Talk Ten Tuesdays

Latest Episodes:

Don’t Code for Panic: Understanding the New Medicare Appeal Process Oct 29, 2024

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
Listen for of-the-moment insider insights, framed by the rapidly changing social and...

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Rules of Engagement: Learning to Code Better, Faster, and More Accurately Oct 22, 2024

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:

• 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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Q4 Coding Clinic: The Autopsy Report Oct 15, 2024

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
Listen for of-the-moment insider insights, framed by the rapidly changing social and...

Listen on: Apple Podcasts Spotify

Health and Longevity Oct 08, 2024

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
Listen for of-the-moment insider insights, framed by the rapidly changing social and...

Listen on: Apple Podcasts Spotify

Eleven Key Takeaways from the 2025 ICD-10 Code Updates Oct 01, 2024

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
Listen for of-the-moment insider insights, framed by the rapidly changing social and...

Listen on: Apple Podcasts Spotify

Sleep Deprivation: Study Reveals Serious Health Implications Sep 26, 2024

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
Listen for of-the-moment insider insights, framed by the rapidly changing social and...

Listen on: Apple Podcasts Spotify

Dissecting the Holy Grail of Medical Record Coding Sep 17, 2024

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...

Listen on: Apple Podcasts Spotify

WARNING: The Healthcare Bermuda Triangle Sep 10, 2024

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...

Listen on: Apple Podcasts Spotify

Making the Case for Artificial Intelligence to Reduce Coding and CDI Costs Aug 27, 2024

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
Listen for of-the-moment insider insights, framed by the rapidly changing social and...

Listen on: Apple Podcasts Spotify

The Patient Safety Structural Measure: A New Initiative Designed to Reduce Medical Errors Aug 20, 2024

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...

Listen on: Apple Podcasts Spotify

2025 OPPS Proposed Rule: Important Changes Coming to the Hospital Outpatient Quality Reporting Program Aug 13, 2024

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.

Cozen O’Connor Public Strategies - The Beltway Briefing
Listen for of-the-moment insider insights, framed by the rapidly changing social and...

Listen on: Apple Podcasts Spotify

Is AI a Game-Changer for Coding and CDI? Aug 06, 2024

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.

Cozen O’Connor Public Strategies - The Beltway Briefing
Listen for of-the-moment insider insights, framed by the rapidly changing social and...

Listen on: Apple Podcasts Spotify

National Coding Roundup: Preparing for the New FY2025 IPPS Final Rule Jul 30, 2024

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.

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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Scorching Reality: The Health Impacts of Excess Heat and Climate Change Jul 23, 2024

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.

Cozen O’Connor Public Strategies - The Beltway Briefing
Listen for of-the-moment insider insights, framed by the rapidly changing social and...

Listen on: Apple Podcasts Spotify

2025 OPPS Proposed Rule: Significant Changes Impacting Medicare Payments Revealed Jul 16, 2024

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.

Cozen O’Connor Public Strategies - The Beltway Briefing
Listen for of-the-moment insider insights, framed by the rapidly changing social and...

Listen on: Apple Podcasts Spotify

In Deference to HIM: Chevron Explained Jul 09, 2024

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.

Cozen O’Connor Public Strategies - The Beltway Briefing
Listen for of-the-moment insider insights, framed by the rapidly changing social and...

Listen on: Apple Podcasts Spotify

Hello, CMS: Are You Listening? Add-on Code G2211 Jul 02, 2024

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.

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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Why MedPac Chapter 12 is Fast Gaining Attention Jun 25, 2024

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.

Cozen O’Connor Public Strategies - The Beltway Briefing
Listen for of-the-moment insider insights, framed by the rapidly changing social and...

Listen on: Apple Podcasts Spotify

Mental Health Coping Strategies for Brutal Summer Heat Jun 18, 2024

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.

Cozen O’Connor Public Strategies - The Beltway Briefing
Listen for of-the-moment insider insights, framed by the rapidly changing social and...

Listen on: Apple Podcasts Spotify

Food for Thought: Food as Medicine Jun 11, 2024

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.

Cozen O’Connor Public Strategies - The Beltway Briefing
Listen for of-the-moment insider insights, framed by the rapidly changing social and...

Listen on: Apple Podcasts Spotify

National Coding News Roundup Jun 04, 2024

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.

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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Mental Health Report: Coping with Psychopathologies May 21, 2024

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:

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.
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.

Cozen O’Connor Public Strategies - The Beltway Briefing
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Modifier 25: Where, When, and How to Use It Correctly May 14, 2024

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.

• 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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Is There a Code for Greed? May 07, 2024

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.

• 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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Out with the Old, In with the New: Patient Access Systems Apr 30, 2024

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.

• 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: Underrated, Undervalued, and Now a U.S. Health Crisis Apr 23, 2024

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.

• 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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Transforming Patient Access Services: A Blueprint for Healthcare Success Apr 16, 2024

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.

• Point of View: Angela Comfort, guest cohost during this live broadcast, will report on a subject that has caught her attention.

Cozen O’Connor Public Strategies - The Beltway Briefing
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Saluting World Health Day in Preparation for ICD-11 Apr 09, 2024

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:

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. Dr. Kennedy will be reporting news live from the ACDIS conference taking place in Indianapolis.
Point of View: Angela Comfort, guest cohost during this live broadcast, will report on a subject that has caught her attention.

Cozen O’Connor Public Strategies - The Beltway Briefing
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Data Breaches: What Every Coder Needs to Know Apr 02, 2024

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.

Cozen O’Connor Public Strategies - The Beltway Briefing
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New Code W44: The Ins and Outs of New Foreign Bodies Mar 26, 2024

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.

Cozen O’Connor Public Strategies - The Beltway Briefing
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Looking Ahead to What the Future Holds with ICD-11 Mar 19, 2024

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.

• 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.

Cozen O’Connor Public Strategies - The Beltway Briefing
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The Code that Keeps on Giving: G2211 Mar 12, 2024

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.

Cozen O’Connor Public Strategies - The Beltway Briefing
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Hospital Star Ratings: How to Earn Back Fallen Stars Mar 05, 2024

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.

• 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.

Cozen O’Connor Public Strategies - The Beltway Briefing
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Good News: The Flip Side of Social Psychopathologies Feb 27, 2024

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.

Cozen O’Connor Public Strategies - The Beltway Briefing
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Safe Handling Instructions for Code G2211 Feb 20, 2024

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:

• 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.

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Leveraging Revenue Cycle Management: New Series Begins Today Feb 13, 2024

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.

• 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.

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Searching for a New Z Code: Psychopathologies Feb 06, 2024

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.

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There’s a New Code in Town: Condition Code 92 Jan 30, 2024

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, 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.

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Decoding the Enigmatic Code G2211 Jan 23, 2024

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.

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Never Before Reported: The Impact of 2021 E&M Changes on 2024 E&M Coding Jan 09, 2024

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.

• 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.

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AMA and CMS Alignment on Split/Shared E&M Visits Dec 05, 2023

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:

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.

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Warning: New Add-on Payment Code for E&M Coming Nov 28, 2023

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.

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Warning: New Changes to MDS Assessments for SNFs Nov 21, 2023

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.

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MINOCA and INOCA: Twin Aspects of a Cardio Conundrum Nov 14, 2023

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.

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The FAQs of EMRs Nov 07, 2023

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.

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New Codes Raining Down Daily Oct 31, 2023

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.

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Navigating the New Normal: Understanding Telehealth Coding and Documentation Oct 24, 2023

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.

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An Insider’s View of the AHA Coding Clinic Oct 17, 2023

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:

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 during her popular segment.

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Live from AHIMA Annual Conference Oct 10, 2023

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.

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Preparing for the FY 2024 ICD-10-CM Code Updates Oct 03, 2023

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.

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New ICD-10 Code on Muscle Wasting Becomes Effective Oct. 1 Sep 26, 2023

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:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the latest coding news.
SDoH Report: Juliet Ugarte Hopkins, president of the American College of Physician Advisors, will substitute for Tiffany Ferguson, and will report on 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.
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.

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Artificial Intelligence and E&M Coding: A Powerful New ForceArtificial Intelligence and E&M Coding: A Powerful New Force Sep 19, 2023

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:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will be on board with 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: Lidiya Ter-Markarova, president-elect of the California Health Information Association (CHIA), will serve as guest cohost of Talk Ten Tuesdays, reporting on a subject that has caught her attention.

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National Suicide Prevention Week Sep 12, 2023

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:

RegWatch: Stanley Nachimson, longtime editorial contributor to ICD10monitor and former career professional at the Centers for Medicare & Medicaid Services (CMS), now an IT consultant, will return to the broadcast to report on the latest regulatory news coming out of Washington.
Coding Report: Senior healthcare consultant Gloryanne Bryant will substitute for Laurie Johnson to deliver 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.

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AI and Coding: Beware of the Intersection Aug 30, 2023

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:

Coding Report: Senior healthcare consultant Gloryanne Bryant will substitute for Laurie Johnson to deliver 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.

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How Safe is Safe? AHRQ Patient Safety Indicator Methodology Finally Revealed Aug 22, 2023

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:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will be on board with 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.

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Learn Important Revisions: 2024 CMS Part C Risk Model Aug 15, 2023

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:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will be on board with 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.

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Now Available: 2024 IPPS Final Rule Aug 08, 2023

Start unpacking.

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:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will be on board with the latest coding news.
Coffee Chat: The aforementioned Laurie Johnson and Dr. Erica Remer will discuss aspects of the 2024 IPPS final rule, which they will analyze on Aug. 15, 16, and 17 during the ICD10monitor IPPS Summit.
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.
CDI Report: Fran Jurcak, chief clinical strategist for Iodine Software, will report on how medical record reviews without any query identification can be tedious and often result in job dissatisfaction.
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.

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2024 IPPS Final Rule Expected Soon Aug 01, 2023

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:

Coding Report: Laurie Johnson., senior healthcare consultant with Revenue Cycle Solutions, LLC, will be on board with the latest coding news.
Coffee Chat: The aforementioned Laurie Johnson and Dr. Erica Remer will discuss aspects of the 2024 IPPS rule, which they will analyze on Aug. 15, 16, and 17 during the IPPS Summit.
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.
This and That: The legendary Rose Dunn, past president of AHIMA, and current chief operating officer for First Class Solutions, will join the broadcast with a report on how best to measure coding accuracy.
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.

