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
Utilization managers (UMs) have long served as a resource for clinicians determining the appropriate patient status.
Key considerations include which clinicians are involved, how communication occurs, and how status orders are entered.
Because these processes can vary widely, it is essential to understand what is compliant, what carries risk, and what is simply not allowed.
That’s why it’s essential to stay current on the latest developments in utilization management.
So, listen and learn when special guest Dr. Juliet B. Urgarte Hopkins, chief medical officer for Phoenix Medical Management discusses the role of utilization managers.
The popular weekly Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
• POV: Penny Jefferson, Manager of Coding & Clinical Documentation Integrity Services for the University of California-Davis Medical Center, will share her point of view during the broadcast.
• CDI Report: Cheryl Ericson will provide an update on all things clinical documentation integrity (CDI).
• SDoH Report: Tiffany Ferguson will report on news happening at the intersection of compliance and medical record coding.
• The Coding Report: Christine Geiger will report on the latest coding news.
Tuesday, July 28 marks the 700th live edition of the commemorative Talk Ten Tuesdays broadcast. And in honor of this celebration, the ICD10monitor producers of the popular news and information service have invited Dennis Jones, the assistant vice president of revenue cycle for Jefferson Health, to be the guest host.
During the first half of the broadcast, our other well-known subject-matter experts will also join the broadcast with more news to report, including the following:
• Tech Report: Senior healthcare analyst Frank Cohen to reveal how when claims are viewed in isolation, there is a great likelihood of audits.
• POV: Penny Jefferson, cohost of Talk Ten Tuesdays, will share her point of view (POV) during the broadcast.
• The Coding Report: Chris Geiger, will report on the latest coding news.
• CDI Report: Cheryl Ericson will provide an update on clinical documentation integrity (CDI).
• SDoH Report: Tiffany Ferguson, the CEO for Phoenix Medical Management, will report on news that’s happening at the intersection of patient care and medical record coding.
Then, during the second half of the broadcast, we have invited a host of renowned guest panelists, including the following:
The squeeze is on.
Federal enforcement is intensifying, with behavioral health agencies facing heightened scrutiny following revealing reports from the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG). According to the OIG, there have been numerous fraud cases involving false claims and falsified documentation.
But among this emerging sturm und drang, there is a critical role that health information management (HIM) can play – as you and your team will learn during the next live edition of Talk Ten Tuesdays. That’s when special guest Veronica Richardson, senior compliance consultant at First Class Solutions, will discuss how HIM can play a significant role in behavioral health compliance.
The popular weekly Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
• POV: Penny Jefferson, Manager of Coding & Clinical Documentation Integrity Services for the University of California-Davis Medical Center, will share her point of view during the broadcast.
• CDI Report: Cheryl Ericson will provide an update on all things clinical documentation integrity (CDI).
• SDoH Report: Tiffany Ferguson will report on news happening at the intersection of compliance and medical record coding.
• The Coding Report: Christine Geiger will report on the latest coding news.
The secondary review: Corrective Backup? Or a layer of quality assurance?
Given that clinical documentation integrity (CDI) invariably has interpretative variability, a secondary review is intended to bring consistency to complex issues, according to the Talk Ten Tuesday special guest, Mary McGrady, vice president of CDI for Accuity Health. During the next live edition of the popular Internet broadcast, Mary McGrady will clear up the misunderstanding of the secondary review.
Other well-known subject-matter experts will also join the broadcast with more news to report, including the following:
• SDoH Report: Tiffany Ferguson will report on news happening at the intersection of compliance and medical record coding.
• The Coding Report: Christine Geiger returns to Talk Ten Tuesdays to report on the latest coding news.
• POV: Penny Jefferson, Manager of Coding & Clinical Documentation Integrity Services for the University of California-Davis Medical Center, will share her point of view during the broadcast.
What happens when the Inpatient-Only (IPO) List goes away?
The entire list is expected to be eliminated Jan. 1, 2028.
This will necessitate careful, patient-specific status determinations, rather than automatic assumptions based only on the procedure being performed.
The removal of a procedure from the IPO list does not mean that every such procedure must be classified as “outpatient.” Instead, the clinical team must evaluate the individual patient’s medical condition, functional needs, home situation, and anticipated post-operative course.
Listen and learn during the next upcoming edition of Talk Ten Tuesdays, when Dr. Juliet Ugarte Hopkins will offer practical patient function concepts for supporting inpatient status in the absence of the IPO list.
Other well-known subject-matter experts will also join the broadcast with more news to report, including the following:
• CDI Report: Cheryl Ericson will provide an update on all things clinical documentation integrity (CDI).
• SDoH Report: Tiffany Ferguson will report on news happening at the intersection of compliance and medical record coding.
• The Coding Report: Christine Geiger returns to Talk Ten Tuesdays to report on the latest coding news.
• POV: Penny Jefferson, Manager of Coding & Clinical Documentation Integrity Services for the University of California-Davis Medical Center, will share her point of view during the broadcast.
Public comments have closed on the 2026 AHIMA-ACDIS Query Practice Brief.
In other words, the time to talk is over, and the time to listen has begun.
During the next live edition of the popular Internet broadcast Talk Ten Tuesdays, produced by ICD10monitor, you can hear out senior healthcare attorney Richelle Marting as she leads a reflection session to review key themes from the Brief.
She will also share her analysis of those themes, including the concept of a “compliant” and “non-compliant” query and the problem with referring to certain query formats as “leading.”
If you have had claims denied by third-party payers for “non-compliant” queries or if you have wondered how your organization would respond to allegations of leading or non-compliant queries, you’ll want to listen to this remarkable broadcast.
What’s changed? And what does it really mean to issue a “compliant” query in today’s healthcare landscape?
Listen and learn.
Other well-known subject-matter experts will also join the broadcast with more news to report, including the following:
• POV: Penny Jefferson, Manager of Coding & Clinical Documentation Integrity Services for the University of California-Davis Medical Center, will share her point of view during the broadcast.
• CDI Report: Cheryl Ericson will provide an update on all things clinical documentation integrity (CDI).
• SDoH Report: Tiffany Ferguson will report on news happening at the intersection of compliance and medical record coding.
• The Coding Report: Christine Geiger returns to Talk Ten Tuesdays to report on the latest coding news.
After a two-year hiatus, the PEPPER (Program for Evaluating Payment Patterns Electronic Report) is back. It’s now available to all acute care hospitals and critical access hospitals.
During the next live edition of Talk Ten Tuesday, Dr. Ronald Hirsch will share some insights that listeners can get from their PEPPER to improve their hospital’s compliance, quality, and revenue.
To learn more, register now to secure your seat at the table during the next live edition of Talk Ten Tuesdays, coming up at 10 a.m. EST on Tuesday, June 23.
Other well-known subject-matter experts will also join the broadcast with more news to report, including the following:
•Tech Report: Senior healthcare analyst Frank Cohen concludes the third installment in his three-part series on AI and coding.
•POV: Penny Jefferson, cohost of Talk Ten Tuesdays, will share her point of view (POV) during the broadcast.
•The Coding Report: Rose Dunn, who will substitute for Christine Geiger, will report on the latest coding news.
•CDI Report: Cheryl Ericson will provide an update on clinical documentation integrity (CDI).
•SDoH Report: Tiffany Ferguson, the CEO for Phoenix Medical Management, will report on news that’s happening at the intersection of patient care and medical record coding
Nearly every American hospital has at least one physician advisor.
So, how does the physician advisor at your facility measure up? We reached out to longtime physician advisor Dr. Juliet Ugarte Hopkins to address this issue in her capacity as the special guest for the upcoming live edition of the popular Talk Ten Tuesday broadcast.
According to Dr. Ugarte Hopkins, also the chief medical officer for Phoenix Medical Management, “physician advisors should be involved in far more (activities) than secondary status reviews and peer-to-peer calls.”
To learn more, register now to secure your seat at the table during the next live edition of Talk Ten Tuesday, coming up at 10 a.m. EST on Tuesday, June 16.
Other well-known subject-matter experts will also join the broadcast with more news to report, including the following:
• Part II: Coding and AI Senior healthcare analyst Frank Cohen, continues with Part 2 in his three-part series on coding and artificial intelligence.
• POV: Penny Jefferson, cohost of Talk Ten Tuesdays, will share her point of view (POV) during the broadcast.
• The Coding Report: Deanna Peterson, who will substitute for Christine Geiger, will report on the latest coding news.
There’s a quiet battle taking place, with no field hospitals for the sick and wounded, and no bloodshed.
But the stakes are high, and the losses are unforgiving.
It’s the battle of algorithms.
Employed by both payers and providers, the ultimate prize: money, in the form of reimbursement from submitted claims for medical care. Payers deny and recoup. Providers bill as margins shrink.
During the next live edition of the ever-popular Talk Ten Tuesdays broadcast, senior healthcare analyst Frank Cohen, himself a veteran of algorithmic warfare, will escort you behind the front lines and into war rooms, so that you will have a better understanding of what is contributing to rising medical costs. Cohen’s three-part article series on ICD10monitor.com begins this coming Tuesday.
Other well-known subject-matter experts will also join the broadcast with more news to report, including the following:
• POV: Penny Jefferson, cohost of Talk Ten Tuesday, will share her point of view (POV) during the broadcast.
• CDI Report: Cheryl Ericson will provide an update on all things clinical documentation integrity (CDI).
• The Coding Report: Christine Geiger will report on the latest coding news.
Although one could conclude that artificial intelligence (AI) is a relatively new technology in healthcare, the reality is that AI has been silently working in the shadows for a while now.
During the next live edition of the popular Talk Ten Tuesdays broadcast, you’ll hear how AI is guiding the technology of the automated query technology at HITEKS, under the supervision of Gerasimos Petratos, founder and CEO.
And what about the thousands and thousands of healthcare coders? Although AI is changing how healthcare claims are managed, as the technology takes on more straightforward coding tasks, coding professionals are shifting into higher-level validation, analysis, and oversight, according to Raemarie Jimenez, the president of membership for AAPC.
Join us as we explore how AI is reshaping coding workflows and what coders should be preparing for now.
Other well-known subject-matter experts will also join the broadcast with more news to report, including the following:
At last, the secrets of healthcare technology will be revealed during a fresh new two-part series, especially written for the accomplished healthcare professional who wants a refresher course on the latest developments that are quickly enveloping healthcare.
Coders, clinical documentation integrity specialists (CDISs), and Revenue Cycle professionals who comprise the Talk Ten Tuesday (TTT) audience and who live inside the chart and the queue, are expected to benefit from an eye level rather than at the strategy level approach from senior healthcare analyst Frank Cohen, a renowned computer scientist and respected Monitor Monday panelist.
Other well-known subject-matter experts will also join the broadcast with more news to report, including the following:
• IPPS Proposed Rule: George Kelly, President of KA Consulting Division at Panacea Healthcare Solutions, will provide an overview of the 2027 IPPSS Proposed Rule during a presentation on May 28.
• POV: Penny Jefferson, Manager of Coding & Clinical Documentation Integrity Services for the University of California-Davis Medical Center, will share her point of view during the broadcast.
• CDI Report: Cheryl Ericson will provide an update on all things CDI.
• SDoH Report: Tiffany Ferguson will report on news happening at the intersection of compliance and medical record coding.
• The Coding Report: Christine Geiger will report on the latest coding news.
The role of physician advisor began as a friendly clinical champion for case/utilization management and clinical documentation integrity (CDI) teams. Today, the role has evolved into a catchall profession within hospitals.
With a scope that encompasses multiple departments within revenue cycle, quality, and hospital utilization, it has becoming increasingly difficult for single individuals to successfully engage with and meet the needs of these groups.
Enter the concept of sub-specialization within physician advisory teams. How can the labor be strategically divided and effectively managed?
Learn more from Juliet Ugarte Hopkins, MD, Chief Medical Officer of Phoenix Medical Management, Inc., during the next live episode of Talk Ten Tuesday.
Other well-known subject-matter experts will also join the broadcast with more news to report, including the following:
· POV: Penny Jefferson, Manager of Coding & Clinical Documentation Integrity Services for the University of California-Davis Medical Center, will share her point of view during the broadcast.
· CDI Report: Cheryl Ericson will provide an update on all things CDI.
· SDoH Report: Tiffany Ferguson will report on news happening at the intersection of compliance and medical record coding.
· The Coding Report: Christine Geiger will report on the latest coding news.
What’s new for the proposed 2026 American Health Information Management Association/Association of Clinical Documentation Integrity Specialists (AHIMA-ACDIS) Practice Brief?
What’s unchanged? And what does it really mean to issue a “compliant” query in today’s healthcare landscape?
According to healthcare attorney Richelle Martin, the special guest for the next live edition of the popular Internet broadcast Talk Ten Tuesday, there’s plenty to talk about.
The 2026 draft practice brief hits all the hot-button issues, like artificial intelligence (AI)-generated queries, repeat questioning, and the use of prior encounters, while reinforcing the core principle that queries function first and foremost to facilitate a complete and accurate medical record.
Perhaps most provocatively, according to Martin, the document pushes back on misuse of query guidance by auditors and payers, clarifying that these guidelines aren’t meant to serve as weapons for denials.
Other well-known subject-matter experts will also join the broadcast with more news to report, including the following:
• POV: Penny Jefferson, Manager of Coding & Clinical Documentation Integrity Services for the University of California-Davis Medical Center, will share her point of view during the broadcast.
• CDI Report: Cheryl Ericson will provide an update on all things CDI.
• SDoH Report: Tiffany Ferguson will report on news happening at the intersection of compliance and medical record coding.
• The Coding Report: Dr. Franklin Martin, who will substitute for Christine Geiger, will report on the latest news regarding the CMS Two-Midnight rule.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
Learning how daily payer logs can help you and your utilization review (UR) team identify denials earlier, strengthen communication between UR and clinical documentation integrity (CDI), and improve the defensibility of medical necessity carries the potential to be a game-changer for healthcare professionals.
During the next episode of Talk Ten Tuesday, Teri Rice, a regulatory specialist with HCPro, will highlight actionable strategies to reduce your facility’s risk and improve outcomes.
The popular weekly Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
• POV: Penny Jefferson will share her point of view during the broadcast.
• CDI Report: Cheryl Ericson will provide an update on all things CDI.
• SDoH Report: Tiffany Ferguson, will report on news happening at the intersection of compliance and medical record coding.
• The Coding Report: Christine Geiger will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
The Association of Clinical Documentation Integrity Specialists (ACDIS) will conclude the formal agenda of its Annual Conference at the close of business next Tuesday in Chicago, but not before the preeminent Dr. James S. Kennedy reports on the highlights of the 2027 Inpatient Prospective Payment System (IPPS) Proposed Rule.
Kennedy, no stranger to the Talk Ten Tuesday audience, will be the special guest during the next live edition of the popular Internet radio broadcast produced by ICD10monitor.
According to Chuck Buck, the program’s executive producer and program host, Dr. Kennedy brings a unique perspective to the subject because he has “an innate sense of coders and the challenges they face to assign correct codes.”
The weekly broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
· SDOH Report: Tiffany Ferguson will report on news that’s occurring at the intersection of medical record coding and healthcare compliance.
· CDI Report: Cheryl Ericson will provide an update on all things clinical documentation integrity (CDI).
· The Coding Report: Christine Geiger will report on the latest coding news.
· News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
· Point of View: Talk Ten Tuesdays cohost Penny Jefferson will report on a healthcare issue that has caught her attention.
Many of you dedicated healthcare professionals no doubt often find yourselves wearing many different hats, as does Penny Jefferson, cohost of the long-running Talk Ten Tuesdays weekly national podcast.
During the next live edition of the popular Internet program, Jefferson will serve as our special guest.
Jefferson is expected to report on the recent guidance and enforcement from the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG). The nation’s healthcare watchdog has placed renewed focus on risk-adjustment accuracy, defensible documentation, and compliance across both Medicare Advantage (MA) and value-based payment models.
The popular weekly Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
• SDOH Report: Tiffany Ferguson will report on news that’s occurring at the intersection of medical record coding and healthcare compliance.
• CDI Report: Cheryl Ericson will provide an update on all things clinical documentation integrity (CDI).
• The Coding Report: Christine Geiger will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
As federal oversight of risk adjustment and documentation practices intensifies, healthcare organizations are facing new scrutiny regarding how patient complexity is documented and reported.
Recent guidance and enforcement activity from the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) has placed renewed focus on risk-adjustment accuracy, defensible documentation, and compliance across both Medicare Advantage (MA) and value-based payment models.
During the next episode of Talk Ten Tuesday, Jason Jobes, a CDI expert, will discuss why outpatient clinical documentation integrity (CDI) programs are becoming increasingly important in this environment. He will explore how documentation practices, provider education, and governance strategies can help organizations accurately capture patient complexity while reducing audit exposure and protecting revenue.
The popular weekly Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
· POV: Penny Jefferson, Manager of Coding & Clinical Documentation Integrity Services for the University of California-Davis Medical Center, will share her point of view during the broadcast.
· CDI Report: Cheryl Ericson will provide an update on all things CDI.
· The Coding Report: Christine Geiger will report on the latest coding news.
· News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
A recent False Claims Act case is raising an important question for CDI professionals: what if the diagnosis is clinically valid, but the process behind it is challenged?
During the next live edition of the popular Talk Ten Tuesdays podcast, Dr. Robert Oubre, director of CDI and UM at St. Tammany Health System, will report on a motion for summary judgement on a case (Smith vs Mercy Health) on
how malnutrition documentation and electronic medical record (EMR) workflows came under scrutiny. Dr. Oubre will also discuss the role of AHIMA guidance and the importance of compliance oversight. This is a must listen for CDI, coding, and compliance leaders.
The popular Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
· POV: Penny Jefferson, Manager of Coding & Clinical Documentation Integrity Services for the University of Davis Medical Center, will share her point of view during the broadcast.
· CDI Report: Cheryl Ericson will provide an update on clinical documentation integrity (CDI).
· The Coding Report: Christine Geiger will report on the latest coding news.
· News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
Data breaches have unfortunately become a fact of life in America’s healthcare system.
