and documentation is so important.
* *T…
playlist_add
Apr 16, 2019
Removing the Speed Bumps from ICD-11 Adoption: Part II
Fresh from her meeting last week at the World Health Organization (WHO) Morbidity Reference Group in Malmo, Sweden, Margaret Skurka returns to Talk Ten Tuesdays this Tuesday to report on ICD-11 – the new code set that is expected to be released next month by the WHO. Skurka reports on how countries are approaching the implementation of ICD-11. (see ICD11 training videos)
Skurka is the past president of the International Federation of Health Information Management Associations, IFHIMA, and the current IFHIMA/AHIMA representative to the WHO Family of International Classifications Education and Implementation Committee. That committee does work on ICD-11, as well as on improving the quality of coded data internationally while recognizing coders around the world.
This broadcast will also feature these other segments:
* *Tuesday Focus: * Reporting on the challenges associated with ICD-10-PCS coding of cardiovascular surgery is senior healthcare consultant Kristi Pollard, who is with…
playlist_add
Apr 9, 2019
2020 Changes in Risk-Adjusted Reimbursement
What’s next, when it comes to risk-adjusted reimbursement?
Home health is next. Just like diagnosis-related groups (DRGs) and hierarchical condition categories (HCCs), the patient-driven groupings model (PDGM) represents another tremendous opportunity for the health information management (HIM) professional because of the nationwide demands for ICD-10 expertise.
The Centers for Medicare & Medicaid Services (CMS) is moving home health agencies away from a volume-based payment model and toward this new value-based payment system. During this edition of Talk Ten Tuesdays, where we hear from Bonnie S. Cassidy, past president of the American Health Information Management Association (AHIMA), who will share important news on the PDGM program.
The broadcast will also feature these other segments:
* *CDI Report:* Glenn Krauss, nationally recognized clinical documentation improvement (CDI) expert, reports on the top 25 DRGs with improper payment due to insufficient documentation, medica…
playlist_add
Apr 2, 2019
CDI in the UAE: AHIMA World Congress
Clinical documentation integrity (CDI) is seen through an international lens as the contributions of the American Health Information Management Association’s (AHIMA’s) World Congress are recognized during this edition of Talk Ten Tuesdays. The broadcast will usher in the global celebration, coming just in advance of World Health Day on April 7.
Joining the broadcast will be Alexandre Bouché, who created a new international arm of AHIMA –- the AHIMA World Congress (AWC) –- to help its members achieve their full potential and professional recognition in the Middle East, Southeast Asia, and European markets.
This broadcast will also feature these other segments:
* *CDI Report: *Dr. Wilbur Lo provides an overview of the methodology of International-Refined (IR-DRGs). Dr. Lo also reports on how providers in the United Arab Emirates (UAE) are experiencing additional annual revenue, improved patient care and quality of data outcomes based on a gap analysis performed by AWC.
*…
playlist_add
Mar 26, 2019
Surprise Balance Billing Issues: Part II
Surprise balance billing is an issue that is not only generating national interest but also legislative engagement on the state level. In Part I of this series, Holly Louie, past president of the Healthcare Business and Management Association, reported on such billing related to insurance company denials. For Part II, Matthew Albright, former Director of the Administrative Simplification Group at the Centers for Medicare & Medicaid Services (CMS), reports on billing laws on the state level, as well as billing protections by the U.S. Senate.
Albright examines trends in surprise balance billing laws being seen passed in the states, specifically with regard to reimbursement benchmarks. And touches on what states are considering balance bill laws in their 2019 legislative sessions and what the status is on the U.S. Senate’s bipartisan efforts in this area.
The broadcast will also feature these other segments:
* *The ICD-10 Coding Report*: Nationally recognized coding authority Lauri…
playlist_add
Mar 19, 2019
Removing the Speed Bumps from ICD-11 Adoption
Imagine an almost seamless transition from ICD-10 to ICD-11, unlike the sturm and drang that characterized the transition from ICD-9 to ICD-10 – which, finally, after the dust settled, became effective in 2015.
Eliminating the speed bumps could happen. The National Committee for Vital Health Statistics (NCVHS) recently sent a letter to the Secretary of the U.S. Department of Health and Human Services (HHS), proposing that the massive agency use sub-regulatory processes to make version updates to the International Classification for Diseases (ICD) in the same way it handles updates to all the other named HIPAA code set standards. Moreover, HCVHS said that HHS should invest now in a project to evaluate ICD-11 and develop a plan that will enable a smooth and transparent transition at the optimal time.
Reporting our lead story during this edition of Talk Ten Tuesdays will be Margaret Skurka, past president of the International Federation of Health Information Management Associations, I…
playlist_add
Mar 12, 2019
Welcome, Madam President
We are honored to welcome the President and Chair of the 2019 American Health Information Management Association (AHIMA) Board of Directors, Valerie Watzlaf, Ph.D. to this edition of Talk Ten Tuesdays.
Dr. Watzlaf is vice chair of education and associate professor within the Department of Health Information Management (HIM) in the School of Health and Rehabilitation Sciences (SHRS) at the University of Pittsburgh. She also holds a secondary appointment in the Graduate School of Public Health. In those capacities, she teaches and performs research in the areas of HIM, epidemiology, quality improvement, statistics, and long-term care. Welcome, Dr. Watzlaf.