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The Anatomy of Automated Query Solutions Jul 25, 2023

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:

Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report the latest coding news.
SDoH Report: Tiffany Ferguson, a subject matter expert on the social determinants of health (SDoH), will report on news that’s happening at the intersection of coding and the SDoH.
Revenue Cycle Report: Tony DiLuca, principal at PATHS, LLC, will make his debut appearance on Talk Ten Tuesdays, reporting on the revenue cycle.
News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
Point of View: James S. Kennedy, Talk Ten Tuesdays guest cohost, will share his unique point of view.

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Smart Strategies for Boosting Hospital Revenue Jul 18, 2023

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:

Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report the latest coding news.
SDoH Report: Tiffany Ferguson, a subject matter expert on the social determinants of health (SDoH), will report on 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.
CMS Report: Stanley Nachimson, former career professional for the Centers for Medicare & Medicaid Services (CMS), will report on two proposed rules published by CMS Thursday: the 2024 Outpatient Prospective Payment System (OPPS) and the Medicare Physician Fee Schedule (MPFS).
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.

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Beware: Outcomes Impacted at the Intersection of SDoH and CMS Star Rating Quality Measures Jul 11, 2023

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:

Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report the latest coding news.
SDoH Report: Juliet Ugarte Hopkins, MD, president of the American College of Physician Advisors, will substitute for Tiffany Ferguson, and 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.

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Major Updates on ICD-11 Jun 27, 2023

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:

Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report 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.

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The Anatomy of the Latest Coding Clinic Jun 20, 2023

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:

Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report 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.

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Time is Money: Billing Delays Cost Hospitals Billions Jun 13, 2023

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:

Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report 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: James S. Kennedy, president of CDIMD Physician Champions, will guest cohost Talk Ten Tuesdays and report on a subject that has caught his attention during this popular segment.

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Can’t We All Get Along? Jun 06, 2023

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:

Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report 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.

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HCCs and Value-based Care: Important Changes from CMS May 23, 2023

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:

Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report 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.

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A Mental Health Alert May 16, 2023

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:

Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report 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.

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Revenue That’s Lost in the Shuffle May 09, 2023

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:

Coding Report: Gloryanne Bryant, an independent health information management (HIM) consultant, will substitute for Laurie Johnson., senior healthcare consultant with Revenue Cycle Solutions, LLC, with 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: James S. Kennedy, president of CDIMD -Physician Champions, will guest cohost Talk Ten Tuesdays and report on a subject that has caught his attention during this popular segment.

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Too Many Codes, Too Many Changes: Gain Insight on Talk Ten Tuesdays May 02, 2023

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:

Coding Report: Gloryanne Bryant, an independent health information management (HIM) consultant, will substitute for Laurie Johnson., senior healthcare consultant with Revenue Cycle Solutions, LLC, with 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.

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Colorectal Cancer Screening: Weighing Options for Early Detection Apr 25, 2023

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:

Coding Report: Gloryanne Bryant, an independent health information management (HIM) consultant, will substitute for Laurie Johnson., senior healthcare consultant with Revenue Cycle Solutions, LLC, with 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: James S. Kennedy, president of CDIMD Physician Champions, will serve as guest cohost of Talk Ten Tuesdays, reporting on a subject that has caught his attention during this popular segment.

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Five Ironclad Strategies for Avoiding Revenue Loss Apr 18, 2023

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:

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.
Point of View: James S. Kennedy, president of CDIMD -Physician Champions, who will guest cohost Talk Ten Tuesdays, will report on a subject that has caught his attention during this popular segment.

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Coding: The Link to World Health Apr 11, 2023

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:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the latest coding news.
RegWatch: Stanley Nachimson, founder of Nachimson Advisors, LLC, will report on the latest news regulatory news coming out of Washington, DC.
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.

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Where in the World is ICD-11? Apr 04, 2023

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:

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 during her popular segment.

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Regroup – The End of the PHE is Near Mar 28, 2023

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:

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 during her popular segment.

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Probing the ICD-10 Impact on CMS-HCC Risk Adjustment Mar 21, 2023

Are there significant risks of potential fraud and abuse with Medicare Advantage (MA) by plans, vendors, and providers, with an emphasis on ICD-10-CM’s impact on Centers for Medicare & Medicaid Services Hierarchical Condition Category (CMS-HCC) risk adjustment?

Evidently, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) believes there are. Recently, Christi A. Grimm, Inspector General, issued a statement in which she addressed the concerns of the federal watchdog agency.

In response to her speech, we invited Dr. James Kennedy, a 20-year veteran in clinical documentation integrity (CDI) consulting and a popular panelist, to share succinct advice on how a compliance plan can best prepare for OIG audits that are sure to come.

Programming note: Invite your compliance teams to hear what promises to be the best four minutes applicable to this challenge, during the next live edition of Talk Ten Tuesdays.

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on coding colorectal cancer.
SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

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First and Foremost: Getting Paid Correctly Mar 14, 2023

It’s all about the money. It’s not only getting paid, but also getting paid the right amount. Little wonder that this is first and foremost on every provider’s mind. Often, though, success or failure lies in the completion and details of medical notes taken.

So, what’s the deal with medical notes? Why are notes so important, and why are they difficult for providers to complete? We’ve invited Kevin Lasser, Co-founder and CEO of TiaTech, to be our special guest and to answer those questions during the next live edition of Talk Ten Tuesdays.

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the outcome of the recent Coordination and Maintenance Committee (C&M) meeting.
SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

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Coordination & Maintenance Meeting: Live Reports and Updates Mar 07, 2023

ICD10monitor correspondent Linda Holtzman, founder of Clarity Coding, will return to the Talk Ten Tuesdays (TTT) broadcast this coming Tuesday, March 7 to report on the activities at the Coordination & Maintenance Committee (C&M) meeting taking place from the headquarters of the Centers for Medicare & Medicaid Services (CMS).

Holtzman, a longtime C&M observer, will bring her knowledge and expertise to her reporting of this important event – an essential meeting for coders and clinical documentation integrity specialists (CDISs).

The two-day meeting will be held on March 7 and 8, virtually. The usual program will begin at 9 a.m. EST until 5 p.m. EST, until the business is finished. The tentative agendas are light this spring, with 18 topics on the diagnosis side and nine proposals for procedure codes. The procedure code information, however, will not be presented during the meeting.

Remember, TTT will be covering this event live!

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will also report on the C&M meeting.
The Dunn Report: Legendary HIM professional Rose Dunn, COO at First Class Solutions, and past president of the American Health Information Management Association (AHIMA), will report on the latest news about hierarchical categories of classification (HCCs).
SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

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High-Sensitivity Cardiac Troponins: Part II Feb 28, 2023

We will conclude our month-long observance of American Heart Month on the Talk Ten Tuesdays weekly Internet radio broadcast with an upcoming guest appearance of Cardiologist Harry B. Peled, MD with St. Jude Medical Center in Fullerton, Calif.

Last Tuesday, Dr. Mahesh Amin reported on the use of new protocols centered on high-sensitivity troponins for the diagnosis of type 2 myocardial infarction (MI). The response to his appearance was overwhelming; hence the continuation of this timely and critically important topic during the next broadcast.

Our series on the plight of rural hospitals will also continue with Dr. James Kennedy, who will report on an unfolding tragedy facing America’s rural populations as they seek care from facilities faced with drastically dwindling resources.

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

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New Protocols for High-Sensitivity Cardiac Troponins Feb 21, 2023

Last year, the Food and Drug Administration (FDA) issued its approval of using new protocols centered on high-sensitivity troponins for the diagnosis of type 2 myocardial infarction (MI).

Reporting our lead story during the next edition of Talk Ten Tuesdays will be Dr. Mahesh Amin, CV Service Line Medical Director for BayCare Health Systems in Clearwater, Fla., a board-certified cardiologist.

This story, along with a Feb. 28 report by Henry Peled, MD at St. Jude Medical Center in Fullerton, Calif., will conclude the monthlong observance of American Heart Month by ICD10monitor and Talk Ten Tuesdays. In previous February broadcasts, the focus has been on the topics of coding and clinical documentation integrity (CDI).

This live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

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Cardiology: Understanding the Imperative of Pre-Authorizations Feb 14, 2023

In continuing our observance of American Heart Month, during the next live edition of the Talk Ten Tuesdays live Internet radio broadcast we will zero in on the topic of coding and clinical documentation integrity (CDI) issues related to cardiovascular procedures – and, specifically, the importance of obtaining pre-authorizations for cardiology procedures.

Obtaining cardiology procedure pre-authorizations tends to be a time-consuming process, depending on the complexity of the patient’s insurance coverage and staff experience. And that is why we invited Susie Vestevech, the COO for TiaTech USA, to walk you through the process, which can range from several days to several weeks, often requiring multiple phone calls and documentation submissions.

Every year, some 805,000 people in the United States have a heart attack. Basically, someone has a heart attack every 40 seconds. Making certain that your facility is prepared to obtain cardio procedure pre-authorizations is of vital importance every month, not just in February.

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

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Understanding the Pain Points: Coding and Documenting Myocardial Infarction Feb 07, 2023

February is American Heart Month, a time to raise awareness of cardiovascular health and to shine the light on cardiac issues, especially myocardial infarction.

Unfortunately, every year about 805,000 people in the United States have a heart attack. Basically, someone has a heart attack every 40 seconds.

And that is why we invited the Chief Executive Officer for the Innova Revenue Group, Lidiya Ter-Markorova, a clinical documentation integrity expert, to discuss documentation and coding pain points for myocardial infarction during the next live edition of Talk Ten Tuesdays.

The live broadcast will also feature these other segments:

Coding Report: Patricia Chua will report on the latest coding news.
SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer,MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

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Mary's Bookclub: Respiratory Therapy All Access Pass Feb 01, 2023

Listen to Mary's Bookclub, where Mary summarizes the products you can find at the MedLearn online bookstore!
In this episode, Mary goes over the Respiratory Therapy All Access Pass, and why it is an important product for healthcare professionals.

Exclusive Series: The Plight of Rural Hospitals Jan 31, 2023

As rural hospital closures continue to increase (136 have occurred between 2010 and 2021), health information management (HIM) and clinical documentation improvement (CDI) professionals have key roles in ensuring revenue integrity and optimization essential to sound operations and access.