The next edition of the popular Talk Ten Tuesdays will focus on just the latest in a succession of such incidents, as providers scramble to determine what to do to prevent cyberattacks – and how to react when they arise, nonetheless.
The popular Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
• POV: Penny Jefferson, Manager of Coding & Clinical Documentation Integrity Services for the University of Davis Medical Center, will share her point of view during the broadcast.
• CDI Report: Cheryl Ericson will provide an update on clinical documentation integrity (CDI).
• The Coding Report: Christine Geiger will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
After two powerful segments introducing her neurodiversity coding initiative, Tami McMasters Gomez, Executive Director for the Mid-Revenue Cycle, Enterprise-Wide Coding and CDI Operations for the University of California Davis Medical Center, returns to report on how this program is unlocking untapped strengths, improving accuracy, and building a more resilient health information (HIM) workforce. Plus, you and your team will learn first-hand the impact that neurodiverse professionals are already making in the coding workforce.
Most importantly, you’ll come to understand why programs like this one may represent an important pathway to both expanding opportunity and strengthening the future healthcare workforce.
Broadcast segments will also include these instantly recognizable panelists, who will report more news during their segments:
• POV: Penny Jefferson, Director of Coding & Clinical Documentation Integrity Services for the University of Davis Medical Center, will share her point of view during the broadcast.
• CDI Report: Cheryl Ericson will provide an update on clinical documentation integrity (CDI).
• SDoH Report: Tiffany Ferguson, CEO for Phoenix Medical Management, reports on the news that’s occurring at the intersection of medical records and federal regulations.
• The Coding Report: Christine Geiger will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national news correspondent, will anchor the Talk Ten Tuesdays News Desk.
The rise of third-party payer audits is no secret to healthcare professionals and facilities, but one type of audit has gained particular attention in recent years: the clinical validation audit.
Clinical validation audits ultimately lead to a downgrade of a hospital’s diagnostic-related group (DRG) payment, but the process by which they reach that result makes them particularly curious.
During utilization review, health plans make decisions about the patient’s care and, in the case of clinical validation audits, actually make determinations about whether documented medical diagnoses are “clinically valid”. Join us to hear how clinical validation audits work and the rise in provider disputes involving clinical validation audits.
Broadcast segments will also include these instantly recognizable panelists, who will report more news during their segments:
· POV: Penny Jefferson, Director of Coding & Clinical Documentation Integrity Services for the University of Davis Medical Center, will share her point of view during the broadcast.
· CDI Report: Cheryl Ericson will provide an update on clinical documentation integrity (CDI).
· SDoH Report: Tiffany Ferguson, CEO for Phoenix Medical Management, reports on the news that’s occurring at the intersection of medical records and federal regulations.
· The Coding Report: Christine Geiger will report on the latest coding news.
It’s huge, and serious.
Its implications may impact millions, even beyond the halls of healthcare. In fact, it’s the eighth-largest healthcare-related cybersecurity breach in U.S. history.
In Texas alone, 15.4 million residents were involved – nearly half the state’s population. Oregon reports another 10.5 million. Other states are still notifying residents. The final number may climb even higher. The stolen data reportedly includes names, Social Security Numbers, medical information, and health insurance details.
Reporting the details of this enormous data breach during the next episode of Talk Ten Tuesdays will be the legendary Rose Dunn, former president of the American Health Information Management Association (AHIMA).
Broadcast segments will also include these instantly recognizable panelists, who will report more news during their segments:
Part II of the groundbreaking Talk Ten Tuesday series concludes as Tami McMasters Gomez returns to share the real-world impact of UC Davis Health’s neurodiversity coding internship.
In this powerful follow-up, Tami moves beyond the vision and into outcomes — workforce transformation, productivity gains, retention success, and the measurable value of inclusive hiring in HIM.
This isn’t a theory. It’s operational innovation in action.
If you care about strengthening the coding workforce, expanding talent pipelines, and redefining what excellence looks like in the healthcare revenue cycle, you won’t want to miss this conversation.
Broadcast segments will also include these instantly recognizable panelists, who will report more news during their segments:
• POV: Penny Jefferson, Director of CDI Services at the University of California, Davis Medical Center, will share her point of view during the broadcast.
• SDoH Report: Marie Stinebuck, CEO for Phoenix Medical Management, will report on the latest news concerning the social determinants of health (SDoH).
• CDI Report: Cheryl Ericson will provide an update on clinical documentation integrity (CDI).
• The Coding Report: Christine Geiger will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
Once a relic symbolic of earlier times in medicine, the Inpatient-Only (IPO) List has been added to the junkyard of outdated medical processes and practices. And if you and your team fail to plan and align your system appropriately, you risk major financial, operational, and compliance consequences.
The good news: during the next live edition of Monitor Mondays, you’ll learn why inpatient status is no longer guaranteed by procedure. You’ll also learn how the burden of proof for inpatient care now rests in your documentation, along with what you and your team must do to protect appropriate inpatient admissions.
Join us when Dr. Stephanie Van Zandt reveals practical strategies to navigate this new landscape and stay ahead of the curve.
Broadcast segments will also include these instantly recognizablepanelists, who will report more news during their segments:
· POV: Penny Jefferson, Manager of Coding & Clinical Documentation Integrity Services for the University of Davis Medical Center, will share her point of view during the broadcast.
· CDI Report: Cheryl Ericson will provide an update on clinical documentation integrity (CDI).
· The Coding Report: Christine Geiger will report on the latest coding news.
· News Desk: Juliet Ugarte Hopkins, MD will anchor the Talk Ten Tuesdays News Desk.
What if the solution to healthcare’s coding workforce challenges has been hiding in plain sight?
The conversation doesn’t end with rethinking who can succeed in medical coding. In Part II of this special Talk Ten Tuesday series, the focus is on how healthcare organizations can get involved.
This broadcast will highlight a growing partnership with the American Health Information Management Association (AHIMA), and outlines how organizations can participate in a neurodiversity-focused coding internship model.
Learn what it means to host interns, support neurodiverse candidates, and create structured, sustainable pathways into health information management (HIM) careers.
For healthcare leaders facing persistent workforce shortages, accuracy concerns, and burnout, this discussion will move from inspiration to implementation – showing how inclusive workforce strategies can strengthen coding operations while expanding opportunities.
If you’re ready to move beyond awareness and explore practical ways to build a more resilient, forward-thinking coding workforce, this is for you.
The popular Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
What if the solution to healthcare’s coding workforce challenges has been hiding in plain sight?
During this special two-part Talk Ten Tuesday series, UC Davis Health shares how an innovative neurodiversity-focused coding internship is redefining how talent is identified, trained, and retained.
Join Tami McMasters Gomez, Executive Director, for the Mid-Revenue Cycle, Enterprise-Wide Coding and CDI Operations for the University of California Davis Medical Center, when she reports on how this program is unlocking untapped strengths, improving accuracy, and building a more resilient health information (HIM) workforce.
This unique conversation will challenge long-standing assumptions about who succeeds in medical coding.
If you were responsible for the coding operations of a complex medical center, would you build tomorrow’s workforce the same way you do today? Be sure to listen and learn.
This popular Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
· POV: Penny Jefferson, Manager of Coding & Clinical Documentation Integrity Services for the University of Davis Medical Center, will share her point of view (POV) during the broadcast.
· CDI Report: Cheryl Ericson will provide an update on clinical documentation integrity (CDI).
· The Coding Report: Legendary Rose Dunn, COO for First Class Solutions, will handle the coding report for Christine Geiger. Rose will report on the latest False Claims Act (FCA) settlement.
· News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
While many of you might have been enjoying the holiday season, the
beat of healthcare keeps on beating.
Much has happened in the world of medical coding and that is why
the producers of Talk Ten Tuesday are dedicating the next live
edition of the popular national Internet broadcast to the topic of
coding.
And that’s why Dr. James S. Kennedy, a trained medical professional
who loves coding, will be the Talk Ten Tuesday special guest.
The popular Internet broadcast will also feature these additional
instantly recognizable panelists, who will report more news during
their segments:
What’s new when it comes to artificial intelligence (AI) and coding?
Listen to the next edition of the long-running and popular Talk Ten Tuesday and learn from longtime RACmonitor and ICD10monitor contributing author Sharon Easterling.
Sharon Easterling will continue her editorial series on artificial intelligence and medical record coding. The potential for AI in health information is both exciting and daunting as you’ll learn.
The popular Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
Are you wondering what connects the nouns in the headline together?
It’s a Medicare cognitive screening devise. Look at these words and commit them to memory. Try to repeat back this list of words twice a day, from memory: Apple, Chair, Ocean, Book, and Clock.
During the next live edition of the popular Talk Ten Tuesday live Internet broadcast, Gloryanne Bryant will report on what
some medical experts say about an inability to recall these five words.
Could it be signs of cognitive changes or impairment within the brain? Or could it mean that the individual has memory and recall issues?
Register now to learn more.
The broadcast will also feature these instantly recognizable panelists, who will report more news during their segments:
Anyone who has been working within the scope of hospital case/utilization management for any period of time has heard of the Centers for Medicare and Medicaid Services (CMS) Conditions of Participation.
But are you familiar with the CMS Conditions for Coverage? Sometimes referred to as “conditions of payment,” these requirements must be met in order for federal health plans to pay a healthcare facility for a submitted claim.
Welcome to the live edition of Talk Ten Tuesday, Dec. 9, 10 Eastern. That’s when Dr. Juliet Ugarte Hopkins, Chief Medical Officer for Phoenix Medical Management, Inc., will explain how failure to meet some aspects of the CoPs doesn’t mean there is a failure in Conditions for Coverage (CfC).
The broadcast will also feature these instantly recognizable panelists, who will report more news during their segments:
They were once called “clinical documentation improvement” specialists, charged with correcting the medical record to identify an overlooked diagnosis that carried the potential to increase revenue. Later, the description was changed to clinical documentation “integrity” (CDI) specialists.
Butthat was then. This is now.
Today, the job description continues to change. CDI professionals are being asked to take on more and more responsibilities.
And that is why the producers of Talk Ten Tuesday have invited Penny Jefferson, a longtime CDI professional, to be the special guest during the next live edition of the weekly Internet broadcast.
The broadcast will also feature these instantly recognizable panelists, who will report more news during their segments:
· Social Determinants of Health: Tiffany Ferguson,CEOforPhoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
· CDI Report: Cheryl Ericson, Senior Director of Clinical Policy and Education for the vaunted Brundage Group, will have the latest CDI updates.
· The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
· News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
· MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.
Since 80 percent of a person’s health is influenced by factors outside of medical care, it is critical that a healthcare system has an understanding and appreciation for the circumstances of patients’ daily lives that impact their health outcomes, referred to as the social determinants of health (SDoH).
During the next live edition of Talk Ten Tuesday, Lauren Montwill, Vice President of Community Health and Social Impact for the UnitedHealth Group, will report on how her organization is collaborating on the delivery system to collect reliable SDoH data, as well as the effort to build health analytics infrastructure to benchmark, monitor, and track progress toward improving health outcomes and quality measures.
The broadcast will also feature these instantly recognizable panelists, who will report more news during their segments:
Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
CDI Report: Cheryl Ericson, Senior Director of Clinical Policy and Education for the vaunted Brundage Group, will have the latest clinical documentation integrity (CDI) updates.
The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.
It’s often said that “words matter.”
And hospital patient status assignment is no exception.
What do your teams say when a patient is in inpatient status which isn’t supported? How about the reverse: when a patient is in outpatient status with observation services. Can your team change to inpatient?
Words matter, and Dr. Juliet Ugarte Hopkins, chief medical officer for Phoenix Medical Management, Inc., will explain precisely how impactful your choices can be.
During the next live edition of Talk Ten Tuesday, Dr. Juliet Ugarte Hopkins will report on this timely topic.
The broadcast will also feature these instantly recognizable panelists, who will report more news during their segments:
A new version of the Sequential Organ Failure Assessment (SOFA) score, has been introduced.
The new revision aligns the organ dysfunction measurement in critically ill adults with current clinical practices, especially those diagnosed with sepsis.
Published Oct. 29 in Journal of the American Medical Association (JAMA) and is available here https://jamanetwork.com/journals/jama/fullarticle/2840822.
During the next live edition of Talk Ten Tuesday, Dr. James S. Kennedy will discuss this new SOFA-2 revision and its expected impact on clinical validation for sepsis – defined by Sepsis-3 as a life-threatening organ dysfunction caused by a dysregulated host response to infection – and how facility clinical workflows can negotiate denial avoidance with payers with this challenging diagnosis.
The broadcast will also feature these instantly recognizable panelists, who will report more news during their segments:
Welcome to “Is Ambient Listening Right for You?” Or, in the alternative, “Free AI Tools and Other Expensive Mistakes.”
Nick van Terheyden, MD, the special guest during the next live edition of Talk Ten Tuesdays, says he has seen enough of artificial intelligence (AI) “helpers” turn doctors into unpaid editors and part-time exorcists for hallucinating software.
“Clinicians signed up to heal humans, not debug bots,” Dr. Nick said. “Yet here we are, creating ‘AI slop’ so thick it needs its own billing code.”
Dr. Nick also references a Harvard study that says your coworkers think using AI makes you less competent; meanwhile, MIT says you’re probably not getting a dime’s worth of value. But don’t worry, you’re getting your AI tool for free! Which, like the “free drinks” at an all-inclusive resort, often tastes mostly like disappointment.
Finally, Dr. Nick offers this parting shot: “Remember: your medical records can’t be ‘vibe-coded’ clean. And while lawyers blame the AI for their made-up filings, you don’t get that luxury. Choose your AI tool wisely, because ‘no hallucinations added’ shouldn’t have to be in your note.”
The broadcast will also feature these instantly recognizable panelists, who will report more news during their segments:
H.R. 1, known as the One Big Beautiful Bill Act (OBBBA), is set to reshape hospital finances by cutting an estimated $840 billion from Medicaid and Patient Protection and Affordable Care Act (PPACA) funding. As hospitals absorb these losses, many are tightening budgets, reducing staff, and facing renewed labor tensions.
For the first time, clinical documentation integrity (CDI) teams are part of this unionized landscape, connecting frontline workforce issues directly to reimbursement and data accuracy. When strikes or slowdowns occur, they can disrupt queries, coding, and claims, creating both financial and compliance risks. Together, these forces reveal how economic and workforce realities are now intertwined across every level of healthcare.
Reporting the lead story during the next live edition of Talk Ten Tuesdays, the popular Internet broadcast produced by ICD10monitor, will be Penny Jefferson, CDI Manager for UC Davis Health.
The broadcast will also feature these instantly recognizable panelists, who will report more news during their segments:
Have you been told that Medicare and Medicare Advantage (MA) patients who have difficulties with activities of daily living (ADLs) are appropriate for inpatient status if their hospital stay crosses a second midnight?
What direction have you received about “discharge effectuation?”
Are your physicians keen on placing the majority of their patients into inpatient status because they want to prevent delivery of an expensive hospital bill?
During the next live edition of Talk Ten Tuesdays, Dr. Juliet Ugarte Hopkins, the Chief Medical Officer for Phoenix Medical Management, will report on issues that have captured her interest as she discusses these, and other hot topics of misdirection and misinformation often encountered in the healthcare landscape.
The popular broadcast will also feature these instantly recognizable panelists, who will report more news during their segments:
Join us this coming Tuesday, Oct. 14, when Talk Ten Tuesday will bring you an exclusive interview with two nationally recognized healthcare leaders: Thea Campbell and Mackenzie Higgins. Thea Campbell is the 2026 AHIMA President-Elect and Mackenzie Higgins is the 2025 AHIMA Emerging Star award recipient.
The popular broadcast will also feature these instantly recognizable panelists, who will report more news during their segments:
The revenue cycle helps keep hospital revenue flowing. But sometimes, it seems to sputter out, as if not all the cylinders are firing. And that is why the producers of Talk Ten Tuesdays have invited longtime ICD10monitor editorial consultant Dennis Jones, senior director of revenue cycle at the famed Jefferson Health, to be the special guest during the next live edition of the weekly Internet radio broadcast.
The popular broadcast will also feature these instantly recognizable panelists, who will report more news during their segments:
• CDI Report: Cheryl Ericson, Senior Director of Clinical Policy and Education for the vaunted Brundage Group, will have the latest clinical documentation integrity (CDI) updates.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
When the final rule take effect Oct. 1, 2025, coders, providers, and administration leaders will need to adjust to several key changes, including the new MS-DRGs and broad policy changes. And that is why the producers of Talk Ten Tuesday have invited Leigh Poland, vice president of the AGS Health coding service product line to return to the popular Internet broadcast, Talk Ten Tuesday, to report on these significant changes.
The popular Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
• CDI Report: Cheryl Ericson, Senior Director of Clinical Policy and Education for the vaunted Brundage Group, will have the latest clinical documentation integrity (CDI) updates.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• The Coding Report: Jodi Worthington, with First Class Solutions, will substitute for Christine Geiger to report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.
Prolonged hospitalizations can result from many different barriers and delays within the hospital setting.
However, a new challenge is emerging.
And this new hurdle appears to be identified more and more commonly. So, what’s happening?
During the next live edition of Talk Ten Tuesdays, Dr. Juliet B. Ugarte Hopkins, Chief Medical Officer at Phoenix Medical Management, Inc., will reveal this new culprit that appears to be standing between many a patient and a safe discharge.
The popular Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
• CDI Report: Cheryl Ericson, Senior Director of Clinical Policy and Education for the vaunted Brundage Group, will have the latest clinical documentation integrity (CDI) updates.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• The Coding Report: Amy Jo Combs, with First Class Solutions, will substitute for Christine Geiger to report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.
Could sepsis be healthcare’s new frontier?
During the next live edition of the popular Internet broadcast, Talk Ten Tuesday, James S. Kennedy, MD, will report on his recent attendance at The Unite for Sepsis symposium, sponsored by the San Diego-based Sepsis Alliance (https://www.sepsis.org). The event was held in Chicago and attracted clinicians, researchers, technologists, and government officials who collaborated to address and solve sepsis’ prevalent and high morbidity and mortality. Dr. Kennedy is expected to report on new technologies and clinical approaches to sepsis and how health information management (HIM) professionals can address sepsis-related diagnosis and data integrity.