This broadcast will also feature these other segments:
* *The ICD-10 Coding Report:* Chronic conditions have been in the news lately and Laurie Johnson reports on the ten most expensive conditions with regards to ICD-10 codes as well as clinical documentation and HCC impacts. Johnson is a nationally recognized coding authority and…
playlist_add
Mar 5, 2019
Advocating for CDI
As the clinical documentation integrity (CDI) industry continues to grow beyond the traditional inpatient setting, the American Health Information Management Association (AHIMA) is working to provide best-practice resources to provider stakeholders from across the continuum of care. Sharing an update on AHIMA’s advocacy during this edition of Talk Ten Tuesdays will be Tammy Combs, the Association’s director of HIM practice excellence.
The live broadcast will also feature these other segments:
* *The ICD-10 Coding Report*: Nationally recognized coding authority Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on the proceedings taking place during the first day of the Centers for Medicare & Medicaid Services (CMS) Coordination and Maintenance Committee meeting, which was scheduled to get underway Tuesday morning at CMS headquarters in Baltimore.
* *News Desk: *Timothy Powell, compliance expert and ICD10monitor national correspondent, ancho…
playlist_add
Feb 26, 2019
Reporting and Coding Separate Procedures: What Coders Need to Know
Many procedures in the CPT® codebook are designated "separate procedures," but that doesn't mean you can report those procedures "separately" in every case, according to nationally recognized professional coding expert Terry Fletcher, who returns to Talk Ten Tuesdays to offer insight into this topic.
Join Dr. Erica Remer and Dr. Juliet Ugarte Hopkins as they host the podcast, which also features these other segments:
* *The ICD-10 Coding Report:* Nationally recognized coding authority Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on latest coding news.
* *News Desk:* Timothy Powell, a compliance expert, and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
* *The Dunn Report:* National health information management (HIM) expert and past American Health Information Management Association (AHIMA) President Rose Dunn returns to the podcast with a series on how HIM can play a role in other areas of the revenue c…
playlist_add
Feb 12, 2019
New Patient versus Established Patient: The Coder’s Dilemma
Knowing how to distinguish new patients from established patients, apart from ensuring that coding guidelines are being followed, enables you to be reimbursed for the additional work that new patient visits warrant. Moreover, in some cases, not distinguishing new patients from established patients can amount to shortchanging yourself, as you will learn during this edition of Talk Ten Tuesdays, when Terry Fletcher returns to the broadcast to report on evaluation and management (E&M) coding.
Other segments to be featured on the broadcast include:
* *The I 10 Coding Report:* Yellow fever has been reported in the Americas, and this can be prevented – a warning for people who are planning trips to the Caribbean or Latin America. Nationally recognized coding authority Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on this new travel advisory.
* *News Desk:* Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the T…
playlist_add
Feb 5, 2019
ICD-11: It’s Coming – So Start Planning Now
Although still lingering on the horizon, much like a coming storm, ICD-11 is fast approaching – which is why the new code set is on the radar screen at the American Health Information Management Association (AHIMA). In fact, AHIMA reports that it has begun conducting research aimed at addressing coding in order to determine how productivity, accuracy, and quality can be improved across all settings.
Reporting on ICD-11 and how AHIMA is preparing its members for the next coding milestone during the next edition of Talk Ten Tuesdays will be Julie Dooling, AHIMA’s director of health information management (HIM) practice excellence.
Other segments to be featured on the broadcast include:
* *The I-10 Coding Report*: Are there codes for the extreme cold weather that’s impacting much of the nation? Nationally recognized coding authority Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, will be reporting on ICD-10 coding for this freezing cold, specifical…
playlist_add
Jan 29, 2019
Sepsis-3 versus Sepsis-2: In Search of an Offramp
The fallout continues over the recent announcement by UnitedHealthcare (UHC) that it would not use Sepsis-3 when reviewing claims to validate sepsis for payment from providers in the Empire State. New York state law defines sepsis with systemic inflammatory response syndrome (SIRS) criteria, otherwise known as Sepsis-2.
Reporting on Sepsis-3 during the next edition of Talk Ten Tuesdays will be broadcast co-host Erica Remer, MD, founder and president of Erica Remer, MD, Incorporated. Dr. Remer will share insights from a targeted sepsis project that should help clarify how your facility should approach sepsis.
Other segments to be featured on the broadcast include:
* *Coding Report:* The upcoming Super Bowl LIII on Feb. 3 reminds many of the consequences of chronic traumatic encephalopathy (CTE). Nationally recognized coding authority Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on CTE.
* *News Desk: *Timothy Powell, compliance expert and…
playlist_add
Jan 22, 2019
Code or Not to Code: Revisiting ICD-10-CM Guidelines
"The assignment of a diagnosis code is based on the provider’s diagnostic statement that the condition exists. The provider’s statement that the patient has a particular condition is sufficient. Code assignment is not based on clinical criteria used by the provider to establish the diagnosis." — ICD-10-CM guideline I.A. 19
This guideline is frequently cited as the reason coders list diagnoses because the doctor said so. But is the doctor’s say-so enough? Reporting on this recurring issue during the next edition of Talk-Ten-Tuesdays will be broadcast co-host Erica Remer, MD, founder and president of Erica Remer, MD, Incorporated.
Other segments to be featured on the broadcast include:
* *Coding Report:* It’s the flu season in the United States, with most activity expected to peak between now and February. Nationally recognized coding authority Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, will be reporting on this developing story.
* *New…
playlist_add
Jan 15, 2019
Social Determinants of Health: Healthcare Issues Outside Your Hospital Are Affecting What Happens Inside
Social determinants of health (SdoH) are swamping hospitals like rising rivers following a storm. A reported $1.7 trillion in healthcare costs are now attributed to 5 percent of the nation’s population, with a majority of that sum related to the SdoH.