Even so, small facilities, especially those operating independently, simply do not have the resources that larger chains have to negotiate favorable payer contracts and to implement processes, technologies, and training essential to withstanding payer denials.

In addressing these crucially important issues, Talk Ten Tuesdays, the live Internet radio program produced by ICD10monitor, will begin a new series that will address rigorous revenue integrity solutions that can be developed in a rural environment, while offering tips in creating win-win scenarios with medical/provider staffs.

Join expert coder James S. Kennedy, MD – a native of East Tennessee, which has its own share of rural hospitals – as he offers experience, guidance, and hope essential to success.

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
Talk Law: Healthcare attorney Karen N. George with the Los Angeles-based law firm of Buchalter will resume her popular segment, reporting on healthcare law.
News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer,MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

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Coding Confusion: AMA’s Two-in-One Code Calamity Jan 24, 2023

Who knew that when the venerable American Medical Association’s (AMA’s) combining two hospital encounter service types into one code set of inpatient/observation services – initial and subsequent – consternation would be the outcome. The confusion: what entity can actually bill an inpatient initial code, 99221-99223, and who must default to subsequent codes or report office and other outpatient codes when seeing patients in the observation setting?

The good news: during the next live edition of the long-running and popular Talk Ten Tuesdays Internet broadcast, Terry Fletcher will return to the broadcast and offer her interpretation of the rules, and how multi-specialty practices will handle these changes. Moreover, Fletcher, a nationally recognized professional coder, educator, and auditor, will report on the contrast between CPT® and Medicare when reporting these services.

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
Journaling John: John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, will continue with his journal entries.
News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer,MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

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The Reporting Dilemma: DRG Mismatches (Part II) Jan 17, 2023

The term “DRG mismatches” is most often used to describe situations wherein the working diagnosis-related group (DRG) selected by the clinical documentation improvement specialist (CDIS) differs from the final coded DRG, signaling that the CDIS and the coder have arrived at different principal diagnoses. In other situations, a procedure may have been coded incorrectly by the CDI professional, causing the DRG mismatch.

But here’s good news: there’s a new workflow for resolving inpatient DRG mismatches. With this new workflow, the CDIS and coder no longer have to spend countless hours reconciling DRG mismatches.

During the next live edition of Talk Ten Tuesdays, Patty Chua, president of Innova Revenue Group, will report on the positive coding implications this new workflow has created.

The live broadcast will also feature these other segments:

Revenue Cycle Report: Susan A. Vestevich, JD, chief operations officer for Tia Tech USA, will report on the need for physician credentialing to ensure proper billing and reimbursement.
SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will make her debut appearance on Talk Ten Tuesdays, having been a regular panelist on the long-running Monitor Mondays. Ferguson will report on the news that’s happening at the intersection of coding and the SDoH.
Journaling John, MD: John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, will continue with his journal entries.
News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
Point of View: James S. Kennedy, MD, president of CDIMD, will serve as co-host, and will report on a subject that has caught his attention.

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Mary's Bookclub: Nuclear Medicine All Access Pass Jan 12, 2023

Listen to Mary's Bookclub, where Mary summarizes the products you can find at the MedLearn online bookstore!
In this episode, Mary goes over the Nuclear Medicine All Access Pass, and why it is an important product for healthcare professionals.

Exclusive: The Reporting Dilemma: DRG Mismatches (Part I) Jan 10, 2023

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:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
RegWatch: Stanley Nachimson, founder of Nachimson Advisors, LLC, will report on the latest regulatory news coming out of Washington, D.C.
Journaling John: John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, will continue with his journal entries.
News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer,MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

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Mary's Bookclub: Infusion & Injection All Access Pass Dec 14, 2022

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In this episode, Mary goes over the Infusion & Injection All Access Pass, and why it is an important product for healthcare professionals.

Crossing State Lines: Telehealth Dec 13, 2022

Telehealth is considered to be rendered at the physical location of the patient, and therefore a provider typically needs to be licensed in the patient’s state. When the public health emergency (PHE) was declared in March of 2020, most states, followed the federal exceptions under the 1135 CARES Act waivers, allowing, an out-of-state provider to render services via telemedicine in a state where they are not located, or allow a clinician to provide services via telehealth in a state if certain conditions are met. However, as of summer 2021, 80 percent of the states implemented telehealth pandemic workarounds. Because these laws were issued under state emergency declarations, they were never meant to be permanent. During the next live edition of Ten Tuesday, healthcare consultant, Terry Fletcher will report on some updates to state rules and what physicians need to do to make sure they are compliant.

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
RegWatch: Stanley Nachimson, founder of Nachimson Advisors, LLC, will report on the latest news regarding ICD-11.
Journaling John: John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, will continue with his journal entries.
News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer,MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

National Coding Roundup Dec 06, 2022

New codes. Old codes. Deleted codes. ICD-10 codes, evaluation and management (E&M) codes, and Z codes.

It’s raining codes, and during the next live edition of Talk Ten Tuesdays, you’ll hear the very latest coding news – along with all you need to know to keep you performing at the top of your game.

The live broadcast will also feature these other segments:

CDI Report: Cheryl Ericson, a recognized clinical documentation integrity (CDI) subject matter expert, will report on the latest CDI news.
The Dunn Report: The legendary Rose Dunn, a nationally recognized professional in health information and former CEO, president, and board member of the American Health Information Management Association (AHIMA), will file her popular Dunn Report. She currently serves as COO of First Class Solutions, Inc.
Journaling John: John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, will continue with his journal entries.
TalkBack: Erica Remer,MD, 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.

Mary's Bookclub: Comprehensive Cardiology All Access Pass Nov 30, 2022

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In this episode, Mary goes over the Comprehensive Cardiology All Access Pass, and why it is an important product for healthcare professionals.

Z Codes: How Mapping Patient Responses Reveals Community Health Disparities Nov 29, 2022

Be sure to join us for the next live edition of Talk Ten Tuesdays, when Karen Bartrom, director of clinical integration and documentation at Cameron Memorial Hospital in Indiana, will report on how Z codes – the social determinants of health (SDoH) and ICD-10-CM codes – can reveal insights related to the health of a community.

With the mapping of patient SDoH responses to Z-codes, valuable aggregate data on a community’s health disparities can be validated and measurable. And the capturing of Z-codes then moves from anecdotal patient stories to strategic analysis, which opens opportunities to identify and develop community programs – as you will learn during the next upcoming edition of the popular weekly Internet broadcast.

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
Journaling John: John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, will continue with his journal entries.
News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer,MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

COVID-19 Public Health Emergency: More to Come in 2023? Nov 22, 2022

Will the United States experience another federal public health emergency (PHE) beyond Jan. 11, 2023? The U.S. Department of Health and Human Services (HHS) on Oct. 13 renewed the PHE for an additional 90 days. Meanwhile, states continue to wait for a 60-day termination warning, as HHS had promised earlier.

Joining the broadcast during the next live edition of the popular Internet radio program Talk Ten Tuesdays will be nationally recognized professional coder, auditor, and consultant Terry Fletcher, who will weigh the pros and cons of continuing the PHE. Also appearing on the program will be Dr. Jennifer Brettler and Kimberly Seery, both from ChristianaCare, a Delaware-based health system; they will give you on a close-up look at Patient Safety Indicators (PSIs).

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
The Mental Health Report: Internationally renowned psychiatrist and author H. Steven Moffic, MD, will return to the broadcast with a special Thanksgiving report.
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.

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Mary's Bookclub: Ultrasound Coder Nov 16, 2022

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In today's episode, Mary explains the importance of Ultrasound Coder. Listen in to find out why this textbook could be a great addition to add to your essential library.

Patient Safety Indicators: Under Pressure to Reduce PSI Composite Scores Nov 15, 2022

Our exclusive series on patient safety indicators (PSIs), being produced by ICD10monitor and Talk Ten Tuesdays in association with ChristianaCare, will continue next week.

During the next live edition of Talk Ten Tuesdays, Dr. Jennifer Brettler and Kimberly Seery, both from the Delaware-based health system, will give you on a close-up look at AHRQ Patient Safety Indicator 90 – Patient Safety and Adverse Events Composite. Diving deep into the subject, you will also gain critically important information on PSI 03 – Pressure Ulcer and PSI 09 – Postoperative Hemorrhage or Hematoma Rate.

Both will share with you areas of opportunity and how a multidisciplinary chart review can help reduce your PSI composite score.

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
The Dunn Report: Rose Dunn, a nationally recognized professional in health information and former CEO, president, and board member of the American Health Information Management Association (AHIMA), will file her popular Dunn Report. She currently serves as COO of First Class Solutions, Inc.
Journaling John: John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, will continue with his journal entries.
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.

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2023 Medicare Physician Fee Schedule: Health Equity at the Intersection of Cancer Screening Nov 08, 2022

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:

RegWatch: Stanley Nachimson, former CMS career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington, D.C.
Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
Journaling John: John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, will continue with his journal entries.
News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer,MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

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Medicare Disadvantage: Diagnosis Manipulations, Denying Care Nov 01, 2022

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:

PSI Series: The series on patient safety indicators (PSIs) continues with Dr. Jennifer Brettler and Kimberly Seery reporting on the PSI Inclusion and Exclusion criteria for PSI 04.
Talk Law: Karen George, an attorney at Buchalter in Los Angeles, and a member of the firm’s health care practice group, will file a report on the latest healthcare laws.
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.

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Last Call: An Updated Industry Practice Brief Offers Guidelines for Achieving a Compliant Query Oct 25, 2022

Today is the very last day to comment on the recently posted industry practice brief titled Guidelines to Achieving a Compliant Query Practice, co-authored by the American Health Information Management Association (AHIMA) and the Association of Clinical Documentation Integrity Specialists (ACDIS). The updated brief was released on Oct. 10, 2022 and has been open for comments.

During the next live edition of the popular and long-running Talk Ten Tuesdays broadcast, Karen Carr, an AHIMA CDI practitioner, will explore the next steps in the process of finalizing the practice brief for publication.

Other segments during the live broadcast will include the following:

Revenue Cycle Report: Dr. Ramesh Madhavan, founder and CEO for TiaTech, will discuss the results of the recently deployed survey that asked both Monitor Monday and Talk Ten Tuesday listeners to describe their biggest holdup in the revenue cycle management (RCM) process. Dr. Madhavan, practicing neurologist and program director for neurology, has expertise in understanding the challenges, pains, and disconnects within the RCM process, having had leadership in hospital data-mining and clinical informatics. He will speak to those RCM pains, as well as the survey results, in his segment.
Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
Journaling John: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, will continue with his journal entry.
News Desk: Timothy Powell, CPA will anchor the Talk Ten Tuesdays News Desk.
TalkBack: James Kennedy, MD will report on a subject that has caught his attention.