As an added feature, the legendary Rose T. Dunn, past president and interim CEO for the American Health Information Management Association (AHIMA) and current COO for First Class Solutions, will report on RADV audits.
The popular Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
• CDI Report: Cheryl Ericson, Senior Director of Clinical Policy and Education for the vaunted Brundage Group, will have the latest clinical documentation integrity (CDI) updates.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
You waited and waited.
Finally, the big day came, and just as quickly, day turned into evening – and there you were with cloudy vision, halos, and difficulty reading. Not to mention the occasional glare.
You and about 25 percent of patients experience a common complication following cataract surgery (or, more precisely, “posterior capsule opacity,” or PCO). The good news: the standard treatment is YAG laser capsulotomy (CPT® 66821).
The legendary Rose T. Dunn, past president and interim CEO for the American Health Information Management Association (AHIMA) and current COO for First Class Solutions, will return to the Talk Ten Tuesdays broadcast to report on this treatment and topic.
The popular Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.
• CDI Report: Cheryl Ericson, Senior Director of Clinical Policy and Education for the vaunted Brundage Group, will have the latest clinical documentation integrity (CDI) updates.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
Artificial intelligence (AI) has quickly transitioned from something to expect in the future to the here and now today. The potential for AI in health information is both exciting and daunting. Reporting the lead story during the next live edition of Talk Ten Tuesday will be longtime RACmonitor and ICD10monitor contributing author Sharon Easterling.
Sharon Easterling will continue her editorial series on artificial intelligence and medical record coding.
The popular Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.
• CDI Report: Cheryl Ericson, Senior Director of Clinical Policy and Education for the vaunted Brundage Group, will have the latest clinical documentation integrity (CDI) updates.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
At one time, a physician advisor in a hospital was a rarity. That was then, but this is now, with many healthcare systems having not just one physician advisor, but often many on staff. Does this emerging need signal the deployment of a new position within the physician advisory service team?
To learn more, ICD10monitor producers have invited Dr. Juliet B. Ugarte Hopkins to explain when and how this might be accomplished.
Dr. Ugarte Hopkins, the chief medical officer for Phoenix Medical Management, Inc., will be the special guest during the next live edition of Talk Ten Tuesday.
The popular weekly Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
• CDI Report: Cheryl Ericson, Senior Director of Clinical Policy and Education for the vaunted Brundage Group, will have the latest clinical documentation integrity (CDI) updates.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.
Although the proposed rule for the 2026 Inpatient Prospective Payment System (IPPS) has been released by the Centers for Medicare & Medicaid Services (CMS), mastering the complexities will continue to challenge most coders and coding team members. That is why ICD10monitor producers have asked Dr. James S. Kennedy to join the upcoming edition of Talk Ten Tuesdays: to highlight potentially significant roadblocks that are likely to confront coders as they prepare to implement the new rule that becomes effective Oct. 1, 2025.
As a sidebar, Dr. Kennedy, along with nationally recognized coding authority Christine Geiger, will team up for the 2026 IPPS Masterclass series, taking place live Aug. 13, 14, and 15.
The popular weekly Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
• CDI Report: Cheryl Ericson, Director of clinical documentation integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.
During the next live edition of the popular Talk Ten Tuesday Internet broadcast, you’ll learn how artificial intelligence (AI) and autonomous coding are quickly reshaping the day-to-day work of coders.
From inpatient DRG suggestions to outpatient evaluation and management (E&M) automation, these tools speed up workflows, reduce errors, and help prevent costly denials, according to Penny Jefferson, the special guest for the Internet program, produced by ICD10monitor.
You’ll also learn the human side of automation—how coders remain essential for complex decision making, quality assurance, and accurate clinical representation.
The popular weekly Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
• CDI Report: Cheryl Ericson, Director of CDI for the vaunted Brundage Group, will have the latest CDI updates.
• The Coding Report: Amy Jo Combs, with First Class Solutions, will substitute for Christine Geiger to report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.
According to the Centers for Disease Control and Prevention (CDC), accidental falls are the leading cause of injury for adults 65 and older, with more than 1 in 4 older adults reporting falls every year.
During the next live edition of Talk Ten Tuesday, Dr. James S. Kennedy will discuss the clinical concept of the “fragility fracture,” and how the under-documentation of fragility fractures results in inaccurate ICD-10-CM coding, adversely affecting Centers for Medicare & Medicaid Services (CMS) MS-DRGs, hospital-acquired conditions (HACs), and other quality measures. Be sure that your coding supervisor, clinical documentation integrity (CDI) director, and quality teams listen in to partner collectively with the medical staff with identifying this prevalent condition.
The popular weekly Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH;
• CDI Report: Cheryl Ericson, Director of CDI for the vaunted Brundage Group, will have the latest CDI updates;
• The Coding Report: Jodi Worthington, with First Class Solutions, will substitute for Christine Geiger to report on the latest coding news;
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk; and
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.
Substance abuse is a pervasive issue with profound implications for hospitals.
It has been estimated that up to 25 percent of hospitalized patients have a substance abuse disorder. And up to 44 percent of these patients abuse some substance during hospitalization. The annual estimated hospital cost for treating substance abuse disorders is as high as $13 billion.
But it’s not limited to patients, according to physician and attorney Dr. John K. Hall, who will be the special guest during the next live edition of Talk Ten Tuesdays.
According to Dr. Hall, estimates show that up to 15 percent of physicians and 20 percent of nurses also have a substance abuse disorder. It affects patient outcomes, hospital operations, financial health, and the broader healthcare system. The complexity of substance use disorders requires a nuanced understanding of diagnostic categories, accurate coding, and awareness of the legal and employment ramifications.
The popular weekly Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH;
• CDI Report: Cheryl Ericson, Director of clinical documentation integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates;
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news;
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk; and
• Point of View: Dr. James S. Kennedy, who will be sitting in for Angela Comfort, will report on a topic that has captured his attention.
Attention, calling all coders!
Is your hospital compliantly following all the the steps in the Condition Code W2 process?
It’s imperative to understand all the details that must be followed, no matter how complex and daunting.
Implementation is mandated by the Centers for Medicare & Medicaid Services (CMS). Participation is not optional. So take a moment and ask yourself: are your attending physicians re-billing for Medicare Part B patients?
During the next live edition of the popular live Internet broadcast Talk Ten Tuesdays, the Medical Director of Phoenix Medical Management, Inc., Dr. Juliet Ugarte Hopkins, will walk you and your team through the requirements that need to be followed for Medicare Part B re-billing.
The popular Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH;
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news;
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk; and
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.
Artificial intelligence (AI) has quickly transitioned from something to expect in the future to the here and now today. The potential for AI in health information is both exciting and daunting. Reporting the lead story during the next live edition of Talk Ten Tuesday will be longtime RACmonitor and ICD10monitor contributing author Sharon Easterling.
Sharon Easterling is slated to create an editorial series on artificial intelligence. Her report on this topic will be a preview of what readers and listeners will learn during her series.
The popular Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH;
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news;
• Field Report: Dennis Jones, a veteran Monitor Mondays and Talk Ten Tuesdays contributing author, will report on the latest developments regarding the revenue cycle. Jones is the senior director of revenue cycle at Jefferson Health.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk; and
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.
As state laws, federal regulations, and insurance policies continue to evolve, healthcare organizations face growing demands to ensure that gender-affirming care is appropriately documented and reported.
Reporting on these serious coding challenges and the dire consequences of failing to achieve compliance during the next edition of Talk Ten Tuesdays will be senior healthcare consultant Penny Jefferson, the special guest for the broadcast coming up at 10 a.m. EST on Tuesday, July 1.
The popular Internet broadcast will feature the additional following instantly recognizable panelists, who will report more news during their segments:
• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates;
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news;
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk; and
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.
Your pets might be doing more than just keeping you company. They could be reshaping your immune system.
Early exposure to pets, especially in childhood, may reduce allergies and asthma by diversifying gut bacteria and strengthening immunity, according to Dr. Nick van Terheyden, director of Incremental Health. Dr. Nick is scheduled to be the special guest during the next live edition of Talk Ten Tuesdays, coming up at 10 a.m. EST on Tuesday, June 24.
The popular Internet broadcast will feature the additional following instantly recognizable panelists, who will report more news during their segments:
• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates;
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news;
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk; and
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.
Could physician advisors become dinosaurs in healthcare, bound for extinction?
The role of the physician advisor has developed into an absolute necessity in hospitals of all sizes around the country. As the healthcare landscape rapidly evolves, physician advisors have served as critical players, bridging the gap between confusion and clarity within clinical and administrative functions.
Yet, the question remains unanswered: why are only a fraction of physician advisors employed as full-time employees?
During the next live edition of Talk Ten Tuesdays, Juliet B. Ugarte Hopkins, MD, Medical Director of Phoenix Medical Management, Inc., will report on the pitfalls of inadvertently diluting the physician advisor’s focus and level of expertise.
The popular Internet broadcast will feature the additional following instantly recognizable panelists, who will report more news during their segments:
• CDI Report: Cheryl Ericson, Director of clinical documentation integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates;
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news;
• Field Report: Dennis Jones, a veteran Monitor Mondays and Talk Ten Tuesdays contributing editor, will report on the latest developments regarding the revenue cycle. Jones is the senior director of revenue cycle at Jefferson Health;
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk; and
• Point of View: Dr. Kennedy will report on his efforts to advocate for a change in the definition of sepsis. Dr. Kennedy will be sitting in for Angela Comfort, who continues as the co-host for the long-running and popular weekly Internet broadcast.
One of the largest regional coding organizations in America’s healthcare universe – the California Health Information Association (CHIA) – wrapped its final workshops this past week, with delegates flying home to share their insights on what was considered to be a pivotal experience.
The ICD10monitor producers of Talk Ten Tuesdays have secured a rare appearance of CHIA’s past president, Gloryanne Byrant, who agreed to share five key takeaways from the annual conference.
During the next live edition of Talk Ten Tuesdays, coming up at 10 a.m. EST on June 10, the popular Internet broadcast will feature the additional following instantly recognizable panelists, who will report more news during their segments:
• CDI Report: Cheryl Ericson, Director of CDI for the vaunted Brundage Group, will have the latest CDI updates;
• Field Report: Dennis Jones, a veteran Monitor Mondays and Talk Ten Tuesdays contributing editor, will report on the latest developments regarding the revenue cycle. Jones is the administrator of the revenue cycle at Jefferson Health;
The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news;
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk; and
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.
The national conference of the largest regional coding organization chapters in America’s healthcare universe gets underway this weekend – and James S. Kennedy, MD, will be there.
Dr. Kennedy, president of CDIMD, a national coding and clinical documentation integrity (CDI) consultancy, will be reporting on major events taking place at the California Health Information Association (CHIA) conference, starting this weekend in Southern California.
As a longtime editorial contributor to RACmonitor and ICD10monitor, Dr. Kennedy, will be the special guest during the next live edition of Talk Ten Tuesdays, coming up at 10 a.m. EST on June 3. The Internet broadcast, produced by ICD10monitor, is expected to feature the additional following instantly recognizable panelists, who will report more news during their segments:
•Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH;
•CDI Report: Cheryl Ericson, Director of CDI for the vaunted Brundage Group, will have the latest CDI updates;
•The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news;
•News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk; and
•MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.
UnitedHealth Group (UHG) stock is plummeting following the abrupt resignation of its CEO Andrew Witty. His sudden departure, coming on Tuesday, May 13, came amid multiple lawsuits and threatened actions by private, state, and federal agencies across the country, and amid massive criticism for the company’s tendency to deny beneficiaries coverage for services at elevated rates.
Witty’s exit from the giant payer – a long-time dominant force related to revenue cycle, provider staffing, utilization, and managed and commercial health insurance plans – seems to have rattled many in America’s sprawling health delivery system. So, how could these recent events affect other hospitals and health systems?
During the next live edition of the popular Talk Ten Tuesdays, the Internet broadcast produced by ICD10monitor, Dr. Juliet Ugarte Hopkins will share what she thinks of what might lie ahead. Dr. Ugarte Hopkins is the medical director for Phoenix Medical Management, Inc. and the Immediate Past President of the American College of Physician Advisors.
Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH;
• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates;
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news;
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk; and
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.
Radiology reports are rich in clinical detail, yet ICD-10 codes often fail to fully capture the complexity and specificity of imaging findings.
That is why the producers of Talk Ten Tuesdays and ICD10monitor have invited Laura Manser to explore the most common disconnects between radiology documentation and ICD-10 coding – especially in areas like incidental findings, laterality, and linking imaging results to medical necessity.
During the next edition of the weekly broadcast, Manser is also expected to highlight common errors, such as coding suggestive findings as definitive diagnoses, and provide practical guidance on bridging the gap between documentation and compliance.
Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.
The revenue cycle can be thought of as a machine that keeps churning nonstop, making everything work, financially speaking, for your hospital.
But even the most well-oiled machinery can get clogged, meaning it doesn’t perform at its peak. And that is why the producers of ICD10monitor and Talk Ten Tuesdays have invited Jessica Miller-Dobbs to join the popular Internet broadcast as its special guest for some shop talk.
Jessica is the Director of Health Information Management (HIM) and Revenue Cycle for Datavant. She is scheduled to appear during the next live edition of Talk Ten Tuesdays, 10 a.m. Eastern on May 6, for a refreshingly new approach in learning how to get your revenue cycle humming.
Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
Payer edits and denials are pervasive in healthcare reimbursement.
These problems typically arise from coding inaccuracies, insufficient documentation, or non-compliance with payer-specific guidelines. These challenges can lead to revenue loss, increased administrative burden, and frustration among healthcare providers.
A skilled coding staff plays a vital role in mitigating these issues. Proactive identification of potential red flags at the time of coding can decrease the number of edits and denials being returned from the payer.
Join our special guest Lorie Mills, director of health information services for Primeau Consulting Group, during the next live edition of Talk Ten Tuesday, April 29, 10 Eastern for a refreshingly new approach to understanding how and what smart coding can do to avoid these expensive and frustrating issues.
Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.
• The Coding Report: Substituting for Christine Geiger will be Amy Jo Combs, Senior Coding Compliance Consultant for First Class Solutions. She will discuss the significant difference between “History of” and “in remission” when reporting leukemia.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
Custodial and social hospitalizations have long been a hospital challenge.
From inadequate patient support and services to medically unwarranted occupancy of inpatient beds, plus lack of payment for provision of care, prevention and management of these cases continues to be an issue.
While much has been discussed about how to proceed, many hospitals fail.
And that is why the producers of ICD10monitor and Talk Ten Tuesday have invited Dr. Juliet B. Ugarte Hopkins to be the special guest during the next live edition of Talk Ten Tuesday.
Dr. Ugarte Hopkins is the medical director for Phoenix Medical Management, Inc. and immediate past president of the American College of Physician Advisors. Dr. Ugarte Hopkins will report on this developing crisis
Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
In today’s healthcare environment, America’s hospitals are experiencing increases in payer denials as a result of incorrect application of drug HCPCS units and a drug HCPCS modifier (JW/JZ).
These denials have increased costs for providers, because the existing staff is either being redirected to spend more time on the issue or additional staff are being hired to resolve the drug charge denials. Healthcare industry professionals need an easy-to-use and cost-effective resource to submit their claims correctly the first time.
During the next live edition of Talk Ten Tuesdays, senior healthcare consultant Tiffani Bouchard will review the current environment in which coders work while explaining how new technology tools and solutions have the potential Drew Updike drewupdike@gmail.com to expedite the drug lookup process.
Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
Effective communication is a critical skill in navigating clinical and non-clinical interactions to avoid disaster striking a facility’s bottom line.
In fact, poor communication directly impacts the bottom line. Today, amid a cacophony of competing and complex issues spanning generations and a range of viewpoints, there is an overarching need to foster collaboration.
During the next live edition of Talk Ten Tuesday, Lorie Mills, director of health services for Primeau Consulting Group, will report on the importance of identifying both effective and ineffective communication practices, and their impact on organizational success.
Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
• Point of View: Dr. James S. Kennedy, founder of CDI MD, will serve as the guest cohost, and will report on a topic that has caught his attention.
World Health Day, which will be officially observed on Monday, April 7, will mark what organizers claim will be a year-long celebration. Here at ICD10monitor and Talk Ten Tuesdays, we will celebrate a bit early, during the next edition of the Talk Ten Tuesdays live Internet broadcast.
Headlining the broadcast will be Lorraine Fernandes, immediate past president and communications chair of the International Health Information Management Association.
This year’s World Health Day theme focuses on efforts to end preventable maternal and newborn deaths, and “to prioritize women’s longer-term health and well-being.”
The World Health Organization (WHO) cites published estimates that nearly 300,000 women lose their lives due to pregnancy or childbirth annually. The WHO also states that more than 2 million babies die during their first month of life, and that 2 million more are stillborn.
Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• CDI Report: Cheryl Ericson, director of clinical documentation integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, a veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
National Doctors’ Day is Sunday, March 30. Even though the national one-day observance is only a few days away, the ICD10monitor producers of Talk Ten Tuesdays want to ensure that everyone is aware of the significant contributions made daily by America’s doctors. Hence, our recognition of the occasion will continue during the next live edition of the popular weekly Internet broadcast.
As part of the celebration, physician and attorney Dr. John K. Hall has been invited to be the special guest on Talk Ten Tuesdays. Dr. Hall, a popular panelist on Monitor Mondays, has distinguished himself as an astute reporter of healthcare news: he introduced the audience to the concept of Chevron Deference at the time when little information was available on an unprecedented development.
Dr. Hall will report on two virus outbreaks in particular that have captured the attention of Americans.
Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• CDI Report: Cheryl Ericson, Director of clinical documentation integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, a veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
Time is money. And nowhere is that adage more relevant than in today’s American hospitals.
For example, consider the patient who is medically ready for discharge, but still waiting for a skilled nursing facility (SNF) bed to open up. Or the case in which a patient might medically require a cardiac catheterization before being safely cleared to discharge to home, but there’s a delay until the procedure can be performed on Monday.