And while the focus has been largely on the most vulnerable and disenfranchised members of populations, the new face of SDoH is evolving as a consequence of an increase of natural and manmade disasters, as well as new attention being given to longstanding issues such as rural health, human trafficking, business closures, and loss of pensions for an increasing number of older adults.
Returning to Talk Ten Tuesdays to report on this developing story is nationally recognized SDoH authority, author, and educator Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP, the founder of EFS Supervision Strategies, LLC.
Other segments to be featured on the broadcast include:
* *Coding Report:* Coders will be dealing with new payment models in 2019,…
playlist_add
Dec 12, 2018
Mystery Disease: Latest Update on AFM
The mystery continues.
At the time of this report there were a reported 116 confirmed cases of acute flaccid myelitis (AFM) across 31 states, with the most cases reported in Colorado (15) and Texas (14). Plus, there are another 170 possible cases that haven’t been confirmed.
AFM is similar to polio and leads to a sudden onset of paralysis. This condition mostly affects children younger than 4. These patients experienced a viral illness with fever and cough 3-10 days prior to the paralysis onset.
Returning to Talk Ten Tuesdays to report on this developing story will be Jennifer P. Rubin, MD, attending physician in the neurology division of Northwestern University’s Feinberg School of Medicine.
Other segments to be featured on the broadcast include:
* *Tuesday Focus:* There’s a reported fine line between coding for moderate sedation and monitored general sedation. Exploring this seemingly unchartered territory is Terry Fletcher, a nationally recognized professional physician…
playlist_add
Dec 4, 2018
Perilous Compliance Challenges Facing Today’s New Coders
Never before has the responsibility of an organization to provide clear, facility-specific guidelines and in-depth training for coders been more apparent than it is today – especially now with the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) poised to conduct diagnosis-related group (DRG) validation audits. Reporting our lead story during this edition of Talk Ten Tuesdays will be Cari Greenwood who will discuss how your team should intensify training –- particularly when it comes to assigning correct codes for high-frequency, problem-prone, and high-cost diagnoses.
Other segments to be featured on the broadcast include:
* *News Desk: *Mary A. Inman, partner at Constantine Cannon’s London office, reports on the expected dismissal of the $188.1 million False Claims Act lawsuit filed by Med Analytics, LLC against Providence Health, now Providence St. Joseph, for allegedly upcoding various diagnoses.
* *RegWatch: *Leading healthcare tech…
playlist_add
Nov 27, 2018
To Link, or not to Link: That is the Question for Physician Documentation
Are you experiencing this dilemma at your facility? You ask your physicians to add linking verbiage to their documentation for accuracy, which in turn has a negative impact on their publicly reported scores regarding complications and other metrics. Should physicians exclude the linking verbiage? Should they enter “as expected,” or should they simply avoid addressing these issues? Reporting on this complex issue during the next edition of Talk Ten Tuesdays will be Sharon Savinsky, clinical documentation improvement specialist (CDIS) team manager at Winchester Medical Center in Winchester, Va.
Other segments to be featured on the broadcast include:
* *News Desk: *Laurie Johnson will anchor the Talk Ten-Tuesdays News Desk. Johnson is a senior healthcare consultant with Revenue Cycle Solutions, LLC and an ICD10monitor contributor.
* *Coding Report: *Although the Centers for Medicare & Medicaid Services (CMS) has released the final rule on the 2019 Medicare Physician Fee Schedul…
playlist_add
Nov 13, 2018
The Enigma of Sepsis: Providers vs. Payers
When it comes to defining sepsis, who wins? Is it providers, who rely on the current definition of sepsis as “life-threatening organ dysfunction caused by a dysregulated host response to infection?” Or do payers prevail – the ones who control the reimbursement? And under what circumstances would you ever side with a carrier that has denied a claim of sepsis?
Reporting our lead story during this edition of Talk Ten Tuesdays will be Roland Dale, responsible for denials prevention, for Hardin Medical Center, who shares his experience in these situations while offering important and timely advice.
Other segments to be featured on the broadcast include:
* *News Desk: *Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
* *Dateline Washington: *Talk Ten Tuesdays legislative analyst Rhonda Taller has the latest news coming out of Washington, D.C. Rhonda is a member of the HIMSS professional development committee.…
playlist_add
Nov 6, 2018
Physician Burnout and PTSD: How Traumatic Events Impact Care
The tragic events that shocked the nation’s collective conscience on an otherwise peaceful recent Saturday morning call to mind the intersection of physician burnout and post-traumatic stress syndrome.
With physician burnout reported to be widespread and suicides among physicians escalating at an alarming rate, do disasters – both natural and manmade – disproportionately impact the profession? Or are there other conflicts endemic to healthcare that tear at the emotional and mental health of physicians, thus creating a sense of helplessness?
Reporting on our lead story during this edition of Talk Ten Tuesdays will be Dr. Tracy Sanson, a practicing emergency physician, consultant, and educator on leadership development and medical education. A national and international speaker, Dr. Sanson also serves as a core faculty member for the American College of Emergency Physicians.
Other segments to be featured on the broadcast include:
* *CDI Report:* What does the future of clinic…
playlist_add
Oct 30, 2018
ICD-10 Official Guidelines versus Coding Clinic for ICD-10-CM-PCS
The FY 2019 Official Guidelines for Coding and Reporting versus the American Hospital Association (AHA) third-quarter Coding Clinic: when it comes to coding body mass index (BMI), there’s a contradiction.