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Do No Harm: A Team Approach to Improve Patient Safety Indicators Oct 18, 2022

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:

E&M Update: Senior healthcare consultant Colleen Deighan Ejak with 3M Health will continue her series on the updates to evaluation and management (E&M) codes for 2023;
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; and
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.

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Mary's Bookclub: Nuclear Medicine & PET Coder Oct 12, 2022

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.

Exclusive New Query Practice Brief: What’s New and What’s Out Oct 11, 2022

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:

E&M Update: Senior healthcare consultant Colleen Deighan with 3M Health, continues her series on the updates to E&M codes for 2023.
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.
Journaling John: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, will continue with his journal entry.
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.

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National Healthcare News Roundup Oct 04, 2022

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.

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Major E&M Changes for 2023: Consultation Services Will Never be the Same Sep 27, 2022

The American Medical Association (AMA) has announced significant revisions to Evaluation and Management (E&M) services for 2023. Consultations, inpatient and outpatient consultations, are two of the E&M categories being revised for Jan. 1, 2023. The revisions made to consultations include code deletions, revision to the criteria for E&M level selection and additions to the guidelines. Reporting our lead story during the next live edition of Talk Ten Tuesdays will be Colleen Deighan, senior consultant with 3M.

Other segments during the live broadcast include the following:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
Mental Health Report: Internationally renowned psychiatrist Dr. H. Steven Moffic returns to the broadcast with an update on burnout—this in advance of National Depression Month in October, which follows September’s Suicide Awareness Month.
Talk Law: Healthcare attorney Karen George with the law firm of Buchalter, continues her series on the intersection of healthcare and the law.
News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer,MD, founder and president of Erica Remer, MD, Inc., and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

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Mary's Bookclub: CT/MR Coder Sep 21, 2022

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.

Claim Denials: Dissecting the Severity of Malnutrition Sep 20, 2022

Hospital inpatient denials continue at a furious pace.

And there is strong evidence of a pattern of denied claims with a principal or secondary diagnosis of sepsis, a principal or secondary diagnosis of acute respiratory failure and denied hospital inpatient claims with the secondary diagnosis of malnutrition. When it comes to denials for a diagnosis of malnutrition, there appears to an additional focus on ICD-10-CM code of E43 Unspecified Severe Protein-Calorie Malnutrition.

Finding the root cause of the denial and then identifying solutions is the direction to improve compliance and obtain accurate patient severity data and reimbursement, as you will learn from national coding expert Gloryanne Bryant during the next live edition of Talk Ten Tuesdays.

Other segments during the live broadcast include the following:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
E&M Update: Senior healthcare consultant Colleen Deighan with 3M Health, continues her series on the updates to E&M codes for 2023.
CDI Report: Cheryl Ericson, a recognized clinical documentation integrity (CDI) subject matter expert will report on clinical validation denials.
News Desk: Timothy Powell, CPA will anchor the Talk Ten Tuesdays News Desk.
Journaling John: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, will continue with his journal entry.
POV: Healthcare attorney Karen M. George with the law firm of Buchalter, will substitute for Dr. Erica Remer, and will share of her Point of View (POV) with audience members.

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2023 Evaluation and Management Services: Observation and Inpatient Services Revisions Part II Sep 13, 2022

Extensive changes are coming your way for hospital observation and inpatient services. And the time to prepare is now and this upcoming live edition of the long-running Talk Ten Tuesday broadcast is the place to begin to grasp the breadth and depth of these revisions from the American Medical Association.

Colleen Deighan, senior consultant with 3M, will continue the second in her multi-series of reports as she discusses the two evaluation and management (E&M) categories including guideline changes for reporting these services accurately and sharing steps you will need to take for preparing your physicians and your coding staff for success.

Other segments during the live broadcast include the following:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the ongoing Coordination and Maintenance Committee meeting taking place at that hour in the CMS headquarters in Baltimore.
Mental Health Report: Internationally renowned psychiatrist H. Steven Moffic reports on the nation’s state of mental health.
RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington, D.C.
News Desk: Timothy Powell, CPA will anchor the Talk Ten Tuesdays News Desk.
Journaling John: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, will continue with his journal entry.
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.

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Mary's Bookclub: Peripheral & Cardiology Coder Sep 01, 2022

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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.

2023 Evaluation and Management Services: Preparing for Changes Part I Aug 30, 2022

The American Medical Association (AMA) revised the criteria for evaluation and management (E&M) services for the Office Visit categories of New and Established patients. For 2023, similar revisions have been approved for the remainder of the E&M section. Revisions were also made to services for emergency, observation, inpatient, consultations, nursing, home and residence and prolonged care.

During the next live edition of Talk Ten Tuesday, Colleen Deighan, senior consultant with 3M, will begin her first in a multi-series of reports, sharing key revisions and identifying important steps for preparing physicians and coding staff for success.

Other segments during the live broadcast include the following:

Coding Report: Meg DeVoe, senior product manager for TruCode, and who will be substituting for Laurie Johnson, will report on the latest coding news.
Mental Health Report: Internationally renowned psychiatrist H. Steven Moffic reports on the nation’s state of mental health, noting a slightly optimist job satisfaction among America’s psychiatrists.
News Desk: Timothy Powell, CPA will anchor the Talk Ten Tuesdays News Desk.
Journaling John: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, will continue with his journal entry.
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.

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Noncompliant Homework: When HIPAA and OSHA Come Knocking at Your Home Aug 23, 2022

Are you a healthcare telecommuter? Is your workspace HIPAA compliant?

While there are advantages of working remotely, there’s a monstrous risk for those who are obligated to comply with HIPAA: keeping patients’ protected health information (PHI) protected.

Not convinced it’s a big deal? The U.S. Department of Health and Human Services (HHS) has the authority to levy hefty financial penalties when entities fail to properly manage their telecommuters’ access and protection of PHI.

During the next live edition of Talk Ten Tuesdays, nationally recognized professional coder, auditor and consultant Terry Fletcher, will give you some “check-lists” to make sure your remote workers, or telecommuters are compliant, along with some examples of violations as well as compliance policies from OSHA.

Other segments during the live broadcast include the following:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC will report on the latest coding news.
Talk Law: Karen George, an attorney at Buchalter in Los Angeles, and a member of the firm’s health care practice group, will report on the recent Special Fraud Alert issued by the HHS Office of Inspector General concerning provider arrangements with telehealth companies.
News Desk: Timothy Powell, CPA will anchor the Talk Ten Tuesdays News Desk.
Journaling John: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, will continue with his journal entry.
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.

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While PSI-90 is Suppressed, PSI-04, the Death Rate Payment, Lives On Aug 16, 2022

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:

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.
Journaling John: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, will continue with his journal entry.
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.

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OCR Warning: Patient Right of Access to Medical Records Can’t be Denied Aug 09, 2022

The U.S. Department of Health and Human Services (HHS) of the Office of Civil Rights (OCR) is warning healthcare providers about the mandatory compliance with the HIPAA Right of Access promulgated in the 21st Century CURES Act. So far, enforcement actions bring to 38 the number of financial penalties against HIPAA-covered entities for failing to provide patients with timely access to their medical records.

During the next live edition of the long-running Talk Ten Tuesdays, nationally recognized professional coder, auditor and consultant Terry Fletcher, reports on the do’s and don’ts of withholding patient requests for their protected health information. Fletcher will also delve into the penalties and legal exposure that awaits those who are non-compliant.

Other segments during the live broadcast include the following:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC will report on the latest coding news.
News Desk: Timothy Powell, CPA will anchor the Talk Ten Tuesdays News Desk.
RegWatch: Stanley Nachimson, former CMS career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington, D.C.
Journaling John: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, will continue with his journal entry.
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.

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Mary's Bookclub: Essentials of Interventional Radiology Coding Aug 03, 2022

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.

Sabotaging Your Coding and CDI Reporting Aug 02, 2022

Coders, clinical documentation integrity specialist and revenue cycle professionals will be the beneficiaries next Tuesday during the live edition of Talk Ten Tuesdays when healthcare attorney and litigator Brianna J. Santolli returns to the broadcast and cuts through the legal jargon to warn of tactics deployed by some Medicare Advantage Organizations (MAO) to preserve profits by inappropriately denying prior authorizations. Using a recent case conducted by U.S. Department of Health and Human Services, Office of the Inspector General, Santolli, a litigator at the law firm Kelley Drye & Warren LLP, will explain in clear and simple terms how even though, the coding and documentation was correctly reported for the services provided, MAO will often deny or delay services for medically necessary care.

Other segments during the live broadcast include the following:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC will report on the latest coding news.
News Desk: Timothy Powell, CPA will anchor the Talk Ten Tuesdays News Desk.
Journaling John: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, will continue with his second journal entry in this, new segment.
Mental Health Report: Award-winning author and internationally recognized psychiatrist H. Steven Moffic, will report on America’s mental health against the recent announcement the Centers for Medicare & Medicaid Services to make 988 Suicide and Crisis Lifeline available nationwide.
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.

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Telehealth: Myths and Truths Jul 26, 2022

Controversy, confusion and contradiction are obfuscating the reporting of telehealth services, especially now during the recently extended public health emergency. There is so much inconsistency with how to report telehealth right now, between what Medicare determines you can do, and what the mix of commercial payers declare is appropriate. And then there are individual state executive orders. What is the reality of telehealth rules like place of service, modifiers, and audio and video versus audio-only options?

In the light of this maelstrom of entanglements, we asked professional coder and consultant Terry Fletcher to return to the broadcast next Tuesday, July 26, 10 a.m. Eastern.

As an added attraction, we are pleased to welcome Ernie Clevenger, the newly elected president of the Health Care Administrators Association to the broadcast.

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC will report on the latest coding news.
News Desk: Timothy Powell, CPA, a consultant with Besler, will anchor the Talk Ten Tuesdays News Desk.
Journaling John: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, will continue with his second journal entry in this new segment.
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.