So, when is it okay to delay?
Answering that question as well as reporting on the nuances of such delays will be Juliet Ugarte Hopkins, MD, the special guest during the next edition of the long-running and popular Talk Ten Tuesdays broadcast produced by ICD10monitor.
Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• CDI Report: Cheryl Ericson, Director of CDI for the vaunted Brundage Group, will have the latest CDI updates.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
Overwhelmed by nutrition advice?
You’re not alone.
From sketchy influencer “secrets” to Big Food’s algorithm-driven traps, a myriad of pitfalls means making healthy choices has never been harder.
Questions abound: should you go all-in on the potato diet? Or embrace the all-meat life? (Spoiler: probably not.)
This week, during the long-running and popular Talk Ten Tuesdays Internet broadcast produced by ICD10monitor, Dr. Nick van Terheyden will cut through the noise – breaking down diet fads, industry tricks, and practical ways to eat better, without the overwhelm.
Because good nutrition shouldn’t be this complicated.
Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
Overwhelmed by nutrition advice?
You’re not alone.
From sketchy influencer “secrets” to Big Food’s algorithm-driven traps, a myriad of pitfalls means making healthy choices has never been harder.
Questions abound: should you go all-in on the potato diet? Or embrace the all-meat life? (Spoiler: probably not.)
This week, during the long-running and popular Talk Ten Tuesdays Internet broadcast produced by ICD10monitor, Dr. Nick van Terheyden will cut through the noise – breaking down diet fads, industry tricks, and practical ways to eat better, without the overwhelm.
Because good nutrition shouldn’t be this complicated.
Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
Overwhelmed by nutrition advice?
You’re not alone.
From sketchy influencer “secrets” to Big Food’s algorithm-driven traps, a myriad of pitfalls means making healthy choices has never been harder.
Questions abound: should you go all-in on the potato diet? Or embrace the all-meat life? (Spoiler: probably not.)
This week, during the long-running and popular Talk Ten Tuesdays Internet broadcast produced by ICD10monitor, Dr. Nick van Terheyden will cut through the noise – breaking down diet fads, industry tricks, and practical ways to eat better, without the overwhelm.
Because good nutrition shouldn’t be this complicated.
Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
Discharge orders have evolved. Today, they indicate the end of hospital billing for an encounter.
However, when the discharge order is placed on a day other than the day a patient actually leaves the hospital, it can often lead to under-reporting the patient’s length of stay (LOS) and other issues. And when some clinicians are told to place such an order when patients are medically ready to leave – even if there is no safe discharge plan – this forces the team to make the tough decision: to discharge or not to discharge. Thus, potential patient safety issues arise, as Dr. Juliet Ugarte Hopkins will report as the special guest during the next live edition of Talk Ten Tuesdays.
Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
Could generative artificial intelligence (AI) revolutionize healthcare, or is it just a risky trend?
During the next must-see live broadcast of Talk Ten Tuesdays, Dr. Christopher Boyle will walk you through the potential and pitfalls of generative AI. His journey will take you on an exploration of three promising uses of AI that focus on safety, documentation, and coding accuracy. You’ll learn how you can balance the benefits of AI while ensuring compliance. Dr. Boyle will also report on how AI is addressing the social determinants of health (SDoH).
Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
When a law enforcement officer comes to your facility, what do you need to know? And what should you do?
While until recently, this topic was seldom on the top of lists of
healthcare issues, a recent move by the Trump Administration (Executive Order) appears to have revoked a longstanding policy that prevented federal law enforcement agents (U.S. Immigration and Custom Enforcement) from going to certain areas long considered safe – think hospitals and schools – to conduct enforcement activities.
So, what should you do – and what can you do, legally?
Register now to attend the next live edition of Talk Ten Tuesdays, coming up at 10 a.m. EST on Feb. 4, when healthcare attorney David Glaser will weigh in on the topic as the broadcast’s special guest.
Listen and learn as Glaser will tell you what you and your team can and should do when faced with these unusual and unwelcomed visits.
Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
It could be the shot heard ‘round the world: the announcement recently of Stargate, a multi-billion-dollar artificial intelligence (AI) project now underway in the U.S. and backed by huge corporations, including Oracle, Open AI, and SoftBank, among others. But what will be the impact on healthcare, and notably, health information management (HIM) professionals?
Reporting on this huge healthcare issue during the next edition of Talk Ten Tuesdays will be the legendary Rose Dunn.
Dunn, who served as past president and former interim CEO of the American Health Information Management Association (AHIMA), will do double duty next Tuesday. She will also handle reporting duties for the Talk Ten Tuesdays Coding Report, substituting for Christine Geiger. In that capacity, Dunn is expected to report on the 60-Day Refund Rule, part of the 2025 Physician Fee Schedule.
Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will report the latest documentation quandaries your team is likely to encounter this year.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, veteran healthcare subject matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
Looking to unravel healthcare’s complex issues? Looking to streamline your operations and improve decision-making?
Join us this coming Tuesday, Jan. 14 at 10 a.m. EST, when the long-running Talk Ten Tuesdays kicks off its 2025 broadcast season with special guest Frank Cohen, senior director of analytics for VMG Health. Cohen will share his insight on Hanlon’s Razor, a principle that can be summarized as “never attribute to malice that which can be adequately explained by incompetence.”
This principle isn’t about blame-sharing, but rather about how to foster empathy and clarity while also helping to develop constructive problem-solving.
Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• CDI Report: Cheryl Ericson, Director of clinical documentation integrity (CDI) for the vaunted Brundage Group, will make her debut appearance as the broadcast’s CDI correspondent.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, veteran healthcare subject expert, will begin the 2025 Talk Ten Tuesdays broadcast season as the co-host for the long-running and popular weekly Internet broadcast. Comfort, assistant vice president of revenue integrity for Montefiore Health, assumes the broadcast job following the expected departure of Erica Remer, MD.
We’re living in a hybrid world. And now the hybrid concept has become part of the coding and clinical documentation integrity (CDI) world.
The process of physician querying is already a stressful activity for many CDI and coding professionals. It has recently become even more stressful, because many hospitals are receiving a new type of denial: a hybrid between coding and clinical validation. It arises when a payer denies a diagnosis added by query, because their auditor determined that the query was non-compliant.
During the next live edition of Talk Ten Tuesdays, senior healthcare consultant Cheryl Ericson will return to the broadcast to help coders and CDI specialists (CDISs) better code and report amid this new added twist of a threat.
Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Field Report: Substituting for Tiffany Ferguson will be Laurie Johnson, who is expected to report on trauma coding occasioned by Wednesday’s fatal shooting of the UnitedHealthcare CEO, Brian Thompson.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• RegWatch: Former Centers for Medicare & Medicaid Services (CMS) career professional Stanley Nachimson will report on the latest regulatory news coming out of Washington, D.C.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
The Centers for Medicare and Medicaid Services (CMS) measures and, in some cases, penalizes facilities whose inpatient mortality or readmission (up to 3 per cent of their traditional Medicare revenue) rates for pneumonia, heart failure, acute myocardial infarction, and other conditions exceed their established benchmarks.
Since these measures are based solely on ICD-10-CM/PCS-based administrative data applied to algorithms developed by Yale University, inaccurate documentation and coding can unwittingly misrepresent a facility’s excellent performance resulting in underserved underpayments.
During the next live edition of the long-running Internet broadcast, Talk Ten Tuesday, Dr. James S. Kennedy, president of CDIMD in Nashville, Tenn., will present five relatively simple CDI strategies involving the CMS mortality and readmission measures that, if implemented, will more accurately reflect your facility’s excellent performance and lower or eliminate undeserved penalties. Be sure to take notes and invite your colleagues from quality to listen as well.
Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:
Even savvy dentists tend to find a challenge in boosting their reimbursements by correctly coding procedures as medical claims instead of dental ones.
During the next live edition of Talk Ten Tuesdays, Jeff Holt will report on the benefits of this strategy, including common pitfalls that make dentists want to pull their hair out. You’ll discover that the benefits of having top-notch coders and cutting-edge tech is like finding the Holy Grail.
Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
Tune in to Talk Ten Tuesdays live on LinkedIn, or sign up below to join our email list for exclusive access to our live streaming platform.
He was enthralling as he explained his revolutionary technology that empowers healthcare professionals to make crucial decisions in real time that improve patient care. Dr. Gerasimos Petratos, founder and CEO for HITEKS, had successfully automated the tenuous physician query process.
In our continuing series of technical reporting, “Healthcare Technology,” the producers of ICD10monitor and Talk Ten Tuesdays have invited Dr. Petratos to be the special guest during the next live edition of the weekly Internet radio broadcast.
Beyond outlining the automated query process, Dr. Petratos is expected to provide an update on other proprietary products in his company’s arsenal.
Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
In the wake of last Tuesday’s Presidential Election, the producers of ICD10monitor and Talk Ten Tuesdays have invited world-renowned psychiatrist H. Steven Moffic, MD to analyze America’s collective psyche.
As in all election outcomes, there were losers and winners. Yet how we, as Americans, manifest these feelings will be the essence of the next live edition of the popular and long-running Internet radio program.
Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:
• Field Report: Senior healthcare consultant Gloryanne Bryant will report on a subject that has been generating industry buzz.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
Cozen O’Connor Public Strategies - The Beltway Briefing
Listen for of-the-moment insider insights, framed by the rapidly changing social and...
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Feeling parched?
Well, you’re not alone. Hospitals across the country are dealing with a saline shortage.
Thanks to Hurricane Helene’s unwelcome visit to the Baxter International facility in North Carolina, your IV bags may be running low. Imagine a busy highway suddenly reduced to a single lane: that’s what this IV shortage feels like for impacted healthcare providers.
During the next live edition of the long-running and popular live Internet radio program Talk Ten Tuesday, Dr. Nick van Terheyden will report on just about everything related to this topic, from switching to oral meds (because who needs a needle when you can swallow?) to challenging those pesky “keep the veins open” (KVO) orders (seriously, do you really need to keep those veins open all the time?)
Join Talk Ten Tuesdays and leave feeling hydrated and empowered!
Also part of the broadcast, these instantly recognizable panelists will report more news during their segments:
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will continue with the final installment in her three-part series on the significant changes in the newly released ICD-10 codes.
• RegWatch: Former Centers for Medicare & Medicaid Services (CMS) career professional Stanley Nachimson will report on the latest regulatory news coming out of Washington, D.C.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
Cozen O’Connor Public Strategies - The Beltway Briefing
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The panic was widespread. Rumors were flying. Cellphone alarms were sounding.
From large hospital conference rooms to upholstered cubicles, everyone seemed to have the same sense of disbelief and mounting frustration: Acentra Health (previously Kepro) had announced a new appeal process for Medicare patients – specifically, those whose status changed from inpatient to observation.
Among those who maintained a sense of composure was healthcare regulatory guru Ronald Hirsch, MD.
Dr. Hirsch, a popular presenter on Monitor Mondays, produced by RACmonitor, carefully read the documents and concluded that while no one in healthcare wanted to be burdened with another Medicare form, the news was much less dire than it had first seemed.
That is why the ICD10monitor producers of the popular Talk Ten Tuesdays Internet radio program invited Dr. Hirsch to report on his analysis of the new Medicare appeal process.
Also as part of the broadcast, these instantly recognizable panelists will report more news during their segments:
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will continue with the final installment in her three-part series on the significant changes in the newly released ICD-10 codes.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
Tune in to Talk Ten Tuesdays live on LinkedIn, or sign up below to join our email list for exclusive access to our live streaming platform.
Cozen O’Connor Public Strategies - The Beltway Briefing
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The Rules of Engagement for medical coding and clinical documentation integrity (CDI) are based on four authoritative sources: the ICD-10-CM/PCS Official Coding Guidelines, the American Hospital Association (AHA) Coding Clinic Advice, the American Health Information Management Association (AHIMA) Standards of Ethical Coding, and practice briefs. These are, in the words of senior healthcare consultant Gloryanne Bryant, “the Big Essentials.”
Bryant, past president of the California Health Information Association (CHIA), will report on each of these essential publications during the next live edition of the ever-popular Talk Ten Tuesdays live Internet broadcast.
Also during the broadcast, these instantly recognizable panelists will report more news during their segments:
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will continue with the final installment in her three-part series on the significant changes in the newly released ICD-10 codes.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
Cozen O’Connor Public Strategies - The Beltway Briefing
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The American Hospital Association’s (AHA’s) Coding Clinic edition for the fourth quarter of 2024 has been published, and it includes several key changes of which providers nationwide should take heed.
And that is why the producers of ICD10monitor have invited renowned subject matter expert Dr. James S. Kennedy to delve into the details and provide you with cautionary insights.
Also during the broadcast, these instantly recognizable panelists will report more news during their segments:
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will continue with Part Two of her three-part series on the significant changes in the newly released ICD-10 codes.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
Cozen O’Connor Public Strategies - The Beltway Briefing
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Health and longevity are within reach for everyone, no matter from where you’re starting. And it’s never too late to begin.
During the next live edition of Talk Ten Tuesdays, Dr. Nick van Terheyden will cover some key areas upon which to focus so you can start bringing about improvements in your life by making small, consistent changes that are expected to lead to lasting improvements in your well-being.
Over the course of the next few coming Tuesdays, Dr. Nick will dive deeper into these areas and beyond to explore additional healthy fundamentals. You are invited you to send in your suggestions for future topics – for example, what exactly are macronutrients and micronutrients, and why should we know?
Also during the broadcast, these instantly recognizable panelists will report more news during their segments:
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will begin a three-part series on the significant changes in the newly released ICD-10 codes.
• RegWatch: Former Centers for Medicare & Medicaid Services (CMS) career professional Stanley Nachimson will report on the latest regulatory news coming out of Washington, D.C.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
Cozen O’Connor Public Strategies - The Beltway Briefing
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The Centers for Medicare & Medicaid Services (CMS) has released the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code updates for the 2025 fiscal year (FY).
The FY 2025 ICD-10-CM updates introduce more than 300 code changes, including 252 new codes, 13 deletions, and 36 revisions, reflecting ongoing advancements in clinical documentation and disease specificity. These code changes will go into effect for discharges on Oct. 1, 2024.
During the next live broadcast of the popular Talk Ten Tuesdays Internet broadcast, produced by ICD10monitor, AGS Health Vice President of Coding Services Leigh Poland will return to share 11 key takeaways. These updates reflect the continuous evolution of medical coding to match advancements in medical practice, patient care, and research.
Also during the broadcast, these instantly recognizable panelists will report more news during their segments:
• The Coding Report: Pamela Scott, Vice President of Coding Support and Compliance Services with First Class Solutions, will report on the latest coding news.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
Cozen O’Connor Public Strategies - The Beltway Briefing
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Sleep is essential for all living organisms, from jellyfish to humans, and even bacteria have phases that resemble rest. Experiments show that severe sleep deprivation is lethal, as seen in rats, fruit flies, and Randy Gardner's 1964 11-day sleepless experiment.
But what does it mean for you?
Join Dr Nick as he explores a natural experiment in sleep deprivation that resulted in slashing fitness and aerobic capacity. The impact of just one bad night of sleep was staggering and the clear message is prioritizing sleep—it’s as critical to your health as exercise and nutrition. Neglect it at your own risk!
Also during the broadcast, these instantly recognizable panelists will report more news during their segments:
•The Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
•Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
•News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
Cozen O’Connor Public Strategies - The Beltway Briefing
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Elusive and seemingly unattainable, the crux of medical record coding essentially can be distilled into these apparently irreconcilable elements—accuracy, speed and knowledge.
Overlay on this current situation the incessant need to be aware of constant updates, inevitable staffing changes, the apparent searching for some 74,000 codes and the ensuing financial impact your organization undoubtedly experiences, then you know the challenges you and your colleagues face daily.
Keenly aware of these obstacles, the producers of ICD10monitor, have invited the vice president of iCoreConnect, Jeff Holt to be the special guest during the next live edition of Talk Ten Tuesday.
iCoreConnect is credited with supporting one of the nation’s largest payers with the technology needed to quickly and accurately approve and deny claims, while also greatly reducing the denial rates for that payer’s remote home health division.
Holt is expected to debunk many of the prevailing myths that seem to swirl around coders and their work product.
Also during the broadcast, these instantly recognizable panelists will report more news during their segments:
• The Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.
• Point of View: Angela Comfort, guest cohost of the live broadcast, will report on a subject that has caught her attention.
Cozen O’Connor Public Strategies - The Beltway Briefing
Listen for of-the-moment insider insights, framed by the rapidly changing social and...
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Ships and airplanes apparently vanish into thin air. Mystery abounds. It’s the legendary Bermuda Triangle. But wait! Might there also be a healthcare Bermuda Triangle?
Internationally renowned psychiatrist Dr. H. Steven Moffic will make the case for just that during the next live edition of Talk Ten Tuesdays.
Dr. Moffic will report on the three key legs of this pressing issue. September is National Suicide Awareness Month. Next Sept. 11 marks the 23rd anniversary of the 9/11 attacks, after which came an associated rise of Islamophobia. Finally, there was a recent report on the increase of burnout among healthcare professionals. Dr. Moffic is expected to report on how these mental health challenges have evolved into systems which, he believes, can be improved.
Also during the broadcast, these instantly recognizable panelists will report more news during their segments:
• The Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.
• Point of View: Angela Comfort, guest cohost of the live broadcast, will report on a subject that has caught her attention.
Cozen O’Connor Public Strategies - The Beltway Briefing
Listen for of-the-moment insider insights, framed by the rapidly changing social and...
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As senior healthcare leaders and stakeholders continue to look for ways to reduce coding and clinical documentation integrity (CDI) resource expenditures, making the business case for new technology such as artificial intelligence (AI) has never been more essential than it is right now.
That is why the ICD10monitor producers of the popular Talk Ten Tuesday live Internet weekly broadcast have asked subject matter expert Cassi Birnbaum to be the special guest during the next live edition.
Birnbaum is expected to describe the current technology landscape while highlighting advanced AI systems that could augment or replace conventional systems and workflows.