The Guidelines say BMI codes should only be assigned when the associated diagnosis meets the definition of a reportable diagnosis. AHA guidance states that obesity is always coded, even without supporting clinical significance. What’s a coder to do?
During this edition of Talk Ten Tuesdays, James Kennedy, MD offers timely and practical advice on how to handle and resolve this issue.
Other segments to be featured on the broadcast include:
* *Coding Report:* ICD-11 is being touted for its complexity and granularity, as you’ll learn when national health information management (HIM) expert and past American Health Information Management Association (AHIMA) President Rose Dunn returns to the broadcast.
* *CDC Report: *It’s flu season, and the Centers for Disease Control an…
playlist_add
Oct 23, 2018
Understanding the Definition of Sepsis-3: The Sepsis Saga Continues
UnitedHealthcare (UHC) has thrust Sepsis-3 into the national healthcare conversation with its recent announcement that come Jan. 1, 2019 it use the SEP-3 definition to determine if a diagnosis of sepsis is clinically validated, advising that the Sequential (sepsis-related) Organ Failure Assessment (SOFA) score is to be used to determine if sepsis is present. Although the definition of Sepsis-3 was announced in February 2016, its acceptance has become more widespread as you learn when Dr. Edward Hu addresses this timely subject during this edition of Talk Ten Tuesdays. Dr. Hu is the executive director of Inpatient Physician Advisor Services for the University of North Carolina Health Care System and president of the American College of Physician Advisors.
Other segments to be featured on the broadcast include:
* *Coding Report:* The fourth-quarter 2018 issue of AHA’s (the American Hospital Association’s) Coding Clinic for ICD-10-CM/PCS has been released. Gloryanne Bryant reports…
playlist_add
Oct 16, 2018
Third-Quarter AHA Coding Clinic: A Developing Story
The third-quarter 2018 issue of AHA’s (the American Hospital Association’s) Coding Clinic for ICD-10-CM/PCS has been released, and during this edition of Talk Ten Tuesdays, Gloryanne Bryant will report on its significance.
Other segments to be featured on the broadcast include:
* *News Desk: *Daniel Zirkman, MD, anchors the Talk Ten Tuesdays News Desk with the very latest news on hospitals in the disaster zone, coping with the aftermath of Hurricane Michael. Zirkman rode out Hurricane Florence from his hospital, CarolinaEast Health System, in New Bern, North Carolina, where he is chief physician advisor.
* *Tuesday Focus: *Rhonda Buckholtz, chief compliance officer for Century Vision Global*, *reports on a recent study her organization undertook involving certified coders and clinical documentation integrity specialists (CDISs).
* *Coding Report: *Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC and an ICD10monitor contributor, reports on the…
playlist_add
Oct 9, 2018
ICD-10 Coding of Medicinal Marijuana: Developing Story
Medical marijuana allows chronically ill patients to relieve painful, often debilitating symptoms legally instead of taking pills that many claim are mostly unhelpful. So why are there are no valid codes for submission for payment in the Current Procedural Terminology® (CPT), Healthcare Common Procedural Coding System (HCPCS), or National Drug Code (NDC) for medical marijuana?
The current state of claims payments for medical marijuana clearly has yet to be defined. So, what is the answer? Reporting this timely story during this edition of Talk Ten Tuesdays will be Terry Fletcher, a nationally recognized professional physician coding expert.
Other segments to be featured on the broadcast include:
* *News Desk: *Larry Field, DO, anchors the Talk Ten Tuesdays News Desk with the very latest healthcare news. Field is the treasurer of the American College of Physician Advisors.
* *Tuesday Focus:* Two new studies point to the alarming issue of physician burnout. The Journal of the Am…
playlist_add
Oct 2, 2018
New ICD-10 Codes Address Human Trafficking
Twenty-nine new ICD-10 codes that are expected to leverage the ability of providers to document clients who might be at risk of sex and labor exploitation go into effect Oct. 1.
Reporting on this developing story during this edition of Talk Ten Tuesdays is Nelly Leon-Chisen, the director of coding and classification for the American Hospital Association (AHA). The new codes will serve as the official diagnoses used to describe diseases, causes of diseases, and deaths related to human trafficking.
Other segments to be featured on the broadcast include:
* News Desk: Larry Field, DO, anchors the Talk Ten Tuesdays News Desk with the very latest healthcare news. Field is the treasurer of the American College of Physician Advisors.
* Dateline Washington: Leslie Krigstein, vice president of congressional affairs for the College of Health Information Management Executives (CHIME), reports on the latest healthcare news coming out of Washington, D.C.
* CDI Report: ICD10monitor contrib…
playlist_add
Sep 25, 2018
Fourth Universal Definition of Myocardial Infarction: The Coder and the Cardiologist
During this edition of Talk Ten Tuesdays, the fourth universal definition of myocardial infarction (MI) is reported on from two perspectives: the cardiologist and the coder.
Joining the broadcast to offer the cardiologist perspective is Dr. Geoffrey Rose, division chief of adult cardiology with the Sanger Heart and Vascular Institute at Atrium Health. Nationally recognized coding authority Terry Fletcher joins the conversation to report on the new clinical concepts found in the fourth definition of MI.
Other segments to be featured on the broadcast include:
* Tuesday Focus: The LGBTQ population faces a multitude of health disparities, including barriers to appropriate healthcare access, discrimination, and violations of patient rights. Reporting this story is Julie A. Dooling, a director at the American Health Information Management Association (AHIMA).