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Cost Efficiency with the CMS Merit-Based Incentive Payment System Jul 19, 2022

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:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC will report on the latest coding news.
Tuesday Focus: PSIs, Providers and Queries: Christel Kemble, the PSI/HAC consultant for Covenant HIM, will report on the recent study concerning the Hospital-Acquired Condition (HAC) reduction program.
News Desk: Timothy Powell, CPA, a consultant with Besler, will anchor the Talk Ten Tuesdays News Desk.
Journaling John: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, will continue with his next journal entry.
Point of View: Terry Fletcher, a guest cohost who will be substituting for Dr. Erica Remer, will report on a subject that has appeared on her radar screen.

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Mary's Bookclub: Cardiac Rhythm Management Coder Jul 13, 2022

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.

Warning: New CPT® Documentation Guidelines for all E&M Coming 2023! Jul 12, 2022

As expected, the American Medical Association (AMA) has updated the guidelines for E&M services, starting in 2023. These relate to hospital services, emergency department visits, nursing facility services, home visits, and prolonged care services. Just as important, the AMA has deleted some observation care codes, the annual nursing facility assessment code, along with the domiciliary and rest home codes. Some of the existing prolonged services care codes and level one consultation codes will be deleted as well.

To help you sort out what’s in and what’s out, we asked nationally recognized professional coder, auditor and educator Terry Fletcher, to be our sherpa during this exclusive E&M tour on the next live edition of on Talk Ten Tuesdays, July 12 at 10 a.m. Eastern.

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC will report on the latest coding news.
RegWatch: Stanley Nachimson, former CMS career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington, D.C.
News Desk: Timothy Powell, CPA, a consultant with Besler, will anchor the Talk-Ten-Tuesdays News Desk.
Journaling John: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, will continue with his second journal entry in this new segment.
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.

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Front and Center: 2022 ICD-10-CM/PCS Coding Clinic Update, Spinal Fusion ICD-10-PCS Coding, 2022 Telehealth Tune-up Jul 06, 2022

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.

Mary's Bookclub: Coding Essentials for Laboratories Jun 29, 2022

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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.

“Where’s the Money, Honey?” Medicare Physician Payments at Risk Jun 28, 2022

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:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC will report on the latest coding news.
Mental Health Report: Internationally recognized and award-winning psychiatrist H. Steven Moffic, MD, will begin a new series on mental health. His focus this Tuesday will be on PTSD, a particularly relevant segment given that June is PTSD Awareness Month.
News Desk: Timothy Powell, CPA, a consultant with Besler, will anchor the Talk-Ten-Tuesdays News Desk.
Journaling John: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, will continue with his second journal entry in this new segment.
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.

Sitting in for executive producer and program host Chuck Buck will be Dennis Jones.

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Beware: Modifier 25 Could be DOA Jun 21, 2022

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:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
Talk Law: Brianna J. Santolli, Esq., a healthcare and litigation attorney with Riker Danzig LLP, will continue with the broadcast’s newest segment.
News Desk: Timothy Powell, CPA, a consultant with Besler, will anchor the Talk Ten Tuesdays News Desk.
Journaling John: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, will continue with his second journal entry in this new segment.
Point of View: Susan Gatehouse, a guest cohost who will be substituting for Dr. Erica Remer, will report on a current healthcare topic that has caught her attention.

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Mary's Bookclub: Coding Essentials for Infusion & Injection Therapy Services Jun 15, 2022

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.

Telehealth and Risky Business Jun 14, 2022

Has the U.S. Department of Health and Human Services (HHS) clarified which telehealth services are valid for data submissions for the HHS-operated risk adjustment (RA) program?

Moreover, can Hierarchical Condition Category (HCC) ICD-10-codes – the risk-adjustment model designed to estimate future healthcare costs for patients – be used when the services reported are provided under the public health emergency (PHE) telehealth waivers?

You need to know. And you will, when you listen to the next live edition of Talk-Ten-Tuesdays, coming your way Tuesday, June 14 at 10 a.m. EST. That’s when nationally recognized professional coder, auditor, consultant, and author Terry Fletcher will report on the regulatory guidance from the Centers for Medicare & Medicaid Services (CMS) to help ensure you remain compliant.

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
News Desk: Timothy Powell, CPA, and a consultant with Besler, will anchor the Talk-Ten-Tuesdays News Desk.
Journaling John: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, will continue with his second journal entry in this new segment.
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.

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National HIM, Coding, and CDI Roundup Jun 07, 2022

Revenues are trending down. Audits are on the upswing. Experienced revenue cycle professionals are in short supply. And complex coding and documenting issues seem to be an everyday occurrence.

With all the evident Sturm und Drang confronting healthcare professionals of late, ICD10monitor and Talk Ten Tuesdays are producing a special 60-minute edition of the famed Internet broadcast that will air Tuesday, June 7 at 10 a.m. EST.

A wide range of subjects and subject matter experts promises to provide the most comprehensive coverage of contemporary healthcare issues facing America’s healthcare system, with meaningful reporting on coding, clinical documentation integrity (CDI), revenue cycle, patient financial services (PFS), and compliance.

Among those expected to be reporting Tuesday include the following experts:

Shannon DeConda
Rose Dunn
Cheryl Ericson
Dennis Jones
Laurie Johnson
James Kennedy, MD
Kevin Lasser
Timothy Powell
Stanley Nachimson
Brianna Santolli
Erica Remer, MD
John Zelem, MD

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Mary's Bookclub: Coding Essentials for Respiratory Therapy/ Pulmonary Function Jun 01, 2022

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 – To Screen or Not to Screen? May 24, 2022

Behavioral health can be confusing. To screen or not to screen, what are the questions?

Joining us this Tuesday for the lead story is a new panelist, Christine Hall. Christine Hall is the CEO and Senior Consultant for Stirling Global Solutions, LLC. She has 30+ years of healthcare administration and information management experience.

Christine is a subject matter expert in compliance, specialty coding, auditing, risk adjustment, telehealth and reimbursement.

During the next live edition of Talk Ten Tuesdays, Christine will educate us on who can and should provide behavioral health screenings. She will also go over the correct codes to report and the requirements for reimbursement in behavioral health.

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
Talk Law: Brianna J. Santolli, Esq., a healthcare and litigation attorney with Riker Danzig Scherer Hyland & Perretti LLP, will continue with the broadcast’s newest segment.
News Desk: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, will anchor the Talk Ten Tuesdays News Desk.
Talkback: Dr. Erica Remer will be back with her popular segment Talkback Tuesdays.

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US Government Accountability Office: Holding CMS Accountable May 17, 2022

With telehealth usage during the pandemic—up from 2.1 million services in 2019, to 32.5 million services from March 2020-February 2021—the GAO (US Government Accountability Office) realized that Medicaid hasn’t collected or assessed any data on the quality-of-care beneficiaries received from telehealth services.

The GAO now recommends that they do so. Given concerns the GAO has raised about the quality of care provided via telehealth, this beneficiary data is crucial. It’s also consistent with how CMS has encouraged states to use data on quality of care to identify disparities in health care and target opportunities for improvement to advance health equity.

During the next live edition of Talk Ten Tuesdays, Terry Fletcher, a healthcare coding expert, will discuss how the GAO is holding CMS accountable for assessing the effect of increased telehealth use by Medicaid Beneficiaries.

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
Talk Law: Brianna J. Santolli, Esq., a healthcare and litigation attorney with Riker Danzig Scherer Hyland & Perretti LLP, will continue with the broadcast’s newest segment.
Tuesday Focus: Christel Kemble, an RN at Covenant Health will be discussing patient safety indicators (PSI) and the problems around them.
News Desk: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, will anchor the Talk Ten Tuesdays News Desk.
Point of View: Susan Gatehouse, a guest cohost who will be substituting for Dr. Erica Remer, will report her point of view.

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Patient Visits: Walking the Indistinguishable Fine Line May 10, 2022

Billing and collecting patient visits continue to challenge most healthcare providers and a frequent question often heard is “Can we bill a preventative medicine and new patient visit on the same day?”

As a point of reference, there are circumstances when a preventative visit and a problem-oriented visit could be billed on the same date. The problem: the uncertainty of what those circumstances are and differing policies among payers, including Medicare. Do they all agree with these rules for payment? During the next live edition of Talk Ten Tuesdays, Terry Fletcher, a nationally recognized professional coder, auditor and consultant, will describe the issue and report on the otherwise indistinguishable fine line between preventative and problem-oriented evaluation and management (E&M) visits.

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
Tuesday Focus: Colleen Deighan, a senior healthcare consultant with 3M HIS Consulting, will report on lessons learned from the CDI inpatient experience and how that informs CDI implementation in the outpatient setting.
News Desk: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, 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.

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2023 IPPS Proposed Rule: Important Coding and CDI Implications May 03, 2022

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:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
Talk Law: Knicole Emanuel, Partner with Practus, will continue with the broadcast’s newest segment.
RegWatch: Stanley Nachimson, former CMS career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington, D.C.
News Desk: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, will anchor the Talk-Ten-Tuesdays News Desk.
Point of View: Susan Gatehouse, a guest cohost who will be substituting for Dr. Erica Remer, will report on payor strategies that should be implemented to mitigate the already long road to payment.

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One Million COVID-19 Deaths to Create 360,000 Grievers Apr 26, 2022

A tragic milestone is about to be reached, bringing with it the potential to wreak havoc on America’s crumbling mental health infrastructure: the United States is poised to record one million deaths caused by the deadly coronavirus pandemic.

Collateral damage created by these deaths could likely be compounded by hundreds of thousands grieving the loss of loved ones and suffering from the new DSM-official condition: prolonged grief disorder. The number of potential grievers could be approximately 360,000 individuals – a staggering number, whose grieving could overwhelm an already frail mental health system.

Providing context and commentary to this imminent mental health crisis during the next edition of Talk Ten Tuesdays will be Dr. H. Steven Moffic, an award-winning psychiatrist, prolific writer, and speaker.

The live broadcast will also feature these other segments:

Talk Law: ICD10monitor and Talk Ten Tuesday launch a new segment called, “Talk Law,” featuring Brianna J. Santolli, Esq., a healthcare and litigation attorney with Riker Danzig Scherer Hyland & Perretti LLP.
Tuesday Focus: Barostim Heart Failure: Susan Gatehouse, founder and CEO for Axea Solutions, will report on the proper procedural and coding training to ensure accurate reimbursement.
News Update: Health Equity: A recent JAMA study shows that more than 50 percent of Black women over the age of 20 have high blood pressure. Nationally recognized healthcare consultant, Terry Fletcher, will report on what the AMA is doing to give Black women the resources they need to tackle this health issues, but also, understanding why it is important to service not only the majority, but the minority when it comes to healthcare equity.
News Desk: Dr. John Zelem, founder and CEO of Streamline Solutions Consulting, will return to 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.