Also during the broadcast, these instantly recognizable panelists will report more news during their segments:
• The Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
Cozen O’Connor Public Strategies - The Beltway Briefing
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Recognizing that preventable medical errors, infections, and injuries are estimated to account for the deaths of 250,000 people annually, the Centers for Medicare & Medicaid Services (CMS) has expanded public reporting by hospitals on rates of patient safety events. Furthermore, CMS recently introduced the Patient Safety Structural Measure, effective 2025.
Reporting on the details of this new initiative during the next edition of Talk Ten Tuesdays will be Leah Binder, president and CEO for The Leapfrog Group. Binder, long considered one of the more influential people in healthcare, is scheduled to be the special guest during the next live edition of the long-running and popular Internet broadcast, produced by ICD10monitor.
Also during the broadcast, these instantly recognizable panelists will report more news:
• The Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
Cozen O’Connor Public Strategies - The Beltway Briefing
Listen for of-the-moment insider insights, framed by the rapidly changing social and...
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The Centers for Medicare & Medicaid Services (CMS) Outpatient Prospective Payment System (OPPS) Proposed Rule includes proposed policies that align with several key goals for the agency, one of which is promoting safe, effective, patient-centered care. CMS has several quality measure changes being proposed to the Hospital Outpatient Quality Reporting (OQR) program within the OPPS Proposed Rule.
During the next live edition of the long-running and popular Internet broadcast ICD10monitor, Colleen Ejak, from 3M/Solventum, will report on the important details concerning the Hospital OQR program and the 2025 proposed impact to outpatient quality reporting.
Also during the broadcast, these instantly recognizable panelists will report more news:
• The Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
News reports, essays, and technical papers continue to laud the efficacy of generative article intelligence (AI) in healthcare. But what about AI and its application to the revenue cycle?
Cassi Birnbaum, formerly the administrative director at Stanford Medicine Health Care, is set to return to Talk Ten Tuesday with an exclusive report on how AI can be used in managing and processing unstructured data across clinical notes, insurance claims, diagnostic images, medical charts, and more.
And, given the release of the Inpatient Prospective Payment System (IPPS) Final Rule for the 2025 fiscal year (FY), Dr. James S. Kennedy will report on some of the new codes, relating their relevance to health information management (HIM) professionals.
Also during the broadcast, these instantly recognizable panelists will report more news:
• The Coding Report: The legendary Rose T. Dunn, chief operations officer for First Class Solutions, as well as a past president and former interim CEO of the American Health Information Management Association (AHIMA), will file the Talk Ten Tuesdays coding report on behalf of Laurie Johnson.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
The summer is here, and it’s raining codes.
There are ICD-10 codes, CPT® codes, and the Z codes.
Plus, coming up is the 2025 Inpatient Prospective Payment System (IPPS) Final Rule, which is expected to contain some new codes and deletions of others, for an expected net total increase of ICD-10 codes.
In preparation, the producers at ICD10monitor have dedicated this next upcoming live edition of Talk Ten Tuesday as the “National Coding Roundup.”
Also during the broadcast, these instantly recognizable segments will air:
• This and That: The legendary Rose T. Dunn, chief operations officer for First Class Solutions, as well as a past president and former interim CEO of the American Health Information Management Association (AHIMA), will report on a topic or two that has caught her attention.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.
• Point of View: Dr. James S. Kennedy, president of CDIMD, will share his point of view as he co-hosts the long-running broadcast with Chuck Buck.
As global temperatures soar and heatwaves become more frequent, the connection between climate change and rising heat is undeniable. The results are not limited to uncontrolled wildfires but extend to widespread health consequences of excess heat from immediate threats like heat exhaustion and heat stroke to the exacerbation of chronic conditions such as cardiovascular and respiratory diseases.
Vulnerable populations, including the elderly, children, and outdoor workers, face heightened risks, with heat stress also impacting mental health, leading to increased anxiety and depression.
The broader implications for public health are staggering, straining healthcare systems and economic resources and further impacting populations through air quality declines, vector-borne diseases, and food insecurity.
To address this burgeoning problem America need comprehensive strategies, including public health interventions, urban planning innovations, and robust updates to policies and behavior. During the next live edition of Talk Ten Tuesday, Dr. Nick will explore how we mitigate and adapt to our new warmer future.
Also during the next Talk Ten Tuesday broadcast, these instantly recognizable segments will include the following:
• RegWatch: Former Centers for Medicare & Medicaid Services (CMS) career professional Stanley Nachimson will report on the latest regulatory news coming out of Washington, D.C.
• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesday News Desk.
• Point of View: Dr. James S. Kennedy, president of CDIMD, will report on the latest hospital rankings from U.S. News and World Reports.
The Centers for Medicare & Medicaid Services (CMS) has released the Outpatient Prospective Payment System (OPPS) Proposed Rule for the 2025 calendar year (CY).
This published information outlines significant changes impacting Medicare payment policies for hospital outpatient services. Key proposals include adjustments to payment rates, updates to the Inpatient-Only (IPO) List, and revisions to the Ambulatory Payment Classification (APC) groups. The rule also introduces measures related to tackling health inequalities, broadening access to mental health services, and fostering safe, effective, and patient-focused care. These updates aim to ensure more efficient, equitable, and high-quality outpatient care across the healthcare system, according to Angela Comfort, who will be the special guest covering the pending changes during the next live edition of Talk Ten Tuesdays.
The popular live broadcast will also feature these other instantly recognizable segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
What is “Chevron deference?”
And why is it important – especially to health information management (HIM) professionals?
And who among the most learned and wise HIM professionals is arguably best qualified to report on this otherwise arcane judicial principle?
That would be the legendary Rose T. Dunn.
Dunn has offered to speak on this topic during the next edition of Talk Ten Tuesdays and is expected to highlight examples that are sure to resonate with HIM professionals. Rose is the former interim CEO for the American Health Information Management Association (AHIMA) and the recipient of the AHIMA Distinguished Member and Legacy Awards.
By the conclusion of the live edition of the long-running Internet radio broadcast, you will have gained a practical understanding of the real essence of this otherwise obscure legal concept.
The live broadcast will also feature these other instantly recognizable segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
Where in the world is G2211?
Both payers and providers still report lack of information from the Centers for Medicare & Medicaid Services (CMS) about use of this code. If you remember, CMS promised stakeholders an FAQ document back in January. To date it has not been released.
And yet, knowing how to document the service is probably the most-asked question when it comes to this code. Currently there are no specific documentation guidelines from CMS, but there are best-practice tips based on the code description and other documentation guidelines.
During the next live edition of Talk Ten Tuesdays, Lenota Williams will review some of the questions she and her team have been hearing from providers – such as the status of reimbursement, and what coders probably should expect going forward.
The live broadcast will also feature these other instantly recognizable segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
Each year the Medicare Payment Advisory Commission, MedPAC, provides Congress a report on the Medicare fee-for-service (FFS) payment systems, the Medicare Advantage (MA) program, and the Medicare prescription drug program (Medicare Part D). Within the MedPAC report is also the often (until now) under-reported Chapter 12.
During the next live edition of Talk Ten Tuesdays, Colleen Ejak, Solution Advisor for 3M/Solventum, will report on the particulars from Chapter 12 of this report, including the status of the MA program.
Colleen will be sharing specifics from the report regarding MA enrollment trends and updates on risk adjustment reporting and risk-conscious coding practices.
The live broadcast will also feature these other instantly recognizable segments:
• Dateline Healthcare: Former Centers for Medicare & Medicaid Services (CMS) career professional Stanley Nachimson will report on the latest healthcare news.
• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.
• Point of View: Angela Comfort, guest cohost of the live broadcast, will report on a subject that has caught her attention.
With summertime fast approaching, also on the horizon are the inevitable stressors leading to increased psychiatric diagnoses and possible surges in psychopathologies.
As temperatures increase, so do incidents of mental health unrest – tempers flaring, mood disorders, and possible cognitive impairment.
That is why, with summer officially entering our lives on June 20, we have invited world-renowned psychiatrist Dr. H. Steven Moffic to appear on the next edition of Talk Ten Tuesdays – to provide us with strategies to help ward off such mental health issues.
The live broadcast will also feature these other instantly recognizable segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
He once explained to us the value of sleep, and gave tips on how to get more of the once-devalued therapy.
That was then. This is now.
And during the next live edition of Talk Ten Tuesdays, Dr. Nick van Terheyden will turn his attention to another vital healthcare issue: nutrition. This buzzworthy topic is becoming increasingly relevant as the White House and federal agencies continue their interest in the pivotal role of food as medicine, particularly in the context of the social determinants of health (SDoH).
The live broadcast will also feature these other recognizable segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.
• Point of View: Angela Comfort, guest cohost of the live broadcast, will report on a subject that has caught her attention.
Welcome to the 600th live edition of the long-running Talk Ten Tuesdays broadcast, produced by ICD10monitor.
In commemorating this special edition, the producers are pleased to welcome the legendary Rose T. Dunn, chief operating officer at First Class Solutions, Inc. in St. Louis, a healthcare information management leader since 1988. Rose is the author of “The Revenue Integrity Manager’s Guidebook,” available from the National Association of Healthcare Revenue Integrity. She will headline a distinguished panel of coding subject-matter experts as the broadcast continues to cement its legacy as the single most important source of ICD-10 coding news and analysis.
The live broadcast will also feature these other recognizable segments:
• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news happening at the intersection of medical record auditing and the social determinants of health (SDoH).
• 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.
In recognition of May’s National Mental Health Awareness Month, ICD10monitor and Talk Ten Tuesdays have invited world-renowned psychiatrist and award-winning author H. Steven Moffic, MD to update his theory of social psychopathologies for the next live edition of the weekly Internet radio broadcast. According to Dr. Moffic, those are harmful individuals and group “isms,” “antis,” and social phobias.
The live broadcast will also feature these other recognizable segments:
As if buried in shifting sands like a booby trap, Modifier 25 is poised to wreak havoc on claims when it’s appended incorrectly to an evaluation and management (E&M) charge – typically to indicate a separate service on the same date of service.
So, what’s a provider to do? When is it actually appropriate to append Modifier 25?
How do providers indicate that there was a significant yet separately identifiable E&M service that went above and beyond the typical pre- and post-work associated with the applicable procedure?
And how can providers avoid a possible audit by the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG)?
In response to these and other questions, ICD10monitor and Talk Ten Tuesday have invited Leonta Williams, AAPC Director of Education, to serve as the broadcast’s next special guest.
The live broadcast will also feature these other recognizable segments:
• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news happening at the intersection of medical record auditing and the social determinants of health (SDoH).
• 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.
The ongoing consolidation of independent physician practices, in many cases resulting in ownership by private equity groups and large health systems, is causing a shift from traditional medicine to the corporate practice of medicine. The result often is not in the best interest of patients, given that the focus tends to be on maximizing profits rather than patient care.
What are the solutions to this ongoing crisis?
During the next live edition of Talk Ten Tuesday, Nathaniel Arana, founder and CEO for NGA Healthcare, will offer specific strategies you can implement to prevent your practice from the possibility of being acquired by private equity.
The live broadcast will also feature these other recognizable segments:
• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news happening at the intersection of medical record auditing and the social determinants of health (SDoH).
• 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.
There’s a renewed sense of urgency. Today’s healthcare providers must modernize their approach to patient access and financial clearance operations, according to Matt Bridge, senior vice president of AGS Health and the special guest during the next live edition of Talk Ten Tuesdays.
Bridge is expected to report on the pitfalls of using outdated patient access systems. He will reveal how inefficiencies and delays contribute to revenue loss. He will also offer actionable solutions to this ever-growing problem.
The live broadcast will also feature these other recognizable segments:
• Coding Report: Gloryanne Bryant, independent healthcare consultant, will substitute for Laurie Johnson to report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news happening at the intersection of medical record auditing and the social determinants of health (SDoH).
• 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.
Tired of tossing and turning?
You’re not alone. A Gallup poll released last Monday revealed that 57 percent of Americans said they would feel better if they could get more sleep.
And that is why ICD10monitor and Talk Ten Tuesdays invited Dr. Nick van Terheyden – to investigate our national sleep crisis.
During the next live edition of the long-running Internet broadcast, you’ll discover why we seem to be clocking in fewer Z’s. Dr. Nick is also expected to reveal some sneaky culprits behind your sleepless nights, while offering you practical tips to reclaim your rest. He will debunk some of the myths and explore some effective sleep hygiene practices, along with fresh insights to help you prioritize your well-being – from winding down-rituals to “tech detoxes.”
Listen and learn. Benefit from the playbook to help you hit the hay right and wake up refreshed.
The live broadcast will also feature these other recognizable segments:
• Coding Report: Gloryanne Bryant, independent healthcare consultant, will substitute for Laurie Johnson to report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news happening at the intersection of medical record auditing and the social determinants of health (SDoH).
• 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.
Properly managed patient identity queues are the foundation of an effective master person index that minimizes issues and facilitates streamlined care coordination.
Conversely, unresolved identity queue backlogs can have costly implications for patient care, safety, and revenue integrity. It’s a growing problem with a time-consuming, resource-intensive resolution that few HIM departments have the capacity to handle.
During the next live broadcast of the popular and long-running Talk Ten Tuesday, the Internet broadcast produced by ICD10monitor, Rachel Podczervinski will report on what’s behind the seemingly sudden surge in identity errors and actions hospitals and health systems can take to reduce the volume and streamline patient identity queue management.
The live broadcast will also feature these other recognizable segments:
Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• News Desk: James Kennedy, MD, will substitute for Timothy Powell to anchor the Talk Ten Tuesdays News Desk.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news happening at the intersection of medical record auditing and the social determinants of health (SDoH).
• Point of View: Angela Comfort, guest cohost during this live broadcast, will report on a subject that has caught her attention.
World Health Day will be observed on Sunday, April 7 but on Tuesday, April 9, 10 a.m. Eastern Time, Talk Ten Tuesday will recognize World Health Day with the special guest appearance of Lorraine Fernandes, immediate past president (2019-2022) of the International Federation of Health Information Management Association (IFHIMA). Today, Fernandes serves as the Communications Chair for IFHIMA.
During the next live broadcast of the popular and long-running Talk Ten Tuesday, the Internet broadcast produced by ICD10monitor, Fernandes will delve into critical topics such as information governance in the era of digital health transformation and the implementation of ICD-11, which is set to replace the outdated ICD-10. Her insights will illuminate the evolving global health landscape, emphasizing the importance of accurate data for better health outcomes.
The live broadcast will also feature these other recognizable segments:
The continued onslaught of cybersecurity attacks is only getting worse.
These attacks have impacted the healthcare system in dramatic fashion, starting with the Change Healthcare payment network being brought down.
Hopefully, everyone – including coders – will be more vigilant and wary of potential attacks and attempts to breach security. The constant development of new approaches and innovative tools means that if you or your facility have not yet been subject to an attack, it is likely only a matter of time before this comes knocking on your door.
In helping providers get prepared, ICD10monitor and Talk Ten Tuesdays (TTT) have invited Nick van Terheyden (aka Dr. Nick), the clinical specialist at Iodine Software, to share his recent experiences and insights – and to offer some suggestions on how you might be fooled and what you can do to protect yourself, your business, and your family.
The live broadcast will also feature these other recognizable segments:
•RegWatch: Former Centers for Medicare & Medicaid Services (CMS) career professional Stanley Nachimson will report on the latest regulatory news coming out of Washington, D.C.
•Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
•Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news happening at the intersection of medical record auditing and the social determinants of health (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.
In a move towards greater specificity, the nation’s healthcare providers have a new ICD-10-CM code category: Code W44.
Having gone into effect October 2023, the new code category (foreign body entering into or through a natural orifice) is seen as enhancing specificity, although Code W45 had already existed for foreign bodies entering through the skin.
During the next live edition of Talk Ten Tuesdays, Gina Yacovelli, DHSc, associated with Coding & Billing Solutions, will report on how and why pediatricians are the most likely provider group to benefit from the increased detail, while noting that the greater level of specificity will be helpful to all providers when such encounters arise.
The live broadcast will also feature these other recognizable segments:
• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news happening at the intersection of medical record auditing and the social determinants of health (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.
On the horizon, looming like an ominous thunderhead, is ICD-11. But wait! There’s more: the expanding role of coding in big data, for example. The evolving healthcare IT, and how it will redefine the coding profession. All this and more is coming your way.
That’s why ICD10monitor and Talk Ten Tuesdays invited senior healthcare consultant Angela Comfort, assistant vice president of revenue integrity at Montefiore, to take you on an exclusive trip into the future of ICD-11 and health informatics during the next live edition of the long-running Talk Ten Tuesdays, produced by ICD10monitor.
The live broadcast will also feature these other recognizable segments:
• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news happening at the intersection of medical record auditing and the social determinants of health (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.
Code G2211 continues to be a gift disguised as something else.
As many nuances surrounding the code continue to linger, there are still some areas that are not as clear-cut as many healthcare professionals would prefer.
As a refresher, G2211 allows providers (primary care, as well as specialists) to bill for additional cognitive work effort that is not currently captured in the evaluation and management (E&M) codes typically billed for these services.
One of the gray areas surrounding G2211 is the appropriate amount and/or type of documentation that should be noted in the medical record to support billing the code. Another issue involves the specific type of condition(s) that can trigger it, and what qualifies it for a high level of complexity.
During the next live edition of Talk Ten Tuesdays, AAPC’s Leonta Williams will continue to explore these nuances and provide updates based on the latest communication(s) from the Centers for Medicare & Medicaid Services (CMS) on proper code usage – and the criteria needed to stay out of hot water.
The live broadcast will also feature these other recognizable segments:
• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news happening at the intersection of medical record auditing and the social determinants of health (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.
How many hospital star ratings does your facility have?
Do you know? If you don’t, you’re not alone.
Apparently, many coders and clinical documentation integrity specialists (CDISs) don’t know. But you should know. That’s why ICD10monitor and Talk Ten Tuesdays have invited Michelle Wieczorek, a registered nurse (RN) and a CDI authority, to explain what the hospital star rating means and how coders and CDISs impact those stars. Wieczorek, an independent revenue cycle consultant, will also explain how to earn back fallen stars.