* News Desk: Gloryanne Bryant, National Director Coding Quality, Education, Systems and Support; Kaiser Permanente National R…
playlist_add
Sep 18, 2018
2019 IPPS Updates: Reviewing Major Disease Category 18
In this edition of Talk Ten Tuesdays Chuck Buck and Holly Louie, RN welcome special guest Dr. Emmel Golden, a physician associate and medicine lead for Enjoin. Dr. Golden, board-certified in internal medicine and pulmonary disease, will report on, among other topics, those associated with major disease category 18, including the confusing aspects of coding systemic inflammatory response syndrome, or SIRS.
Other segments to be featured on the broadcast include:
* News Desk: Knicole Emanuel, Esq, anchors the Talk Ten Tuesdays News Desk and reports on Medicare waivers in times of natural disasters. Knicole is a partner at Potomac Law Group, PLLC.
* Coding Changes: The American Medical Association (AMA) released its 2019 code changes last week. Continuing her reporting on this developing story is senior healthcare consultant Deborah Grider with Karen Zupko and Associates.
* Tuesday Focus: Sharon Easterling will report on the impact of Hurricane Florence in the Carolinas, especia…
playlist_add
Sep 11, 2018
ICD-10 Coordination and Maintenance Committee Meeting: Live Reporting
The next big milestone for ICD-10 is the 2018 Coordination and Maintenance Committee meeting in Baltimore. The two-day meeting covered the latest requests for diagnosis and procedure codes. Monitoring and reporting on the meeting during this edition of Talk Ten Tuesdays will be Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC and an ICD10monitor contributor.
Other segments to be featured on the broadcast include:
* News Desk: Larry Field, DO, anchors the Talk Ten Tuesdays News Desk and reports on the newly released Fourth Universal Definition of Myocardial Infarction. Dr. Field is the treasurer of the American College of Physician Advisors.
* Tuesday Focus: The American Medical Association has released its 2019 code changes. Reporting on this developing story is senior healthcare consultant Deborah Grider.
* Mental Health Report: Catherine Harrison-Restelli, MD, medical director for hospital services at Sheppard Pratt Health System, reports on Soc…
playlist_add
Aug 28, 2018
Proposed E&M Changes: The Good, the Bad, and the Ugly (Part II)
Questions are overflowing about the Centers for Medicare & Medicaid Services’ (CMS’s) proposed changes to evaluation and management (E&M) coding and reimbursement found inside the proposed 2019 Medicare Physician Fee Schedule.
Returning this coming Tuesday for the next edition of Talk Ten Tuesdays will be Sally Streiber, president of Practical Coding Solutions, LLC. Sally is expected to answer some of those questions when she continues her two-part series reviewing the proposed changes.
Sally will report on the “good” and the “bad” aspects of anticipated impacts.
Other segments to be featured on the broadcast include:
* News Desk: Larry Field, DO, will anchor the Talk Ten Tuesdays News Desk with the very latest healthcare news. Field is the treasurer of the American College of Physician Advisors.
* CMS, Are You Listening? In the closing days before the public comment period ends (Sept. 10) for the proposed 2019 Medicare Physician Fee Schedule and E&M changes, natio…
playlist_add
Aug 21, 2018
Proposed E&M Changes: The Good, the Bad, and the Ugly
Backlash continues over the Centers for Medicare & Medicaid Services (CMS) proposed changes to evaluation and management (E&M) coding and reimbursement found inside the proposed 2019 Medicare Physician Fee Schedule.
But it’s not all bad news. On this edition of Talk Ten Tuesdays, when Sally Streiber, president of Practical Coding Solutions, LLC, returns to the broadcast and launch part one of her two-part series reviewing the proposed changes.
Sally will begin the first part of her series with the “ugly,” notably a 50 percent reduction of the less-expensive service when an E&M code and a procedure are billed on the same date of service. Sally will return on Aug. 28 with part two, reporting the good and the bad of other anticipated impacts.
Other segments to be featured on the broadcast include:
* Talk Tuesdays News Desk: The NFL continues to make payouts for former players who have been diagnosed not only with chronic traumatic encephalopathy, but now Parkinson’s and amyo…
playlist_add
Aug 14, 2018
Are HIM Coding Professionals Qualified to Query for Clinical Validity? Part II
Nearly 30 days ago, we posed the question “Are HIM Coding Professionals Qualified to Query for Clinical Validity?” leading up to the July 17 edition of Talk Ten Tuesdays, and the responses continue to roll in, nearly unabated.
Specifically, we asked at that time, “are seasoned coding professionals competent or trained well enough to interpret clinical terms and concepts from the medical record?” And many of you responded with an unequivocal “yes.” As a consequence, we will proceed with Part II of this series, when we continue to explore reaction to this question – which, after decades, still remains contentious.
Reporting our lead story during this edition of Talk Ten Tuesdays will be Anny Pang Yuen, author, consultant, and founder of AP Consulting Associates, LLC.
Other segments to be featured on the broadcast include:
* News Desk: Larry Field, DO, anchors the Talk Ten Tuesdays News Desk with the very latest healthcare news. Field is the treasurer of the American C…
playlist_add
Aug 7, 2018
ICD-11: Hear the Latest Industry Buzz
There is a lot of buzz out in the industry about ICD-11, especially since the World Health Organization (WHO) released the new code set in June as first reported by ICD10monitor and Talk Ten Tuesday. Nevertheless, ICD-11 is a trending topic—a topic we will explore during this edition of Talk Ten Tuesdays. That’s when nationally recognized coding authority Rhonda Buckholtz will report on the need to make sure all of the coding options have been refined in ICD-10-CM in order to make coding more productive in ICD-11.