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The PHE has been extended; the consequences are unknown Apr 19, 2022

The Public Health Emergency (PHE) was extended, as expected, April 16. But here’s the caveat when it comes to PHE waivers: not all waivers were created equal. For example, does a PHE declaration waive or preempt state licensing requirements for healthcare providers? Are HIPAA protections for virtual care removed?

Reporting this developing story during the next live edition of Talk Ten Tuesdays will be nationally recognized professional auditor, coder, educator and author Terry Fletcher. Listen and learn as Fletcher walks you and your team through the labyrinth of issues associated with the current PHE extension and what those mean for physicians and what assumptions not to make.

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
The Dunn Report: The Problem with Problem Lists. Rose Dunn, a nationally recognized professional in health information and former CEO, president, and board member of the American Health Information Management Association (AHIMA), will report on the challenges she is experiencing with Medicare Advantage payers. She currently serves as COO of First Class Solutions, Inc.
News Desk: Dr. John Zelem, founder and CEO of Streamline Solutions Consulting, will return to 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.

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Promising New Hope for ICD-11 Apr 12, 2022

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:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
Tuesday Focus: Public Health Emergency: Nationally recognized physician coder, auditor, educator, and author Terry Fletcher will report on the latest news concerning the COVID-19 public health emergency (PHE).
News Desk: Gloryanne Bryant, a member of the ICD10monitor editorial board, will anchor the Talk-Ten-Tuesdays News Desk.
Point of View: Susan Gatehouse, a guest cohost who will be substituting for Dr. Erica Remer, will report on payer strategies that should be implemented to mitigate the already long road to payment.

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World Health Day Sees New Hope for ICD-11 Apr 05, 2022

Thursday, April 7, 2022, is designated as World Health Day by the World Health Organization (WHO). And in a fitting preamble to this annual event, ICD10monitor and Talk Ten Tuesdays will feature a special guest: International Health Information Association (IFMA) President Lorraine Fernandes, who will release an official statement by her organization in support of the implementation of ICD-11.

In her prepared remarks, Fernandes will discuss the importance of ICD-11 relative to an estimated 25,000 petabytes of healthcare data generated worldwide in 2021 – and how, through ICD-11, this data holds tremendous promise for meeting the WHO’s Sustainable Development Goals (SDGs) of better health for all. She will also note that ICD-11 will standardize and structure health data so it can be leveraged by technology to help reduce healthcare costs, improve outcomes, and increase universal access to healthcare.

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
Tuesday Focus: Prior Authorizations: Nationally recognized physician coder, auditor, educator, and author Terry Fletcher, will report on the latest developments occurring with a contentious topic.
RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington, D.C.
News Desk: John Zelem, founder and president of Streamline Solutions Consulting, 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.

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Front and Center: Clinical Validation Denials and Critical Care Services Apr 04, 2022

“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.
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Automated CDI Queries: Is this the End for CDISs? Mar 29, 2022

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:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
Tuesday Focus: PSIs, Providers and Queries: Christel Kemble, the PSI/HAC consultant for Covenant HIM, will report on the intersection of Patient Safety Indicators and physician queries.
News Desk: Dennis Jones, administrator of patient financial services (PFS) for Montefiore/Nyack Hospital, 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.

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Welcome to Number 500: Talk Ten Tuesdays Landmark Live Broadcast Mar 22, 2022

Welcome to the 500th live broadcast of Talk Ten Tuesdays.

Ten nationally recognized thought leaders are scheduled to appear during the landmark production. As part of the full 60-minute broadcast, you will hear updates on topics ranging from the deadly coronavirus to the latest healthcare regulatory news, along with updates on ICD-10 coding, clinical documentation integrity (CDI), mental health, and the revenue cycle.

Invited panelists include the following:

Matthew Albright
Rose Dunn, MBA, RHIA, CPA, FACHE, FHFMA
Cheryl Ericson, RN, MS, CCDS, CDIP
John Foggle, MD, MBA
Terry A. Fletcher,
BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, ACS-CA
James Kennedy, RHIT, CCS, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer
H. Steven Moffic, MD
Stanley Nachimson, MS
John Zelem, MD, FACS

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Burnout on the Ides of March: Efforts Stall to Contain a Raging Fire Mar 15, 2022

Two years ago this week, the World Health Organization (WHO) described COVID-19 as a pandemic — about the same time a cruise ship was held at sea off the California coast, with 3,500 people on board ultimately testing positive for the coronavirus.

Today, masks are required. Social distancing is practiced. Countries close and open their borders, schools and public facilities shutter and open, and the embers of burnout explode as the Ides of March arrive. ICD10monitor and Talk Ten Tuesdays continue to report on the growing crisis and also the exposure of widening cracks in America’s health system infrastructure caused by the coronavirus, denying healthcare services to many of America’s disadvantaged communities. Reporting of this unchecked burnout during the next live edition of Talk Ten Tuesdays will be one of America’s foremost psychiatrists, H. Steven Moffic, MD.

The live broadcast will also feature these other segments:

Coding Report: Coordination and Maintenance Committee Meeting: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the outcome of the two-day meeting of the Coordination and Maintenance Committee (C&M) meeting held on Tuesday and Wednesday of this past week.
Tuesday Focus: Social Determinants of Health: Terry Fletcher, nationally recognized professional auditor, coder, educator, and author, will report on the need for accurate coding of the social determinants of health (SDoH).
News Desk: John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, 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.

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Four New Cost-Efficiency Models from CMS Mar 08, 2022

Only here on Talk Ten Tuesdays will you learn the whole story behind the latest request from the Centers for Medicare & Medicaid Services (CMS). The agency is asking for feedback on four cost-efficiency models as part of the Merit-Based Incentive Payment System (MIPS) program. The deadline is fast approaching: March 25, 2022. The proposed cost-efficiency models for the CY 2023 MIPS cover positions including emergency physician, psychiatrist, and cardiologist/hospitalist.

During the next live broadcast, CDI physician expert Dr. James S. Kennedy of CDIMD in Nashville, Tenn. will report on CMS’s proposed implementation of these cost-efficiency models, which will be effective Jan. 1, 2023, as authorized by the Medicare and CHIP Reauthorization Act of 2015 (MACRA) – as well as the role CDI teams have in ensuring success in avoiding physician financial penalties of up to 2.7 percent.

The live broadcast will also feature these other segments:

Coding Report: Coordination and Maintenance Committee Meeting: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC will file two reports on the Coordination and Maintenance Committee (C&M) meeting that will be underway at the time of this broadcast from CMS headquarters in Baltimore. Johnson will also file a follow-up report on the C&M meeting at the conclusion of the broadcast.
Tuesday Focus: Continuous Glucose Monitoring: Susan Gatehouse, founder and CEO for Axea Solutions, will report on continuous glucose monitoring (CGM) systems, designed to improve the ability to treat and manage diabetes using everyday technology. However, is the coding for the treatment and management of diabetes adequately captured?
News Desk: John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, 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.

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Front and Center: Clinical Validation Denials & Critical Care Services Mar 03, 2022

“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.
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The Top 10 List: Regulatory Rules for Medicare Telehealth Mar 01, 2022

With Medicare audits looming and U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) Work Plan items now relating to telehealth services performed during the COVID-19 public health emergency (PHE), it is time to make certain that your organization is accurately reporting services and claims within the requirements of the 1135 waivers relevant to the Coronavirus Aid, Relief, and Economic Security (CARES) Act of 2020.
Remember, too, that in the world of healthcare auditing, it’s not “if” you get audited, but “when.”
Because of the immediacy of these Medicare telehealth audits, we asked nationally recognized professional auditor, coder, author, and consultant Terry Fletcher to share with you the top 10 regulatory rules for Medicare telehealth.
The live broadcast will also feature these other segments:

Tuesday Focus: Outpatient CDI Update: The Hospital Outpatient Quality Reporting Program evaluates the regularity of treatment known to provide the best results for certain conditions. Colleen Deighan, a consultant with 3M, will return to provide details on quality measure 40, which reports the percentage of emergency department patients with a diagnosis of ST-segment elevation myocardial infarction (STEMI) who received appropriate treatment within specific time frames upon arrival to the emergency department.
Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington, D.C.
News Desk: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, will anchor the Talk Ten Tuesdays News Desk.

Sitting in for Dr. Erica Remer will be Susan Gatehouse, founder and CEO for Axea Solutions.

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ICD-11 Now Online – But U.S. Adoption on Hold Feb 22, 2022

The recent announcement from the Pan American Health Organization (PAHO) that the World Health Organization’s (WHO’s) ICD-11 coding system went online as of Feb. 11 might have been met with measured enthusiasm globally, but not here in the United States. The much-vaunted coding set isn’t expected to reach America’s shores for perhaps as much as a decade.
Nonetheless, ICD-11 continues to be a topic generating interest among America’s coding community. And that is why we have asked Mary Stanfill, our ICD-11 correspondent, to be the special guest during the next live edition of Talk Ten Tuesdays. Stanfill is expected to provide listeners with an update on the new coding set looming on the horizon.
The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
Tuesday Focus: Coding Alzheimer’s: Susan Gatehouse, founder and CEO for Axea Solutions, will report on coding Alzheimer’s – specifically, the new HCPCS Code J0172, for a new drug treatment. Its effective period will run from Jan. 1, 2022, to March 31, 2022, but many of the finer details could be subject to change during a 90-day comment period.
News Desk: John Zelem, MD, FACS, founder and CEO for Streamline Solutions Consulting, 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.

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Front and Center: Brain Disorders and Coding and MS-DRG Compliance Feb 21, 2022

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.

Front and Center: Sepsis & Malnutrition Feb 16, 2022

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.

Shared/Split Billing: New Rule Confounding, Confusing, Controversial Feb 15, 2022

The billing rules for shared/split evaluation and management (E&M) visits are changing, as they will again in 2023. But although the Centers for Medicare & Medicaid Services (CMS) considers 2022 a transition year, controversy surrounding the 2022 Medicare Physician Fee Schedule (MPFS) is creating contagious confusion.