The live broadcast will also feature these other instantly recognizable segments:
• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news happening at the intersection of medical record auditing and the social determinants of health (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.
During the next live edition of Talk Ten Tuesdays, award-winning author H. Steven Moffic, MD, considered to rank among the world’s most renowned psychiatrists, will report on what he calls “social psychoexemplaries” – the other side of what he reported two weeks ago on social psychopathologies.
Moffic, in his popular daily column in Psychiatric Times, recently mused on the notion of positive social psychiatry, writing “I have come to wonder if positive psychiatry can be expanded to positive social psychiatry, meaning to groups besides individuals. In other words, are there positive social psychiatry group characteristics?”
Learn more about how positive social psychiatry might be a part of your daily experience.
The live broadcast will also feature these other recognizable segments:
• RegWatch: Former Centers for Medicare & Medicaid Services (CMS) career professional Stanley Nachimson will report on the latest regulatory news coming out of Washington, D.C.
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
• Point of View: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will be the guest cohost, substituting for Dr. Erica Remer. Tiffany will report on a subject that has caught her attention during her popular segment.
What are the “do’s” and “don’ts” for the safe handling of HCPCS code G2211, used to report payment to physicians and other qualified healthcare providers for the additional work required to adequately care for patients with serious or complex conditions? The code is now payable for the 2024 calendar year (CY).
Not only has the code quickly become enigmatic, in the lexicon of medical record coding, but it also must be handled with care – as if operating a powerful band saw.
On the surface, the code seems to be relevant and purposeful. But underneath its benign exterior is a complicated network of conditions that could thwart the best efforts of the most healthcare professionals.
That is why –- in the interests of baffled coders and clinical documentation integrity specialists (CDISs) –- ICD10monitor and Talk Ten Tuesdays have invited Ronald Hirsch, MD, the permanent (and popular) panelist on Monitor Mondays, to provide his assessment of the code, while concurrently offering his list of do’s and don’ts for its implementation, during the next live edition of Talk Ten Tuesdays.
The live broadcast will also feature these other recognizable segments:
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news happening at the intersection of medical record auditing and the social determinants of health (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.
Achieving high-performing revenue cycle management (RCM) begins with understanding where your healthcare organization falls on the RCM Maturity Framework, according to Matt Bridge, senior vice president for AGS Health.
Bridge, who will be the special guest during the next upcoming edition of Talk Ten Tuesdays, says this four-stage framework informs a strategic roadmap designed for optimizing and digitally transforming revenue cycle performance and future proofing operations through a hybrid model of in-house management, globalized services, advanced technologies, and actionable analytics. Bridge will begin the first installment in his three-part series on the contemporary challenges facing revenue cycle management personnel during the popular weekly Internet radio broadcast.
The broadcast will also feature these other instantly recognizable segments:
• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news happening at the intersection of medical record auditing and the social determinants of health (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.
We are all familiar with DSM-5 and ICD-10 for the classification of various mental disorders. Both, but especially ICD, also cover some of the social conditions needing medical attention that may or may not be connected to the primary disorder or illness. ICD does that in the Z codes.
However, Z codes are used infrequently.
Moreover, many social problems harmful to individuals, groups, and countries seem resistant to elimination – think racism, sexism, ageism, antisemitism, Islamophobia, cultish thinking, and burnout. During the next live edition of Talk Ten Tuesdays, award-winning author H. Steven Moffic, MD, considered among the world’s most renowned psychiatrists, will offer a classification of what he collectively calls the “social psychopathologies” that mentally harm both perpetrators and victims – and will suggest remedies that could lead to new research and interventions.
The broadcast will also feature these other instantly recognizable 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.
New Condition Code 92 is here, and it’s effective now. The code outlines the billing requirement for intensive outpatient program services for hospital outpatient departments, critical access hospitals (CAHs), and community mental health centers (CMHCs).
To explain what you need to know about correctly billing the new Condition Code 92 during the next weekly edition of Talk Ten Tuesdays will be Rose T. Dunn, past president of the American Health Information Management Association (AHIMA), and currently the COO for First Class Solutions.
But wait – there’s more. Dunn will also report on the latest news related to the electronic submission of medical documentation (esMD). Furthermore, she will report on a proposal to the appeal process so that Medicare beneficiaries could change their status from inpatient to outpatient.
All this and more will be reported during the next live edition of Talk Ten Tuesdays.
The broadcast will also feature these other instantly recognizable segments:
·Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
·Social Determinants of Health: Tiffany Ferguson,CEOforPhoenix Medical Management, Inc., will report on the news happening at the intersection of medical record auditing and the social determinants of health (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.
Shrouded in controversy, the HCPCS code G2211 was released in 2021, proposed by the Centers for Medicare & Medicaid Services (CMS) to pay physicians and other qualified healthcare providers for the additional work required to adequately care for patients with serious or complex conditions. The code is now payable for calendar year (CY) 2024.
The journey for this code to become payable has been fraught with obstacles. First, to financially support it, CMS slashed the conversion factor (CF). Second, CMS released the code without any true documentation guidelines on what exactly would need to be notated in the medical record to support billing. Third, some think there may be conflict between the HCPCS code and the medical decision-making (MDM) component of the Evaluation and Management (E&M) Documentation guidelines recently adopted by both CMS and the American Medical Association (AMA).
During the next live edition of Talk Ten Tuesdays, Leonata Williams will report on some of the nuances regarding this new code. She will also provide important best practices while America’s healthcare system awaits additional guidance from CMS.
The live broadcast will also feature these other recognizable segments:
•Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
•Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news happening at the intersection of medical record auditing and the social determinants of health (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.
Last year, healthcare professionals saw many of the rules for evaluation and management (E&M) services that were implemented in 2021 now applied to 2023 E&M codes. This included codes representing services for hospital inpatient care (99221-99223 and 99231-99233), emergency department visits (99281-99285), nursing facility visits (99307-99210), and all consultation services.
How are these changes likely to impact 2024 E&M coding? Senior healthcare consultant Frank Cohen, founder of the Frank Cohen Group, will report on the significant impact of these changes 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 latest coding news.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news happening at the intersection of medical record auditing and the social determinants of health (SDoH).
• RegWatch: Stanley Nachimson, founder of Nachimson Advisors, LLC, will report on the latest news regulatory news coming out of Washington, D.C.
• 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.
Codes for split (or shared) evaluation and management (E&M) services for 2024 have been revised, simplified, and aligned by the American Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS).
During the next live edition of the long-running Talk Ten Tuesdays broadcast, 3M Senior Consultant Colleen Deighan-Ejak will report on the revised guidelines for determining who performed the substantive portion of a given service. She will also discuss the Medicare payment modifier required when reporting these services.
The weekly live broadcast will also feature these outstanding segments and thought leaders:
There’s a new code in town.
It’s an add-on code, HCPCS Code G2211. And its effective date is Jan. 1, 2024.
The new code is associated with the continuing focal point for all needed medical services that are part of ongoing care related to a patient’s single, serious condition, or complex condition. The Centers for Medicare & Medicaid Services (CMS) will be implementing this separate add-on payment code to be reported with evaluation and management (E&M) categories Office and Other Services.
During the next live edition of Talk Ten Tuesdays, Colleen Deighan-Ejak, a senior healthcare consultant for 3M, will be reporting the nuances of this new add-on payment code, which is part of the calendar year (CY) 2024 Medicare Physician Fee Schedule Final Rule.
The weekly live broadcast will also feature these outstanding segments and thought leaders:
• Coding Report: Laurie Johnson, senior healthcare consultant for 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.
• Point of View: The forementioned Angela Comfort, the Talk Ten Tuesdays guest cohost, will report on a subject that has caught her attention.
There are substantial new changes to the minimum data set (MDS) assessment, including how functional abilities and goals are scored, the introduction of tracking of indications for medication use, and the addition of new measures for tracking communication of transfer-of-health information. The recent changes became effective Oct. 1, the start of the government’s fiscal year.
The MDS assessment is a standardized assessment used in skilled nursing facilities (SNFs) and some swing beds to capture administrative and clinical data for residents. The information compiled in the MDS assessment is used to create resident care plans and determine reimbursement, and it impacts quality measures.
As a warning, SNF personnel should be on the lookout for any denials related to the new ICD-10 codes, according to Deanna Peterson, the special guest during the next live edition of Talk Ten Tuesdays. Peterson, senior vice president of operations and LTPAC services for First Class Solutions and the featured guest on the next upcoming edition of Talk Ten Tuesdays, will report that residents with invalid ICD-10 codes will need those codes to be updated to avoid denials.
The weekly live broadcast will also feature these outstanding segments and thought leaders:
• Coding Report: Laurie Johnson, senior healthcare consultant for 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.
MINOCA (myocardial infarction with non-obstructive coronary arteries) and INOCA (ischemia with non-obstructive coronary arteries) pertain generally to coronary artery disease. During the next live edition of the long-running and popular Internet broadcast Talk Ten Tuesdays, Pam Scott will take you on a coding journey into these conditions and the microvasculature of the heart – located downstream from the epicardial vessels and featuring structures as small as a human hair, which cannot be assessed with a cardiac catheter.
She’ll point out along the way that often, a patient might have symptoms and other diagnostic evidence of coronary artery disease, although when cardiac catheterization is performed, the large epicardial vessels are not blocked (which would explain the symptoms). What has happened in such a case is often that coronary microvascular dysfunction (CDM) restricts the flow of blood to the myocardium and increases resistance in the microvasculature.
Scott will look at new codes intended to identify these conditions, and will discuss the documentation required to assign these codes.
The weekly live broadcast will also feature these outstanding segments and thought leaders:
• 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.
With thousands of followers on social media, Dr. Robert Oubre, aka “The Doctor of Documentation,” will make his Talk Ten Tuesdays debut on Tuesday, Nov. 7, when he will be the broadcast’s special guest.
Dr. Oubre will be reporting on what documentation considerations should be given when patients are reading physician notes appearing on the monitor screen of the electronic medical record (EMR). He is expected to cite the 21st Century Cures Act, which went into effect April 5, 2021, mandating that U.S. healthcare providers give access to all health information in their EMRs “without delay” and without charge to their patients. Many providers feared the passing of this legislation, but more than two years later, have those fears proved justified?
Dr. Oubre is also expected to raise rhetorical questions such as when physicians should reconsider some of the habitual language they may use in medicine that may be offensive to patients.
Angela Comfort, former American Health Information Management Association (AHIMA) senior director for coding services-turned-senior healthcare consultant, will substitute for Dr. Erica Remer. Comfort currently serves as the transformational leader for Montefiore Health System.
The weekly live broadcast will also feature these outstanding segments and thought leaders:
• Coding Report: Laurie Johnson, senior healthcare consultant for 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.
• Point of View: The forementioned Angela Comfort, the Talk Ten Tuesdays guest cohost, will report on a subject that has caught her attention.
Like autumn leaves, new codes and guidelines are raining down on hospitals and physician practices, impacting coders, clinical documentation integrity specialists (CDISs), and professionals managing the revenue cycle.
And while there appears to be no respite, the weary can take comfort during the next live edition of the long-running and popular Talk Ten Tuesdays Internet broadcast, produced by ICD10monitor. That’s when the legendary Rose Dunn, past president of the American Health Information Management Association (AHIMA) and current COO for First Class Solutions, will join the broadcast. Rose is expected to report on the latest nuances of effectively managing the revenue cycle while concurrently addressing the plethora of new codes and coding guidelines.
The weekly live broadcast will also feature these outstanding segments and thought leaders:
• Coding Report: Laurie Johnson, senior healthcare consultant for 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.
As the demand for telehealth services has surged, the nuances of coding and documentation for virtual visits present unique challenges and opportunities. During the next live edition of Talk Ten Tuesdays, Angela Comfort will delve into the specifics of coding for telehealth, including the evolving Centers for Medicare & Medicaid Services (CMS) guidelines, and the importance of accurate documentation to ensure compliance and proper reimbursement.
Also, during her segment, Comfort is expected to explore the future of telehealth coding – and what coding professionals should anticipate as telehealth usage continues to grow.
The weekly broadcast will also feature these outstanding segments and thought leaders:
• Coding Report: Patricia Chua, chief operating officer for the Innova Revenue Group, will report on the latest coding news. She will be substituting for Laurie Johnson.
• 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.
A must-have resource for any coding or clinical documentation integrity specialist (CDIS) is the American Hospital Association (AHA) Coding Clinic. Each quarterly issue provides official guidance for ICD-10-CM and ICD-10-PCS coding for all healthcare settings.
The third-quarter issue covers a variety of topics, from prescribed marijuana use for chronic pain during pregnancy to subcapsular hematoma, epidural hematoma, and several ICD-10-PCS procedures – Hemospray, HeRO® Graft, and NAVA among them, for example.
The fourth-quarter issue contains details on the new codes for the 2024 fiscal year (FY), their use, and official guideline changes. In addition, this issue provides new insight into the coding of “intraoperative serosal tears,” which is extremely helpful.
During the next live edition of Talk Ten Tuesdays, senior healthcare consultant Gloryanne Bryant will be the broadcast’s special guest. As an accomplished webcast leader, she will walk you through the third and fourth quarters of the AHA coding clinic.
The weekly broadcast will also feature these outstanding segments and thought leaders:
The nation’s healthcare spotlight will shine on the American Health Information Management Association (AHIMA) during the organization’s live AHIMA23 Conference, gaveling to order Oct. 8 through Oct. 10 at the Baltimore Convention Center.
During the next live edition of Talk Ten Tuesdays, the legendary Rose Dunn, former AHIMA president and CEO, will be the broadcast’s special guest. She will report on activities taking place there, as several thousand HIM and other healthcare professionals gather for the annual event. Dunn is the current chief operating officer for First Class Solutions, a frequent guest on Talk Ten Tuesdays, and a member of the ICD10monitor Editorial Board.
Additionally, Dr. James S. Kennedy, founder of CDIMD, will serve as the broadcast’s cohost, reporting from the conference floor.
The weekly broadcast will also feature these outstanding segments and thought leaders:
• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the latest coding news.
• SDoH Report: Dr. Juliet Ugarte Hopkins, immediate past president of the American College of Physician Advisors (ACPA), will substitute for Tiffany Ferguson to report the news that’s happening at the intersection of coding and the social determinants of health (SDoH).
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
• Point of View: The aforementioned Dr. James S. Kennedy, Talk Ten Tuesdays guest co-host, will report on a subject that has caught his attention.
The Centers for Disease Control and Prevention (CDC) has released the ICD-10-CM code updates for the 2024 fiscal year (FY), which will be effective starting Oct. 1. The update includes more than 433 diagnosis code changes, including 395 code additions, 25 code deletions, and 13 code revisions.
It is essential for coding professionals to stay up-to-date with these annual code changes, and to understand how to apply them. It is also important that all applicable team members, including coders, physicians, and clinical documentation integrity specialists (CDISs) are educated regarding the coding and documentation requirements.
During the next live edition of Talk Ten Tuesdays, Leigh Poland, vice president of the coding service line at AGS Health, will report on the new code updates.
Poland has more than 20 years of coding experience and has worked in the coding and education realm throughout that time. Her true passion is coding education, making sure coders are equipped to do their job accurately and with excellence.
The weekly broadcast will also feature these outstanding segments and thought leaders:
• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have 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.
There’s a new ICD-10 code presenting a new challenge for facilities, physicians, clinical documentation integrity specialists (CDISs), and coders: E88.A, muscle wasting due to underlying conditions.
This new code represents an opportunity to identify, document, and report the frequent and too-often unrecognized undernutrition, sarcopenia, and cachexia disorders associated with muscle wasting, along with their underlying causes.
During the next live edition of Talk Ten Tuesdays, James S. Kennedy, MD, president of CDIMD near Nashville, Tenn., will address the clinical criteria inherent to these conditions. He will also discuss recent Coding Clinic advice affecting E88.A reporting, and proactive CDI approaches that facilitate expert identification and management of these debilitating conditions.
And to help you gain more value from this exclusive broadcast, Dr. Kennedy has offered the following references on muscle wasting (https://society-scwd.org/muscle-wasting/), sarcopenia (https://society-scwd.org/sarcopenia/), cachexia (https://society-scwd.org/cachexia/), and malnutrition (https://www.tinyurl.com/malnutrition2012).
Following the broadcast, you should be prepared to implement these concepts.
All this and more will be covered during the next edition of the weekly broadcast, which will also feature these outstanding segments and thought leaders:
Artificial intelligence (AI) is what many in healthcare will come to remember about the closing years of this decade in healthcare – a decade of unprecedented technological changes, ranging from telehealth to algorithms.
And now AI is becoming an accepted technology for evaluation and management (E&M) coding. The results appear to be dramatic in terms of remarkable speed and extraordinary accuracy.
Join us during the next live edition of Talk Ten Tuesdays, when Angela Jordan, executive vice president of Chart Pal, the documentation service of Calm Waters, AI, Inc., reports on the latest validation research on E&M leveling and explains how AI can bring a renewed sense of confidence to coders who work tirelessly on E&M coding.
All this and more will be covered during the next edition of the weekly broadcast, which will also feature these outstanding segments and thought leaders:
A reported 700,000 suicides worldwide annually are the impetus for the World Health Organization (WHO) to recognize what it has called a major public health problem ahead of World Suicide Prevention Day on Sept. 10.
In recognition of this global issue, during its next edition, Talk Ten Tuesdays will feature world-renowned psychiatrist and award-winning author H. Steven Moffic as the program’s special guest. Dr. Moffic will report on how to detect early-warning signs of potential self-harm. Dr. Moffic first appeared on the long-running broadcast following the suicide of famed actor and comedian Robin Williams, whose death in July 2014 shook the world’s collective conscience.
All this and more will be covered during the next edition of the weekly broadcast, which will also feature these outstanding segments and thought leaders:
Despite their advanced capabilities, artificial intelligence (AI) tools can occasionally misinterpret ambiguous documentation or lack the nuance necessary for complex decision-making. And that is why coders must continue to exercise their expertise and judgment when reviewing AI-assisted code assignment.