Other segments to be featured on the broadcast include:
* Tuesday Focus: 2019 ICD-10-CM Official Guidelines: The FY2019 Official Guidelines have been released as reported by ICD10monitor. Gloryanne Bryant, past president of the California Health Information Association, reports on the new changes.
* E and M Coding Update: Given the potential impact of major E and M changes in the 2019 Medicare Physician Fee Schedule proposed rule, Deborah Grider, senior healthcare…
playlist_add
Jul 31, 2018
Stressing Out About the Z Codes: Healthcare’s New Imperative
Back in February, as reported by ICD10monitor, the American Hospital Association (AHA) changed coding rules, allowing case managers and social workers to assign Z codes—one of 88 assignable ICD-10 codes to report on claims for homelessness, low income, stressful work environment, low literacy, divorce, personal history of abuse, and many more. But not all healthcare professionals—including a number of physicians—are getting the message.
To help clear up the confusion, Ellen Fink-Samnick, a nationally recognized expert on social determinants of health (SDoH), will report our lead story.
Other segments to be featured on the broadcast include:
* Talk Ten Tuesday News Desk: Timothy Powell, a nationally recognized expert on regulatory matters including the False Claims Act, ZPIC audits, and the OIG, will return to report on the latest healthcare news.
* E&M Coding Update: Given the scale and potential impact of major E&M changes in the 2019 Medicare Physician Fee Schedule prop…
playlist_add
Jul 24, 2018
Reporting Bronchoalveolar Lavage Documentation Nightmare for Docs, Quandary for Coders
Coding guidelines and advice are taking bronchoalveolar lavage (BAL) to a surgical DRG. Should the body part be the bronchus or the lung? Reporting our lead story is Erica Remer, MD and Inpatient Compliance Specialist Stacey Elliott. Both will discuss their concerns.
Other segments to be featured on the broadcast include:
* Talk Ten Tuesdays News Desk: Timothy Powell, a nationally recognized expert on regulatory matters including the False Claims Act, ZPIC audits, and the OIG, reports on the latest healthcare news.
* Dateline Washington: Talk Ten Tuesdays legislative analyst Rhonda Taller has the latest news coming out of Washington, D.C. Rhonda is a member of the HIMSS professional development committee.
* CDI Report: The ICD10monitor contributor Glenn Krauss, the CDI manager at University Health Systems Las Vegas, reports on how CDI supports the revenue cycle.
Talk Ten Tuesdays. More than just talk.™
Click here to view handout from Ellen Fink-Samnick on SDoH
playlist_add
Jul 17, 2018
Are HIM Coding Professionals Qualified to Query for Clinical Validity?
Are seasoned coding professionals competent or trained well enough to interpret clinical terms and concepts from the medical record? Although they have been doing so for decades, the question continues to remain contentious.
Reporting our lead story during this edition of Talk Ten Tuesdays will be Debra Beisel Denton, who works at Maricopa Integrated Health System as the health information management (HIM) system coding educator.
Other segments to be featured on the broadcast include:
* News Desk: Dennis Jones, the patient financial services administrator at Nyack Hospital in Nyack, N.Y., will anchor the Talk Ten Tuesdays News Desk.
* Tuesday Focus: Shannon DeConda, a nationally recognized evaluation and management (E&M) coding authority, reports on the 2019 proposed Medicare Physician Fee Schedule released Thursday by the Centers for Medicare & Medicaid Services (CMS). DeConda is founder of the National Alliance of Medical Auditing Specialists (NAMAS).
* RegWatch: Leading h…
playlist_add
Jul 10, 2018
A Cautionary Tale: Text Messaging Medical Orders
Fast, convenient, and cutting-edge, the new trend of text-messaging medical orders is being met with mixed results. Some favor the ease and speed, while others are concerned that it could comprise patient safety while not accurately documenting patient care.
Reporting our lead story during the next edition of Talk Ten Tuesdays will be Rose Dunn, chief operations officer for First Class Solutions. Rose will report on findings of a survey focusing on texting of medical orders and the challenges this practice creates for the healthcare team. Finally, she’ll sum things up with what the Centers for Medicare & Medicaid Services (CMS) has to say about the practice.
Other segments to be featured on the broadcast include:
* News Desk: Larry Field, DO, anchors the Talk Ten Tuesdays News Desk with the very latest healthcare news. Field is the treasurer of the American College of Physician Advisors.
* Tuesday Focus: Ellen Fink-Samnick, an award-winning industry expert and author, returns…
playlist_add
Jun 26, 2018
The New Reality: ICD-11 Codes
ICD-11 codes are becoming healthcare’s new reality since the new code set was released this week by the World Health Organization (WHO) and reported on by ICD10monitor.
And already important questions are emerging.
Will it be possible to have a paper ICD-11 book? Will there be more electronic tools available to assist with understanding the new classification? These and other topics are covered by the WHO’s Robert Jakob, the special guest on this edition of Talk Ten Tuesdays. Calling in live from Geneva, Dr. Jakob also reports on the major changes to the classification that will be formally presented at the World Health Assembly next May for adoption by member states, effective as soon as Jan. 1, 2022.
Other segments to be featured on the broadcast include:
* News Desk: Larry Field, DO, will anchor the Talk Ten Tuesdays News Desk with the very latest healthcare news. Field is the treasurer of the American College of Physician Advisors.