If you and your team are suffering from such chronic consternation, relief will be within reach when you log on next Tuesday for another live edition of the Talk Ten Tuesdays Internet broadcast. Because that’s when National Alliance of Medical Auditing Specialists (NAMA) Founder Shannon DeConda will report on how best to implement the new rule.

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
Tuesday Focus: What Was Medicare Thinking? Nationally recognized professional coder and auditor Terry Fletcher will join the broadcast to report how best to implement CMS rules when dealing with patients, noting that in 2022, there are some new rules to the Medicare Manual that make little sense to the healthcare professional trying to adhere to best practices when applying the rules.
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.

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New Measures Added to the Hospital Outpatient Quality Reporting Program Feb 08, 2022

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.

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New E&M Codes for Principal Care Management Feb 01, 2022

Principal care management is a service that focuses on the medical and/or psychological needs manifested by a single, complex chronic condition that is expected to last at least three months in duration.

During the next live edition of Talk Ten Tuesdays, Colleen Deighan, senior healthcare consultant for 3M HIS Consulting Services, will return to the weekly Internet radio broadcast to report on principal care management and the new CPT® codes for 2022.

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk-Ten-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.

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SPECIAL EDITION COVID-19: “With” versus “For” Jan 25, 2022

In today’s supercharged general lexicon, words have enhanced meaning. So as more and more hospitals admit patients, the words “for” and “with” are garnering great significance.

With hospitals filling up with patients who have a COVID-19 diagnosis linked to their stay, what is the actual admission for?

During next week's Talk Ten Tuesdays broadcast, we have asked nationally recognized professional coding expert, educator, and author Terry A. Fletcher to report on the ever-evolving COVID-19 diagnosis capture. Fletcher, in her reporting, is expected to discuss new information from New York and New Jersey, where there is now a distinction that not all COVID-19 hospitalizations are the same. Listen in to find out now how COVID-19 is being reported in many states for added accuracy.

The live broadcast will also feature these other segments:

Coronavirus Report: Former frontline physician Dr. John Foggle will return to the broadcast with an update on the deadly COVID-19 virus and its newest variant, Omicron. Currently, coronavirus cases and deaths in the United States are soaring.
The Coding Report: Laurie Johnson will report on the latest coding news that has appeared on her radar screen.
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.

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SPECIAL EDITION: Overcoming Distrust in Healthcare Jan 18, 2022

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:

CDI Report: Senior healthcare consultant Cheryl Ericson will report on the latest documentation issues facing clinical documentation integrity specialists (CDISs).
The Coding Report: Laurie Johnson will report on the latest coding news that has appeared on her radar screen.
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.

SPECIAL ADDED FEATURE:
Immediately following the broadcast, Sharon Easterling will report on her newest software application (app), CDIWis.

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The Social Determinants of Health: An Update by Blue Cross Blue Shield Jan 11, 2022

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:

Tuesday Focus: Patient Safety Indicators (PSI): Christel Kemble with Covenant Health will report on the vexing issue of patient safety indicators.
Mental Health Report: Internationally renowned psychiatrist and award-winning author Dr. H. Steven Moffic will report on the “good, bad, and ugly” of America’s collective mental health.
The Coding Report: Laurie Johnson will report on the latest coding news that has appeared on her radar screen.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.

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Compliant CDI Technology Dec 14, 2021

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:

News Update: Malnutrition: Ronald Hirsch, MD, a familiar voice on Monitor Mondays, will report on the latest wrinkle in the clinical data world: “severe malnutrition” has been added to the Program for Payment Patterns Electronic Report (PEPPER). Hirsch will report on why this is crucially important for CDISs.
Tuesday Focus: 2022 Medicare Physician Fee Schedule: Nationally recognized professional auditor, coder, and educator Terry Fletcher will report on financial impacts for physician practices.
The Dunn Report: Denial Prevention: Legendary health information management (HIM) icon Rose Dunn will return to the broadcast with her exclusive report on how to prevent coding denials.
The Coding Report: Laurie Johnson will report on the latest coding news that has appeared on her radar screen.
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.

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Reduce Revenue Leakage: An Important Role for Outpatient CDI Dec 07, 2021

Clinical documentation integrity (CDI) programs can have a broad impact in outpatient settings. One key area for outpatient CDI to consider is denials reduction, which begins with understanding what’s contributing to denial risk.
Denial reduction is really about denial prevention. It’s about analyzing denials by category, by payer, and by reason to uncover trends for high-volume or high-dollar denials, then using that discovery to provide education about clinical documentation issues or gaps.
In the next live edition of Talk Ten Tuesdays, outpatient CDI expert Colleen Deighan will return with the final segment of her popular series on a subject that continues to generate listener interest and questions. Deighan will also conduct a listener’s survey during the weekly Internet radio broadcast.
The live broadcast will also feature these other segments:

Tuesday Focus: Susan Gatehouse will report on the potential impacts of the new Edit 20 (Unspecified Code Edit) for inpatient claims opens up an opportunity for enhanced CDI with targeted education. The list of unspecified diagnosis codes, subject to the new edit, will require targeted training for your billing staff to avoid reimbursement issues, and provides a platform for improving CDI.
News Update: Mary H. Stanfill, a new ICD10monitor correspondent focusing on ICD-11, will provide the latest update on the new code set looming on the horizon.
The Coding Report: Laurie Johnson will report on the latest coding news that has appeared on her radar screen.
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.

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Chronic Care Management: Are You Leaving Money on the Table? Nov 30, 2021

Are you facing a problem with your physcians? They find themselves with patients who have not just one but two or more chronic conditions that need managing? Not just for in-person encounters, but from an ongoing, non-face-to-face perspective?
Many practices have this patient population, but are not capturing care management services correctly, or at all, for work that is already being done.
It’s a huge problem with potentially serious financial impacts. But the answer is close at hand. Listen to the next live edition of Talk Ten Tuesdays for the 411 on care management services, along with the 2022 update, and discover how this is a revenue stream you don't want to miss out on. That’s when nationally recognized physician auditor, coder, and educator Terry Fletcher will return to the broadcast with advice on this ever-daunting challenge.
The live broadcast will also feature these other segments:

RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on the most recent regulatory news coming out of Washington, D.C.
The Coding Report: Laurie Johnson will report on the latest coding news that has appeared on her radar screen.
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.

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Exclusive ICD-11 Update: Recommendations for Immediate Action Nov 23, 2021

Like the inevitable approach of a slow-moving freight train, ICD-11 is on the horizon, heading this way. It’s coming.
That’s why we asked Margaret Skurka to join us for the next upcoming edition of Talk-Ten-Tuesdays: to give you an exclusive update on the new code set for America’s health system. Skurka, a member of the National Committee of Vital Health Statistics (NCVHS), participated in describing for the Honorable Xavier Becerra, Secretary of the U.S. Department of Health and Human Services (HHS), recommendations regarding adoption of ICD-11 in the United States. Skurka, having served in healthcare for more than 40 years, will be make her farewell appearance during the next live edition of the weekly Internet radio broadcast.
The live broadcast will also feature these other segments:

Special Report: Outpatient CDI and E&M: Outpatient clinical documention integrity (CDI) expert Colleen Deighan will return to continue her popular series on a subject that continues to generate listener interest and questions. Deighan will also conduct a listener’s survey and report on revised documentation requirements related to office-visit evaluation and management (E&M) services.
Tuesday Focus: Former HHS Office of Inspector General (OIG) Special Agent Eric Rubenstein will report on the constellation of new claims audits. Rubenstein is now director of litigation for Advize Health, LLC.
The Coding Report: Laurie Johnson will report on the latest coding news that has appeared on her radar screen.
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.

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An Exclusive Look at Vaccine Mandates: Who Gets the Shot, and Who Doesn’t? Nov 16, 2021

The Omnibus COVID-19 Health Care Staff Vaccination Mandates are out! What entities are included under the regulations, and which are excluded?
Facilities and physician practices have been doing everything they can to get staff and providers vaccinated, in fear of losing their provider status with Medicare and their funds being interrupted. But what organizations really must abide by these requirements under the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoPs)? Hospitals? Physician Offices? Skilled nursing facilites (SNFs)? Home health agencies? Assisted living facilities?
To highlight the correct information on where your organization stands and the impact it will have, please join us for the next edition of Talk Ten Tuesdays on Nov. 16, during which nationally recognized physician coder, auditor, and educator Terry Fletcher will update us on all this and more.
The live broadcast will also feature these other segments:

Mental Health Report: Internationally renowned psychiatrist and author Dr. H. Steven Moffic will return to the broadcast to report on workplace burnout – especially in the healthcare workplace, and in particular among caregivers, in the light of new final rules from the Centers for Medicare & Medicaid Services (CMS).
The Coding Report: Laurie Johnson will report on the latest coding news that has appeared on her radar screen.
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.

Cozen O’Connor Public Strategies - The Beltway Briefing
Listen for of-the-moment insider insights, framed by the rapidly changing social and...

Listen on: Apple Podcasts Spotify

Exclusive: Outpatient CDI in the Emergency Department Nov 09, 2021

Is the emergency department (ED) an outpatient CDI priority for your organization? The emergency department is the main source of admissions to a hospital – and the first location patients typically receive care. What should you consider when determining how an outpatient CDI program could support quality patient care, proper payment, and complete and accurate data?
During the next live edition of Talk Ten Tuesdays, outpatient CDI expert Colleen Deighan will return with another installment in her popular series on a subject that continues to generate listener interest and questions. Deighan will also conduct a listener’s survey during the weekly Internet radio broadcast.
The live broadcast will also feature these other segments:

Special Series: Maternal Morbidity and Mortality: Senior healthcare consultant Kristi Pollard, Director of Coding Quality and Education for the Haugen Consulting Group, wraps up her four-part series on the impact of coding on severe maternal morbidity with a discussion about the intersection of coding and clinical indicators. Conditions specifically in the crossfire are sepsis, acute kidney injury, and coagulation disorders. Pollard will address which data the maternal collaboratives want to track and how you can incorporate these initiatives into existing CDI programs.

The Coding Report: Laurie Johnson will report on the outcome of the recent ICD-10 Coordination and Maintenance Committee meeting.
RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on the most recent final payment rules released by CMS on Tuesday.
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.