This level of vigilance is crucial for ensuring that AI-assisted coding assignment meets stringent standards of quality and compliance – as you’ll learn during the next live edition of Talk Ten Tuesdays. That’s when former American Health Information Management Association (AHIMA) leader Angela Comfort will return to the weekly broadcast as our special guest to report the lead story on how coders need to be prepared to leverage AI technologies while safeguarding the quality and compliance of coding assignments.
All this and more will be covered during the next edition of the weekly broadcast, which will also feature these outstanding segments and thought leaders:
The Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs) affect Leapfrog’s ubiquitous reputation scores and contribute approximately 15 percent to the Centers for Medicare & Medicaid Services (CMS) Hospital-Acquired Condition (HAC) penalty determinations of 1 percent of a hospital’s total inpatient reimbursement.
AHRQ finally released its PSI methodology for the 2023 fiscal year (FY) on Aug. 14, and it involves a significant expansion of the risk-adjusted universe to now include COVID and flag any fracture, not just hip fractures, not present at the time of the inpatient order as a patient safety event. Dr. James Kennedy will join the long-running Talk Ten Tuesdays Internet radio broadcast this coming Tuesday to report on what you need to do to protect your facility’s reputation and reimbursement.
All this and more will be covered during the next edition of the weekly broadcast, which will also feature these outstanding segments and thought leaders:
The Centers for Medicare & Medicaid Services (CMS) has released the finalized 2024 Part C risk adjustment model, which goes into effect Jan. 1, 2024. This revised model, V28, comes with substantial changes to the current V24 model, starting with using the ICD-10-CM classification system – which aligns with the rest of the healthcare system that has been using ICD-10 codes since 2015.
Comparing CMS V24 to V28, there is an increase in the number of Hierarchical Condition Categories (HCCs) and a decrease in the total number of ICD-10-CM codes that map to an HCC payment category.
During the next live edition of Talk Ten Tuesdays, Colleen Deighan Ejak, senior consultant with 3M, will share details of the revisions and how to outline a plan to get your organization ready to implement these changes.
All this and more will be covered during the next edition of the weekly Internet radio broadcast, which will also feature these outstanding segments and thought leaders:
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The 2024 Inpatient Prospective Payment System (IPPS) Final Rule by the Centers for Medicare & Medicaid Services (CMS), plus half a dozen other final payment rules have arrived. To help you and your team prepare for the onslaught of new codes, Leigh Poland, vice president of coding service line for AGS Health, will offer practical tips and best practices so you can effectively adapt to the final rule’s coding changes, thus helping to ensure compliance, and optimizing reimbursement.
All this and more will be covered during the next live edition of the weekly Internet radio broadcast, which will feature these outstanding segments and thought leaders:
The 2024 Inpatient Prospective Payment System (IPPS) Final Rule by the Centers for Medicare & Medicaid Services (CMS), plus half a dozen other payment rules, will all require new codes and fresh new thinking. And that is why ICD10monitor is producing an exclusive national coding update broadcast on Talk Ten Tuesdays.
All this and more will be covered during the next live edition of the weekly Internet radio broadcast, which will feature these outstanding segments and thought leaders:
Could clinical documentation improvement specialists (CDISs) be at risk as a profession, with the growing acceptance of automated query solutions? And what is driving the demand for them?
Today, with the advent of “smart hospitals,” automated query solutions are being used by providers and CDISs in capturing acute and chronic diagnoses, as specified by ICD-10. With this rapidly developing technology, real-time documentation prompts and automated queries are assisting providers as they are writing their notes.
But could these advancements impact the careers of CDISs? Joining the next live edition of the long-running Talk Ten Tuesdays will be the chief executive officer of HITEKS Solutions, Gerasimos “Gerry” Petratos, MD, who will discuss the latest advancements as well as offer career advice to current and future CDISs.
Talk Ten Tuesdays will also feature these outstanding segments and thought leaders:
Revenue leakage presents a huge challenge for healthcare organizations. According to a study by the Healthcare Financial Management Association (HFMA), it can account for up to 5 percent of a healthcare organization’s net revenue – potentially making the difference between an entity being profitable or not profitable.
Fear not, however – there are solutions to tackle revenue leakage. One effective strategy is strong denial management. In fact, the Medical Group Management Association (MGMA) found that healthcare organizations with robust denial management strategies experienced an incredible 15 percent increase in their overall net collection rates.
During the next live edition of the long-running and popular Talk Ten Tuesdays weekly Internet radio broadcast, Susie Vestevich, chief operating officer for TiaTech USA, will return to the broadcast to report on strategies intended to stop the leak.
Talk Ten Tuesdays will also feature these outstanding segments and thought leaders:
At the intersection of ICD-10-CM social determinants of health (SDoH) codes and the Centers for Medicare & Medicaid Services (CMS) Star Rating Quality Measures, one will find a wide array of socio-economic factors and competing issues, all of which carry the potential to profoundly affect healthcare outcomes and ratings.
During the next live edition of Talk Ten Tuesdays, listeners will enjoy the benefits of learning new strategies to leverage these codes for enhanced quality scores and health equity – that’s when former American Health Information Management Association (AHIMA) leader Angela Comfort will return to the weekly broadcast. During her presentation as our special guest, you’ll come to realize the pivotal role these codes play in the CMS pursuit of ensuring balanced, patient-focused care. This essential episode will enlighten healthcare practitioners, policymakers, and administrators alike on utilizing data-centric methods for improved patient services.
Talk Ten Tuesdays will also feature these outstanding segments and thought leaders:
Major updates regarding progress on the imminent ICD-11 code set were made during the recent meeting of the National Committee of Vital Health Statistics (NCVHS), including a request for information on the enigmatic code set, yet to be adopted by the U.S.
Stanley Nachimson, longtime editorial contributor to ICD10monitor and former career professional at the Centers for Medicare & Medicaid Services (CMS), now an IT consultant, monitored the recent meeting and will report other NCVHS actions, including the updating Health Insurance Portability and Accountability Act (HIPAA) standards. Moreover, Nachimson is expected to report on a surprise move made by the Committee.
Talk Ten Tuesdays will also feature these outstanding segments and thought leaders:
What possible factors might trigger an audit or result in money being left on the table? During the live edition of Talk Ten Tuesdays, Gloryanne Bryant, an independent health information management (HIM) consultant, will report on highlights of the 2023 Second Quarter ICD-10-CM/PCS Coding Clinic from the American Hospital Association (AHA) for the second quarter of 2023.
Gloryanne — a 40+ year veteran Health Information Management (HIM) professional and past president of the California Health Information Association (CHIA)— is expected to report on important coding guidance including ICD-10-CM screening for COVID19, plus information on procedure coding.
Talk Ten Tuesdays will also feature these outstanding segments and thought leaders:
Delays in billing can cost healthcare providers billions of dollars annually. Join us during the next live edition of Talk Ten Tuesdays, when the broadcast’s special guest, Susie Vestevich, COO of TiaTech USA, will discuss potential solutions that may be implemented to combat this dire issue.
Talk Ten Tuesdays will also feature these outstanding segments and thought leaders:
A recurring conflict continues to plague America’s patchwork system of healthcare delivery.
How often, muses Mary Beth Pace, vice president of care management at Trinity Health, is the acute-care environment at odds with payers on the issue of inpatient versus outpatient care?
“Is there a better way?” she asks rhetorically. “What if we partnered together?”
During the next live edition of the popular and long-running Talk Ten Tuesdays Internet broadcast, Pace will serve as special guest, reporting on how she envisions new relationships moving forward.
Talk Ten Tuesdays will also feature these outstanding segments and thought leaders:
A major focus for many hospitals is understanding the changes that impact Hierarchical Condition Category (HCC) reimbursement methodology – changes made as a result of the Inpatient Prospective Payment System (IPPS) rule that will become effective in 2024.
Because it’s important for you to know about these changes, we invited John Pitsikoulis principal at Premier Health, to be the special guest during the next live edition of Talk Ten Tuesdays.
Pitsikoulis is expected to report on these recent regulatory and payment model changes, noting that for the first time, the Centers for Medicare & Medicaid Services (CMS) used ICD-10 codes in their analytics for policy changes.
These changes are expected to impact your Medicare Shared Savings Plan (MSSP), Medicare Advantage, and other payment models.
Talk Ten Tuesdays will also feature these outstanding segments and thought leaders:
May is Mental Health Awareness Month, and ICD10monitor and Talk Ten Tuesdays are recognizing the major national milestone with a special appearance of world-renowned psychiatrist and author H. Steven Moffic, MD.
Every year since 1949, Mental Health Awareness Month has been observed in the U.S.
According to Moffic, this year could feature the worst state of America’s mental health since that year. Add to that another level of anxiety among healthcare providers, who are currently grappling with the unforeseen consequences of coming to grips with the end of the nation’s COVID-19 public health emergency (PHE) May 11, and it’s a troubling scenario.
Talk Ten Tuesdays will also feature these outstanding segments and thought leaders:
Nearly 80 percent of medical practice administrators struggle to keep track of and reconcile patient encounters, as you will learn during the next live edition of Talk Ten Tuesdays, when Susie Vestevich will serve as the special guest.
Without adequate tracking, insurance claims aren’t submitted, copays aren’t collected, and patient financial responsibility balances aren’t received.
Talk Ten Tuesdays will also feature these outstanding segments and thought leaders:
The 2024 Inpatient Prospective Payment System (IPPS) proposed rule by the Centers for Medicare & Medicaid Services (CMS), plus half a dozen other proposed payment rules, will all require new codes and fresh new thinking. And that is why ICD10monitor is producing an exclusive national coding update broadcast on Talk Ten Tuesdays.
All this and more will be covered during the next live edition of the weekly Internet radio broadcast, which will feature these outstanding segments and thought leaders:
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Continuing previous discussions of cancer screening covered under preventive benefits, the subject will get a second look on the next edition of Talk Ten Tuesdays – when Robin MillerZweifel joins the broadcast to focus on non-invasive versus invasive procedureoptions for colorectal cancer screening. Robin is also expected to report on the recent National Correct Coding Initiative (NCCI) procedure-to-procedure edits released in October 2022, noting the sequencing of performance for screening procedures. She will also report on the more recent changes to the age requirements for patients to qualify for coverage under the preventive benefits for colorectal cancer screening. And no report on cancer screening would be complete without mention of related procedures, including the gold standard of occult blood testing, Cologuard, and other molecular-based testing, as well as colonoscopy.
All this and more will be covered during the ICD10monitor and Talk Ten Tuesdays recognition of Medical Laboratory Professionals Week.
The live broadcast will also feature these other segments:
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Is your facility suffering from revenue loss? If so, you’re not alone. A study by the Journal of the American Medical Informatics Association (JAMIA) found that clinics can experience a 10 to 30 percent decrease in revenue due to coding errors alone, losing up to $125,000 per year. Moreover, the American Medical Association (AMA) estimates that coding errors cost the healthcare industry approximately $36 billion annually in lost revenue, denied claims, and potential fines.
During the next live edition of Talk Ten Tuesdays, Susie Vestevich, COO for TiaTech, will report on how errors are costing facilities and practices significant revenue losses. But she will also report on how five, ironclad strategies can be implemented to help prevent such losses. Her revenue cycle report is part of an ongoing services presented by TiaTech, USA and ICD10monitor.
The live broadcast will also feature these other segments:
From starkly arid lands to lush, cosmopolitan foreign capitals, a wide-ranging mix of peoples – some old, some new – were the focus of attention as the World Health Organization (WHO), with characteristic dignity, celebrated 75 years of improving the health of mankind.
ICD10monitor (so named for the WHO’s International Classification of Diseases, Version 10) and Talk Ten Tuesdays will mark the occasion with the conclusion of a two-part series recognizing the accomplishments of the WHO, which has been working overtime to alleviate deadly diseases, protect people from pandemics, and promote world peace.
During the next live edition of Talk Ten Tuesdays, Lorraine Fernandes, immediate past president and communications chair of the International Health Information Management Association (IHIMA), will be the special guest and will report on activities that took place during World Health Day.
The live broadcast will also feature these other segments:
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Although World Health Day isn’t until April 7, ICD10monitor and Talk Ten Tuesdays will usher in an early recognition of the worldwide event beginning this coming Tuesday, with the start of a two-part series of broadcasts.
During the next live edition of Talk Ten Tuesdays, Mary H. Stanfill, ICD10monitor and broadcast ICD-11 correspondent, will have an update on the new coding system, which has been, according to the World Health Organization (WHO), adopted by 35 countries, including the U.S.
However, the implementation of the code set here remains, at this time, uncertain. During the subsequent Tuesday broadcast, on April 11, Lorraine Fernandes, immediate past president and communications chair of the International Health Information Management Association (IHIMA), will be the special guest and will report on activities that took place during World Health Day.
The live broadcast will also feature these other segments:
The end is near: the federal COVID-19 public health emergency (PHE) and national emergency declarations will come to a screeching halt on May 11.
And with that, there will be significant effects on healthcare and healthcare providers in the United States. The ends of these declarations could signal a major shift in the response to the pandemic, and may have far-reaching consequences for the industry.
One immediate effect could be a decrease in funding for COVID-19-related activities. And that is why, for the next upcoming edition of Talk Ten Tuesdays, we asked Lidiya Ter-Markarova to report on some of the more causative effects this post-PHE era will have on the healthcare system and providers.
The live broadcast will also feature these other segments:
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:
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:
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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:
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:
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:
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:
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:
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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:
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:
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:
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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 our lead story will be Lidiya Ter-Markarova, a principal at Innova Revenue Group.
The live broadcast will also feature these other segments:
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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:
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:
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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:
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:
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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:
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 the live broadcast will include the following:
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 the live broadcast will include the following:
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 live broadcast will include the following:
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:
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 and the associated financial penalties served as their catalyst for change.
Other segments during the live broadcast will include the following:
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.
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 members.
Other segments during the live broadcast include the following:
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.
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:
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.
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:
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:
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.
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:
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:
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 strategies impacting PSI-04’s inclusions, exclusions, and risk-adjustment that can be implemented by any facility wishing to address any perceived shortcomings.
Invite your director of quality to join as to learn how they can partner with coding and CDI in this important initiative. They will thank you for it.
Other segments during the live broadcast include the following:
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:
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.
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:
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.
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 more at
https://www.aapc.com/medical-coding-education/conferences/regional/denver/#tab-agenda.
The live broadcast will also feature these other segments:
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.
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:
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.
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.
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 feature these other segments:
Sitting in for executive producer and program host Chuck Buck will be Dennis Jones.
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 Talk Ten Tuesdays.
The live broadcast will also feature these other segments:
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.
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:
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:
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.
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:
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:
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:
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 Malnutrition Composite Score eCQM, and others that certainly will have clinical documentation integrity (CDI) and ICD-10-CM/PCS coding implications.
During the next live edition of Talk-Ten-Tuesdays, James S. Kennedy, MD, president of CDIMD, will briefly outline which of these warrant the immediate attention of ICD-10-CM/PCS-oriented physicians, providers, coders, and CDI specialists, who are being asked to formulate and submit comments prior to CMS’s June 17 deadline.
The live broadcast will also feature these other segments:
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:
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:
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:
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:
“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.
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 key solution to assist in streamlining this process. The advent of the electronic health record (EHR) has made real-time decision support possible, due to the common workflows and digitization of clinical data available for processing. However, the avalanche of clinical data produced every day for innumerable medical conditions is stashed away in difficult-to-consume structure, often going untapped.
The live broadcast will also feature these other segments:
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:
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:
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:
“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/
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:
Sitting in for Dr. Erica Remer will be Susan Gatehouse, founder and CEO for Axea Solutions.
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:
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.
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.
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:
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, founder and CEO for Axea Solutions, will report on the practice of single-use endoscopies as an alternative for non-emergent care procedures.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, 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.
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:
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:
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, but it all begins with the initial patient interaction. Providers can directly impact outcomes with an aim to prevent widening health inequities by tailoring strategies targeted at overcoming mistrust and refocusing on improving the patient experience within minority populations.
The live broadcast will also feature these other segments:
SPECIAL ADDED FEATURE:
Immediately following the broadcast, Sharon Easterling will report on her newest software application (app), CDIWis.
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 experience in healthcare and technology strategy. He also serves as payor advisor for for the HL7 Da Vinci Project, and was elected to the HL7 Board in 2020.
The live broadcast will also feature these other segments:
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 broadcast will also feature these other segments:
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:
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:
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:
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:
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:
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:
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:
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:
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 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 psychiatrists.
The live broadcast will also feature these other segments:
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 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 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:
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:
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 your facility. Invite your quality teams to listen as Dr. James Kennedy analyzes this explosive topic.
The live broadcast will also feature these other segments:
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:
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:
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:
"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 other segments:
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:
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 the current OIG 2021 Work Plan.
Nationally recognized physician auditor, educator, and coder Terry Fletcher will report on this developing story during the next live edition of Talk Ten Tuesdays.
The live broadcast will also feature these other segments:
“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:
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 broadcast will also feature these other segments:
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:
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:
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:
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:
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 Shannon DeConda, who will return to the broadcast to take a deeper dive into a subject that has continued to generate buzz since her last appearance several weeks ago..
The live broadcast will also feature these other segments:
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:
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 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: Shannon DeConda, founder of the National Alliance of Medical Auditing Specialists (NAMAS), will return to the broadcast with an update on evaluation and management (E&M) codes.
Mental Health Report: Sexism: Sexism, like racism, causes all sorts of psychiatric problems and diagnoses. Though sexism towards females is more obvious, we in healthcare shouldn’t ignore its occurrence in men, too, according to Dr. H. Steven Moffic, award-winning author and internationally renowned psychiatrist, who will return to the broadcast to report on this hot-button topic – and also comment on the Derek Chauvin verdict that captured the world’s attention.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, 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.
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 modification of PSI-06 criteria, based in sound clinical reasoning.
The live broadcast will also feature these other segments:
This episode is sponsored by:
AHIMA, MRA and AHDAM
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
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:
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:
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:
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:
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:
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:
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 Coordination and Maintenance meeting, and a marker of America’s grim milestone of more than 500,000 souls lost to the deadly coronavirus.