* Tuesday Focus: Ellen Fink-Samnick,…
playlist_add
Jun 19, 2018
Coding and Documenting Sexual Harassment
In the era of #metoo, a new national study – “Sexual Harassment of Physicians Report 2018” – was published this week by Medscape, reporting that more than 10 percent of female physicians have experienced workplace sexual harassment.
Continuing its reporting on women’s health issues, and in particular gender wage disparity, Talk Ten Tuesdays will delve into this topical social issue that has until recently been an underreported in healthcare.
Also weighing in on this matter is special guest Kimberly Templeton, MD, immediate past president of the American Medical Women’s Association and professor of orthopedic surgery at the University Kansas Medical Center.
Other segments to be featured on the broadcast include:
* News Desk: Larry Field, DO, anchors the Talk Ten Tuesdays News Desk with the his experiences with harassment in the workplace. Field is the treasurer of the American College of Physician Advisors.
* CDI Report: Adele Towers, MD, associate professor of medi…
playlist_add
Jun 12, 2018
Introducing the Hybrid CDI
University of Pittsburgh Medical Center (UPMC) is a world-renowned healthcare provider and insurer based in Pittsburgh, Penn. With more than 30 academic, community, and specialty hospitals, 600 doctors’ offices in outpatient sites, and more than 4,600 physicians, operating an array of rehabilitation, retirement, and long-term care facilities, UPMC relies on technology to help enhance its coding and clinical documentation improvement (CDI) program. And the latest reiteration of its CDI program, called Hybrid CDI, constitutes a system that combines off-site as well as on-site clinical documentation integrity specialists.
To learn more about this promising approach, we asked Megan Cortazzo, MD, an assistant professor of physical medicine and rehabilitation at UPMC, to be our special guest on this edition of Talk Ten Tuesdays. Dr. Cortazzo also serves as the medical director of CDI and health information management (HIM) for the UPMC System.
Other segments to be featured on the broadca…
playlist_add
Jun 5, 2018
2019 ICD-10-PCS Codes: New Details Revealed in Recently Released Files
There are 78,881 ICD-10-PCS codes for fiscal year 2019. Of these there will be 392 new codes; eight revision titles; and 216 deleted codes, according to nationally recognized coding authority Gloryanne Bryant, who reports our lead story during this episode. The files, recently released by the Centers for Medicare & Medicaid Services (CMS), and first reported by ICD10monitor, contain information on the ICD-10-PCS updates that all hospital inpatient coding professionals are to use for discharges occurring from Oct. 1, 2018, through Sept. 30, 2019.
* National Spotlight: Nonaccidental trauma (NAT): ICD10monitor contributor and Talk Ten Tuesdays co-host Erica Remer, MD, reports on a coding-clinical disconnect when documenting child abuse—a serious problem on many levels and a particular focus during this episode. Joining the discussion is Laura Hayman, RN, a clinical documentation integrity specialist with a Midwestern teaching facility which is a level 1 pediatric trauma center.
*…
playlist_add
May 22, 2018
Send in the Scribes: Medical Scribes to the Rescue
Smoldering below the surface is burnout, and it’s taking a toll on physicians. With increasingly high rates of reported physician suicides and an alarming decline in the volume of medical school applications, this situation could be the nation’s next healthcare crisis. The good news: A study published in April’s World Journal of Urology reported that using scribes in a urology practice significantly increased physician efficiency, work satisfaction, and revenue. Enter Talk Ten Tuesdays special guest Dr. Suzette Sutherland, associate professor in the department of urology at the University of Washington School of Medicine. Dr. Sutherland reported on her facility’s training program and how using scribes is improving efficiency but also improving physician-patient relationships, patient satisfaction, and provider satisfaction, leading to less physician burnout.
Other segments to be featured on the broadcast include:
* Tuesday Focus - Risk Adjustment: We had two reports on this…
playlist_add
May 15, 2018
New ICD-10 Codes for Women
Whether it’s discussing equal pay for women healthcare professionals, uncovering #MeToo narratives in the medical profession, or examining studies comparing women physicians’ and surgeons’ outcomes favorably to men’s, there has never been a more important time for crucial conversations to take place about women’s health. And that is why National Women’s Health Week will be the subject of this special Talk Ten Tuesdays broadcast.
Other segments to be featured on the broadcast include:
* Tuesday Focus: Lisa Banker, chief physician advisor and vice president for case management at McLeod Health in South Carolina, reported on her perspective on women’s health issues.
* Talk Ten Tuesdays News Desk: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions LLC and ICD10monitor contributor, reported on the latest proposed codes for women’s health.
* CDI Report: Kathy Murchland, manager of CDI for Kettering Health Network in Dayton, Ohio, reported on…
playlist_add
May 8, 2018
Chief Complaint and the Medical Necessity Imperative
If there is no chief complaint, or no acute or chronic condition, auditors may not even continue with the record and negate its value altogether, according to nationally recognized coding and documentation authority Terry Fletcher, who is currently uncovering errors in an ongoing review of more than 1,000 records. During the next edition of Talk Ten Tuesdays, she will share her findings in the second of a four-part series on auditing issues in physician documentation.
Other segments to be featured on the broadcast include:
* Tuesday Focus: There’s a strong emphasis to collect data about the opioid epidemic, specifically from individuals at risk or already addicted. But what are healthcare organizations doing with this information? Lesley Kadlec with the data analytics practice council at the American Health Information Management Association (AHIMA) reports on how the data can be used to respond to this crisis.
* Coder Burnout: Confessions of a formerly burned-out coder will c…
playlist_add
May 1, 2018
New ICD-10 Codes, New Challenges: Reporting on the IPPS Proposed Rule
Not wishing to disappoint, the 2019 Medicare Inpatient Prospective Payment System (IPPS) proposed rule, released on Tuesday, has something for everyone. For coders and clinical documentation integrity specialists (CDISs), there are proposed new codes and tweaks to the MS-DRG methodology as well as changes in New Technology add-on payments. Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions LLC and ICD10monitor contributor, will report on the latest proposal from the Centers for Medicare & Medicaid Services (CMS).
Other segments to be featured on the broadcast include:
* Tuesday Focus: Charles Stellar, president and CEO of the Workgroup for Electronic Data Interchange, took time from his busy schedule to discuss solving the Interoperability issues in healthcare to assure that different information technology systems and software applications can communicate and exchange data.
* News Desk: Charles Locke, MD, a senior physician advisor of care coordination a…
playlist_add
Apr 24, 2018
Auditing Issues Uncovered in Physician Documentation
It's auditing season, and nationally recognized coding and documentation authority Terry Fletcher will be reporting on errors she is uncovering in a review of more than 1,000 records. During this episode, she shares her findings in the first of a four-part series on auditing issues in physician documentation. While maintaining that CPT® and ICD-10 coding does become less risky when documentation is done properly, she offers corrective actions one can to take to prevent negative payer audits.
Other segments featured in this episode include:
* News Desk: Larry Field, DO, anchors the Talk Ten Tuesdays News Desk and present the very latest healthcare news. Field is the treasurer of the American College of Physician Advisors.
* CDI Report: The ICD10monitor contributor Glenn Krauss, the CDI manager at University Health Systems Las Vegas, reports on a holistic approach to documentation improvement versus a narrowly defined approach centering on diagnoses capture.
* Mental Health Re…
playlist_add
Apr 19, 2018
How Risk Adjustment and HCCs Are Impacting Coding and CDI
Are you hearing more about risk adjustment methodologies and Hierarchical Condition Categories (HCCs)? No doubt you are. That's because they impact coding, clinical documentation integrity activities and reimbursement. So what impact can you have on any of these issues? During this episode Marie A. Morin, director at Alvarez and Marsal Healthcare Industry Group LLC, reports on her experiences in assisting clients with risk assessment, coding and documentation practices.
Other segments featured in this episode include:
* News Desk: Larry Field, DO, anchors the Talk Ten Tuesdays News Desk and presents the very latest healthcare news. Field is the treasurer of the American College of Physician Advisors.
* The Coding Report: Nationally recognized author and consultant Deborah Grider, a senior healthcare consultant with Karen Zupko & Associates, reports on coding trigger point injections for pain management. Trigger point injection therapy is used for the treatment of myofascial pai…
playlist_add
Apr 10, 2018
Wage Disparity and the Gender Gap: Probable Causes for Burnout?
The recent Doximity research study that revealed an average national wage gap between male and female physicians of $105,000 was greeted by some healthcare professionals as "old news," while to others it seemed one more thread in the national fabric of the discussion on women's rights in the era of #metoo. Yet this income disparity could also contribute to physician burnout—a diagnosis that is higher among female physicians than their counterparts.
In 2017, the national gender gap for physicians increased, as female doctors earned 27.7 percent less than their male counterparts—an even bigger gap than the national average, according to the Doximity survey.
This news comes at a time when the topic of women's rights both in and out of the workplace has never been more volatile, and women's voices are being heard as never before. There has even been movement toward reviving the Equal Rights Amendment, with the Nevada Legislature last year becoming the first to ratify the ERA after th…
playlist_add
Apr 3, 2018
MIPS: Maligned and Misunderstood
Maligned and misunderstood, the Merit-Based Incentive Payment System (MIPS) is under assault, as industry experts are urging officials at the U.S. Department of Health and Human Services (HHS) to consider repealing the program.
Yet March 31 was when eligible clinicians were to submit their quality data by for the value-based reimbursement program. Delivering an update on MIPS during this episode is nationally recognized revenue cycle authority Lyman Sornberger, chief strategy officer for Capio Partners.
Other segments featured in this episode include:
* *News Desk:* Larry Field, DO, anchors the Talk Ten Tuesdays News Desk and presents the very latest healthcare news. Field is the treasurer of the American College of Physician Advisors.
* *Coding Report:* Senior healthcare coding educator and consultant Laurie Johnson reports on the ICD-10 code proposals put forth during the recent Coordination and Maintenance Committee meeting.
* *RegWatch:* Leading healthcare technology con…
playlist_add
Mar 27, 2018
Medicare Beneficiaries to be Carded
Medicare beneficiaries will soon be receiving from the Centers for Medicare & Medicaid Services (CMS) new identification cards—cards that will use a unique and what CMS describes as a "randomly-assigned number" called a Medicare Beneficiary Identifier (MBI). The new number replaces the Social Security-based Health Insurance Claim Number (HICN). The new cards, scheduled to be mailed next month, are designed to help combat identity theft and fraud. Reporting our lead story is author, educator,d and consultant Duane Abbey, PhD, president of Abbey and Abbey Consultants, Inc.
Other segments featured in this episode include:
* *News Desk:* Lorraine Martinez returns to report on how patients and hospitals are coping since Hurricane Maria devastated Puerto Rico six months ago.
* *Dateline Washington:* Talk Ten Tuesdays legislative analyst Rhonda Taller reports the latest news coming out of Washington, D.C. Rhonda is a member of the HIMSS professional development committee.
* *Codin…