The live broadcast will also feature these other segments:
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 answer listeners’ questions in real time. Joining them on the program will be Lynne Comstock, who, like Remer, is a volunteer inoculator in Corpus Christi, Texas. Remer is volunteering with the Medical Reserve Corps of the Cuyahoga County Board of Health in Ohio.
The global COVID-19 pandemic has now resulted in more than 110 million cases worldwide, as well as 2.45 million deaths. More than 28 million of those cases and more than half a million deaths have occurred in the U.S. alone.
However, the Centers for Disease Control and Prevention (CDC) recently reported that more than 56 million doses of the vaccine have been administered across the country.
Still, 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).
The live broadcast will also feature these other segments:
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 and more than 483,000 deaths have occurred in the U.S. alone.
Two companies, Moderna and Pfizer, have had their COVID vaccines approved for use by the Food and Drug Administration (FDA). Since vaccine distribution began in the U.S. in mid-December 2020, more than 44 million doses have been administered, reaching slightly more than 10 percent of the total U.S. population, according to federal data recently collected by the Centers for Disease Control and Prevention (CDC) and reported on by NPR.
A third company, Johnson & Johnson, earlier this month applied for FDA approval for its single-dose vaccine, and company officials have said they will be able to produce 100 million doses by June. Officials with both Moderna and Pfizer have reportedly said that they plan to have produced 200 million doses apiece by the summer.
The live broadcast will also feature these other segments:
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 County Board of Health in Ohio.
The global COVID-19 pandemic has now resulted in more than 104 million cases worldwide, as well as 2.27 million deaths. More than 27 million of those cases and nearly 460,000 deaths have occurred in the U.S. alone.
Two companies, Moderna and Pfizer, have had their COVID vaccines approved for use by the Food and Drug Administration (FDA). Since vaccine distribution began in the U.S. in mid-December 2020, more than 29 million doses have been administered, reaching 7.2 percent of the total U.S. population, according to federal data recently collected by the Centers for Disease Control and Prevention (CDC) and reported on by NPR.
A third company, Johnson & Johnson, is expected to apply for FDA approval for its single-dose vaccine shortly, and company officials have said they will be able to produce 100 million doses by June. Officials with both Moderna and Pfizer have reportedly said that they plan to have produced 200 million doses apiece by the summer.
The live broadcast will also feature these other segments:
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:
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:
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:
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:
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:
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:
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:
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 family.
Also on top for the broadcast:
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:
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:
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:
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:
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:
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:
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:
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:
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:
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.
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:
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 broadcast will also feature these other segments:
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:
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:
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:
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:
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 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:
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:
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:
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:
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:
“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:
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:
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:
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:
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:
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:
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:
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 these other segments:
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:
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:
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:
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:
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:
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:
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:
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:
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:
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:
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:
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:
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:
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:
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:
All this and more will be coming your way during the next live edition of Talk Ten Tuesdays, Tuesday, Nov. 26, 2019 at 10 a.m. EST.
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:
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 during this edition of Talk Ten Tuesdays will be the aforementioned Ms. Jones, who is also a member of the ICD10monitor editorial board.
The live broadcast will also feature these other segments:
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 data internationally, while recognizing coders around the world.
The live broadcast will also feature these other segments:
“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:
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:
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:
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:
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:
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:
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:
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:
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:
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:
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:
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:
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:
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 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:
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 these other segments:
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 improvement/integrity (CDI) landscape, to assess current issues the industry may be facing, is one of the roles being fulfilled by the American Health Information Management Association (AHIMA). Tammy Combs, director of HIM Practice Excellence/CDI Nurse Plan for AHIMA, reports on this story.
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 Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on the latest coding and documentation issue that has caught her attention.
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 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 Scorecard project.
The broadcast will also feature these other segments:
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 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:
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:
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:
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:
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 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:
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:
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:
Materials from Dr. Remer's segment
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:
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:
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, IFHIMA, and the current IFHIMA/AHIMA representative to the World Health Organization (WHO) Family of International Classifications Education and Implementation Committee. That committee does work on ICD-11, as well as work on improving the quality of coded data internationally while recognizing coders around the world.
The broadcast will also feature these other segments:
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:
Click here to view the link mentioned by Stanley Nachimson in his segment RegWatch
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:
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:
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:
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 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:
"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:
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:
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:
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:
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:
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:
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:
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:
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:
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:
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:
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 contributor Glenn Krauss reports on clinical documentation integrity relative to the lawsuit against Providence Health to recover $188 million for alleged upcoding perpetuated by overly aggressive querying and guiding of physicians to document major comorbidities and complications (MCCs).
TalkBack: Talk Ten Tuesdays co-hostErica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., reports on an issue that recently caught her attention during her popular TalkBack segment.
Talk Ten Tuesdays. More than just talk.™
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 Revenue Cycle, anchors the Talk Ten Tuesday News Desk Live from the 2018 AHIMA convention in Miami, FL.
Mental Health Report:Mental trauma has been in the news. Reporting the could be confusion about trauma and post-traumatic stress syndrome (PTSD) is nationally renowned psychiatrist H. Steven Moffic, MD.
Talk Ten Tuesdays. More than just talk.™
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, especially among area hospitals. Sharon Easterling is the CEO of Recovery Analytics, LLC in Charlotte, N.C. Easterling will discuss best practices for hospitals confronting natural disasters.
RegWatch: Leading healthcare technology consultant Stanley Nachimson returns with his popular segment, RegWatch, through which he reports on the latest regulatory changes coming out of Washington, D.C.
Coding Report: Continuing her reporting on last week’s ICD-10 Coordination and Maintenance Committee meeting will be Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC and an ICD10monitor contributor.
Talk Ten Tuesdays: More than just talk™
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 Social Determinants of Health (SdoH), especially adverse childhood events and their impact on physical and mental health.
Coding Report: Gloryanne Bryant reports on steps facilities should take to strengthen their coding and compliance programs, especially in the wake of the alleged upcoding at Providence St. Joseph health system.
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, nationally recognized coding authority Terry Fletcher will return to the broadcast to report on a number of specialties expected to be impacted if the proposed rule becomes effective Oct. 1.
Tuesday Focus: Senior healthcare consultant Laurie Johnson with Revenue Cycle Solutions, LLC, will preview the upcoming Coordination and Maintenance meeting kicking off Tuesday, Sept. 11.
CDI Report: ICD10monitor contributor Glenn Krauss, the clinical documentation improvement (CDI) manager at University Health Systems Las Vegas, will report on how providers too often approach CDI from a misguided and counterproductive direction, focusing too closely on reimbursement as the primary objective and endpoint of chart reviews.
TalkBack: Talk Ten Tuesdays co-hostErica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., will report on a current issue that caught her attention during her popular TalkBack segment.
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 amyotrophic lateral sclerosis (ALS), according to a recent news report by the Los Angeles Times. Senior healthcare consultant Laurie Johnson, an ICD10monitor contributor, reports on the clinical indicators of these two diagnoses in advance of the NFL season, which kicks off Sept. 6.
Mental Health Report: Feeling the heat? With unseasonably hot weather plaguing most of the U.S., physicians are feeling another kind of burn; burnout. A recent study reports that 52 percent of physicians feel burned out regularly. Returns to report on this topic will be nationally renowned psychiatrist H. Steven Moffic, MD, the Talk Ten Tuesdays resident psychiatrist.
TalkBack: Talk Ten Tuesdays co-hostErica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., reports on her personal role as a patient advocate for her ailing father. Joining the conversation will be Caitlin Donovan, director of outreach and public affairs for the National Patient Advocate Foundation.
Talk Ten Tuesdays. More than just talk.™
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 College of Physician Advisors.
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.
Tuesday Focus: The Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-Based Incentive Payment System (MIPS) can be complicated and confusing for medical practices. Nationally recognized coding authority Terry Fletcher reports on the need for providers to balance regulatory compliance with efficiency.
TalkBack: Talk Ten Tuesdays co-hostErica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., reports on the results of last Tuesday’s Talk Ten Tuesdays Listener Survey, asking if your facility has clinical documentation improvement (CDI) on the weekends.
Talk Ten Tuesdays. More than just talk.™
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 consultant for Karen Zupko and Associates, reports on reaction to the E and M overhaul being proposed by the Centers for Medicare and Medicaid Services (CMS).
News Desk: Larry Field, DO, anchors the Talk TenTuesday News Desk with the very latest healthcare news. Field is the treasurer of the American College of Physician Advisors.
Talk Ten Tuesdays. More than just talk.™
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 proposed rule, Grant Huang, director of content for DoctorsManagement, will report on the major overhaul being proposed by the Centers for Medicare & Medicaid Services (CMS).
Tuesday Focus: Malnutrition: Severe protein calorie malnutrition is under high scrutiny from CMS, U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG), and commercial insurers. Megan Cortazzo, MD, medical director of clinical documentation improvement and health information management at University of Pittsburg Medical Center, will report on why it is happening and how to ensure hospitals and providers get compensated for the services they are providing.
Talk Ten Tuesdays. More than just talk.™
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
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).
Talk Ten Tuesdays. More than just talk.™
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 to report on the new Z codes described in the 2019 proposed Inpatient Prospective Payment System (IPPS).
TalkBack: Talk Ten Tuesdays co-host Erica Remer, MD returns with another installment of her popular segment.
Coding Report: Nationally recognized coding and documentation authority Terry Fletcher reports on the controversy surrounding medical necessity versus medical decision-making (MDM).
Talk Ten Tuesdays. More than just talk.™
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, an award-winning industry expert and author, reports on a recent study at McLean Hospital that reveals how age, socioeconomic status, and other factors might contribute to social isolation and poorer mental health.
Special Report: Catherine Harrison-Restelli, MD, medical director for hospital services at Sheppard Pratt Health System, reports on integrating mental health into primary care.
Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions LLC and an ICD10monitor contributor, reports further on the recently posted ICD-11 codes.
Talk Ten Tuesdays. More than just talk.™
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 medicine and psychiatry and senior clinical advisor at the University of Pittsburgh Medical Center, returns after a long absence with the Talk Ten Tuesday CDI report.
Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions LLC and an ICD10monitor contributor, reports on coding and documenting sexual harassment.
TalkBack: Talk Ten Tuesdays co-hostErica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., will return to the broadcast with her popular TalkBack segment.
Talk Ten Tuesdays. More than just talk.™
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 broadcast include:
News Desk: Gloryanne Bryant, past president of the California Health Information Association and an ICD10monitor contributor shares the latest news on the release of FY2019 ICD-10-CM Code Changes.
Case Management Report: Nationally recognized case management expert and author Stefani Daniels returns to Talk Ten Tuesdays to report on the hot topic of length of stay (LOS). Daniels is the founder and partner of Phoenix Medical Management, Inc.
Coding Report: Nationally recognized coding and documentation authority Terry Fletcher highlights her findings from her four-part series on auditing issues in physician documentation she uncovered in her exclusive reporting for ICD10monitor.
RegWatch: Leading healthcare technology consultant Stanley Nachimson returns with his popular segment, RegWatch, through which he reports on the latest regulatory changes coming out of Washington, D.C.
Mental Health report: Nationally renowned psychiatrist and Talk Ten Tuesday contributor H. Steven Moffic, MD, reports on recent celebrity deaths, physician burnout and physician suicide.
Talk Ten Tuesdays. More than just talk.™
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.
Talk Ten Tuesdays. More than just talk.™
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:
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:
Talk Ten Tuesdays. More than just talk.™
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:
Talk Ten Tuesdays. More than just talk.™
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:
Talk Ten Tuesdays. More than just talk.™
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:
Talk Ten Tuesdays. More than just talk.™
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:
Talk Ten Tuesdays. More than just talk.™
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 the expiration of the original deadline—45 years after Congress submitted the amendment to the states. New ERA legislation is currently pending in several other states.
Discussing the gender gap and wage disparities in medicine during this episode is Dr. Juliet Ugarte Hopkins, a physician advisor for case management, utilization, and clinical documentation at ProHealth Care, Inc. in Wisconsin.
Other segments featured in this episode include:
Talk Ten Tuesdays. More than just talk.™
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:
Talk Ten Tuesdays. More than just talk.™
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:
Talk Ten Tuesdays. More than just talk.™
We will continue to focus on cardiology during this episode, as Jeffrey E. Epstein, MD, FACPA, appears as a special guest along with Glenn Krauss. Together the pair co-authored a paper titled "Physician Documentation Impacts Hospital Mortality Rates for Acute Myocardial Infarctions."
Dr. Epstein reports on the need for better physician documentation to achieve better clinical outcomes – and why the challenge, of course, is physician education.
Other segments featured in this episode include:
Talk Ten Tuesdays. More than just talk.™
Chronic obstructive pulmonary disease (COPD) continues to be a challenge to code and document – its coding in particular, and its sequencing, can be difficult. As a medical diagnosis, COPD is one of the most frequently searched terms on the Internet.
Shedding light on this subject during this episode of Talk Ten Tuesdays is Nelly Leon-Chisen, the director of coding and classification for the American Hospital Association (AHA).
Last Tuesday and Wednesday, the federal ICD-10 Coordination and Maintenance Committee (C&M) met to hear from proposals for new code topics. During this episode we will also have two reports on this major healthcare event, which was held at the Centers for Medicare & Medicaid Services (CMS) headquarters in Baltimore. Reporting on the proposals are Linda Holtzman, the founder of Clarity Coding, and coding educator and consultant Laurie Johnson.
Other segments featured in this episode include:
Talk Ten Tuesdays. More than just talk.™
The federal ICD-10 Coordination and Maintenance Committee (C&M) is scheduled to meet Tuesday and Wednesday, March 6 and 7, to discuss proposals for diagnosis code topics, with the conversation to be led by the Centers for Disease Control and Prevention (CDC).
Join Chuck Buck and Erica Remer, MD during this episode, as coding educator and consultant Laurie Johnson reports on the ongoing deliberations during the C&M meeting, which will take place at the headquarters of the Centers for Medicare & Medicaid Services (CMS) in Baltimore. Johnson is a senior consultant for Revenue Cycle Solutions, LLC.
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Talk Ten Tuesdays. More than just talk.™
February is Black History Month, and Talk Ten Tuesdays is recognizing it with an appearance by Dr. Crystal Watkins, who shares thoughts about her ascension from an African-American student in the Baltimore City Public Schools to becoming an MD, PhD, neuroscientist, and finally director of The Memory Clinic at Sheppard Pratt Health System.
Dr. Watkins' appearance coincides with news that the American Hospital Association (AHA) this past week announced that it will allow notes from social workers and registered nurses to be considered as social determinants of health (SDoH), this on the heels of a USA Today report this week that Baltimore has the highest per-capita murder rate in the nation.
Using the statistics derived from ICD-10 codes might be a useful way in which data can help combat underlying issues, as you will hear when SDoH advocate Diane Iverson, RN, an emergency room nurse in Baltimore, also joins the broadcast.
Other segments featured in this episode include:
Talk Ten Tuesdays. More than just talk.™
Every patient receiving an implantable cardioverters defibrillators (ICDs) for primary prevention will be required to have an encounter for shared decision-making using an evidence-based decision tool, according to the Centers for Medicare & Medicaid Services (CMS). ICDs are often implanted in patients with chronic heart failure whose life expectancy is limited and whose quality of life tends to decline as their heart failure worsens.
CMS released a final decision memo for changes to the national coverage determination (NCD) for ICDs last Friday during American Heart Month. Reporting on this breaking news is Ronald Hirsch, MD, a RACmonitor contributing editor and the vice president of the Regulations and Education Group at R1 Physician Advisory Services.
Other segments featured in this episode include:
Talk Ten Tuesdays. More than just talk.™
February is American Heart Month, and in recognition of this national focus, this episode of Talk Ten Tuesdays will center on how cardiology diagnosis coding for myocardial infarction (MI) is being impacted in 2018. There are now five types of MI code categories. Joining the podcast as our special guest is Terry Fletcher, who reports on these new options and how they will impact your reimbursement.
Other segments featured in this episode include:
Talk Ten Tuesdays. More than just talk.™
Are medical decision-making and medical necessity one in the same? Often, bad advice tends to circulate regarding how to select the correct evaluation and management (E&M) codes.
Healthcare attorney David Glaser was the first to break a news story involving Highmark’s recent policy – evidently recently rescinded – that required physicians to use medical decision-making as a key component of coding. Reporting our lead story during this edition of Talk Ten Tuesdays is David Glaser, who is joined by Betsy Nicoletti, a national consultant on physician coding and founder of Coding Intel.
Other segments to be featured on the broadcast include:
Talk Ten Tuesdays. More than just talk.™
Renal disease has been complicating obstetrics coding. For the first time on Talk Ten Tuesdays, two subject matter experts delve into this subject, which is rife with confusion and contradiction.
The key question is this: is renal disease a medical condition caused by the pregnancy, or a preexisting medical condition complicating the pregnancy? That is why we asked Linda Holtzman from Clarity Coding, Inc., to help explain when to use O26 and O99 codes. Podcast co-host Dr. Erica Remer and Ms. Holtzman resolve this question once and for all.
Other segments to be featured on the broadcast include:
Talk Ten Tuesdays. More than just talk.™
Coding chronic conditions and co-morbidities is becoming increasingly critical as the healthcare landscape shifts toward value-based care, which attempts to advance the triple aim of providing better care for individuals, improving population health management strategies, and reducing healthcare costs. Reporting our lead story on this edition of Talk Ten Tuesdays is Machaelle Diaz, senior program manager for coding quality review and education at McKesson Specialty Health.
Other segments to be featured in this episode include:
Talk Ten Tuesdays. More than just talk.™
Senior healthcare consultant Michelle Wieczorek returns to discuss six ideas she says will improve performance indicators for coding and clinical documentation integrity (CDI) departments.
Wieczorek, who is a senior manager in the DHG Healthcare CFO advisory team, also discusses the ever-increasing importance of Hierarchical Condition Categories (HCCs) in the world of value-based care.
Other segments to be featured this episode include:
Talk Ten Tuesdays. More than just talk.™