Cozen O’Connor Public Strategies - The Beltway Briefing
Listen for of-the-moment insider insights, framed by the rapidly changing social and...

Listen on: Apple Podcasts Spotify

What in the World is a Medical Assistant? Nov 02, 2021

What can a medical assistant do – and not do?
Medical assistants have a narrow list of tasks they can perform for patients or for a doctor in a doctor's office. It's often difficult to know what's allowed, because there are not strong laws or regulations in place regarding medical assistants.
Since no one really “regulates” them, and they are frighteningly under-monitored by any sort of government agency, what rules should they follow?
In the next live edition of Talk Ten Tuesdays, Terry Fletcher, a nationally recognized professional coder, auditor, and educator, will return to the broadcast with an exclusive report on best practices for medical assistants, but also the imperative admonition: they should not be mistakenly used as nurses.
The live broadcast will also feature these other segments:

Special Series: Maternal Morbidity and Mortality: Senior healthcare consultant Kristi Pollard, Director of Coding Quality and Education for the Haugen Consulting Group, will continue her four-part series, reporting how coded data is being used by the Alliance for Innovation on Maternal Health (AIM) to improve maternal outcomes.
The Coding Report: Laurie Johnson will report on the on the outcome of the recent ICD-10 Coordination and Maintenance Committee meeting.
RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington, D.C.
News Desk: Timothy 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.

Cozen O’Connor Public Strategies - The Beltway Briefing
Listen for of-the-moment insider insights, framed by the rapidly changing social and...

Listen on: Apple Podcasts Spotify

Continuing Series on Outpatient CDI: How to Begin an HCC Program Oct 26, 2021

Outpatient CDI expert Colleen Deighan will return to the next edition of Talk Ten Tuesdays to continue her popular series on a subject that continues to generate listener interest and questions.
Deighan will also conduct a listener’s survey during the weekly Internet radio broadcast. When healthcare organizations are considering, planning, or beginning efforts directed toward documentation integrity in the outpatient setting, Hierarchical Condition Categories (HCCs) are a key focus. Deighan will also discuss what to consider when determining the timing of your HCC review, top HCC category specifics, and best practices for compliant HCC reporting.
The live broadcast will also feature these other segments:

Special Series: Maternal Morbidity and Mortality: Senior healthcare consultant Kristi Pollard, Director of Coding Quality and Education for the Haugen Consulting Group, will continue her four-part series, reporting how coded data is being used by the Alliance for Innovation on Maternal Health (AIM) to improve maternal outcomes.
The Coding Report: Laurie Johnson will report on the latest coding news.
The Dunn Report: Rose T. Dunn, a past president and former CEO of the American Health Information Management Association (AHIMA), will report that ED-level denials are mounting everywhere, and payers are using AI and applying their own criteria.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk-Ten-Tuesdays News Desk.
Point of View: Susan Gatehouse, founder and CEO of Axea Solutions, will be substituting for Erica Remer, MD. Gatehouse will provide context and commentary on a subject that has caught her attention during a recent edition of the segment.

Cozen O’Connor Public Strategies - The Beltway Briefing
Listen for of-the-moment insider insights, framed by the rapidly changing social and...

Listen on: Apple Podcasts Spotify

Taking AIM at Maternal Morbidity and Mortality Oct 19, 2021

We’re taking AIM at reducing maternal morbidity and mortality during an exclusive four-part series on ICD10monitor and Talk Ten Tuesdays. The series will be led by senior healthcare consultant Kristi Pollard, Director of Coding Quality and Education for the Haugen Consulting Group. During her series, Kristi will discuss how coded data is being used by the Alliance for Innovation on Maternal Health (AIM) to improve maternal outcomes.

The live broadcast will also feature these other segments:

Special Report: American Health Information Management Association (AHIMA) 2021 President and Chair Katherine Lusk will discuss accomplishments from her term and how the Association continues to advance and advocate for the creation and use of trusted information.
The Coding Report: Laurie Johnson will report on the latest coding news.
Tuesday Focus: Telemedicine or Telemarketing: Former special agent for the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) Eric Rubenstein will report on how fraud, currently being perpetuated against the Medicare population, is best defined as “telemarketing” fraud. Rubenstein is now director of litigation for Advize Health, LLC.
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.

Cozen O’Connor Public Strategies - The Beltway Briefing
Listen for of-the-moment insider insights, framed by the rapidly changing social and...

Listen on: Apple Podcasts Spotify

Outpatient CDI Risk Adjustment and HCC Capture Oct 12, 2021

Outpatient CDI programs can have real impact with risk adjustment and Hierarchical Condition Categories (HCCs). An important component of the HCC risk adjustment model is accurate and appropriate HCC capture, representing a patient’s disease burden year over year.
HCCs reflect hierarchies within related disease categories. A patient can have multiple HCC categories assigned, and each category, along with patient demographics, is factored into the patient’s overall risk adjustment factor (RAF) score.
The higher the RAF score, the sicker the patient. On the upcoming edition of Talk Ten Tuesdays, we’ll will cover the basics of HCCs and what steps to take in order to begin your outpatient CDI program with a focus on these factors. Broadcast Special Guest Colleen Deighan will also conduct a Talk Ten Tuesdays Listener Survey on this topic.
The live broadcast will also feature these other segments:

The Coding Report: In keeping with the broadcast’s theme, Laurie Johnson will report on the new psychiatric codes for fiscal year 2022.
Tuesday Focus: CMS Resumes Targeted Probe-and-Educate Program: Nationally recognized professional, coder, auditor, and educator Terry A. Fletcher will return to the broadcast to report on the resumption of the Centers for Medicare & Medicaid Services (CMS) Targeted Probe-and-Educate (TPE) program, which was delayed in response to the COVID-19 public health emergency (PHE) in March 2020. CMS has given the Medicare Administrative Contractors (MACs) the go-ahead to resume paused TPE reviews and initiate new reviews.
Special Report: CMS One-Year Extension: Susan Gatehouse, founder and president of Axea Solutions, will report on the CMS one-year extension of New Technology Add-on Payments (NTAPs) for 13 technologies for which the payments otherwise would have discontinued beginning in 2022.
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.

The Dilemma of Coding Mental Health Oct 05, 2021

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:

The Coding Report: In keeping with the broadcast’s theme, Laurie Johnson will report on the new psychiatric codes for fiscal year 2022.
Tuesday Focus: Author and consultant Ellen Fink-Samnick will return to the broadcast to report on workplace trauma, noting how trauma has gripped the national workforce, with an intense collective induced stress felt by professionals, patients, and then experienced by frontline practitioners.
RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington, D.C.
News Desk: Timothy 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.

Outpatient CDI and Getting Back to the Basics Sep 28, 2021

Physician engagement, query productivity, and revenue integrity are some but not all of the activities that encompass today’s outpatient clinical documentation integrity (OP CDI) arena, which continues to gain traction among America’s hospitals and health systems.
During an exclusive broadcast report, CDI expert Colleen Deighan will unveil a Talk Ten Tuesdays listener’s survey on this topic, in which listeners are encouraged to participate. Delving into the survey responses, Colleen will join us on a biweekly basis through the end of the year, and share her knowledge and experience on how hospitals and health systems can determine where and how to focus their efforts to have the biggest impact.
The live broadcast will also feature these other segments:

The Coding Report: Laurie Johnson will report on the latest coding news.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
Tuesday Focus: Root operation control guidelines have changed during the last five years, and a new update will take place on Oct. 1, 2021. Senior healthcare consultant Kristi Pollard, director of coding quality and education with Haugen Consulting Group, will report on this topic while providing examples for reporting the control of bleeding.
Special Report: The No Surprises Act, or the "balance billing rule" for emergent out-of-network services, saw a provider reprieve as it pertains to the Jan. 1, 2022 effective date, as the Centers for Medicare & Medicaid Services (CMS) will delay certain provisions of the Act to allow for better infrastructure, interoperability, and communication between payors, facilities, and providers. Nationally recognized professional coder, auditor, and consultant Terry Fletcher will report the good news.
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.

Lessons Learned – A COVID-19 Long Hauler Speaks Out Sep 21, 2021

The National Institutes of Health (NIH) is awarding $470 million to New York University to perform a national study on “tens of thousands of people, to research the long-term effects of COVID-19.”
One such individual who might be included in the study will be the special guest during the next live edition of Talk-Ten-Tuesdays: Deborah Grider, longtime ICD10monitor national correspondent and senior healthcare consultant for Karen Zupko & Associates. Grider will return to the broadcast with an update on her status as a “long hauler,” having contracted the deadly coronavirus more than a year ago.
The live broadcast will also feature these other segments:

The Coding Report: Laurie Johnson will report on the outcome of last week’s Coordination and Maintenance Committee.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
2021 E&M Update: It’s about time: Nearly everyone thought that time reporting for evaluation and management (E&M) services would be eased through the American Medical Association (AMA) 2021 guidelines. Yet there are controversial areas and discrepancies in interpretation of the published guidance, according to Shannon DeConda, who will report on those issues. DeConda is the founder of the National Alliance of Medical Auditing Specialists (NAMAS) and a partner of DoctorsManagement.
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.
Town Hall: Your questions will be answered live during this special interactive broadcast.

COVID-19 Update: Second Surge Underway Sep 14, 2021

The COVID-19 pandemic continues to rage throughout the U.S., fueled by the Delta variant that is driving a new surge of infections of the deadly coronavirus – all this amid growing antagonism about mask mandates and vaccine hesitancy. The U.S. death toll now stands at more than 650,000, with projections indicating more than 750,000 deaths being likely by Dec. 1.
In fact, Idaho, reported to have the nation’s lowest vaccination rate – only 45 percent of its population has received at least one dose of the COVID-19 vaccine – is on the verge on rationing care due to a scarcity of beds and equipment.
For the latest update on COVID-19, the next Talk TenTuesdays broadcast will feature Dr. John Foggle, a former consultant with the World Health Organization (WHO) who designed a course for Project Hope, bringing COVID-19 education to healthcare workers in 23 countries.
The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the Talk Ten Tuesdays Coding Report, along with the broadcast’s weekly Listeners Survey.
Mental Health Report: The death on Monday of actor Michael K. Williams of “The Wire” fame, currently being investigated as a possible drug overdose, suggests several mental health issues – which is why Dr. H. Steven Moffic, award-winning author, and internationally renowned psychiatrist, will be on the broadcast. Dr. Moffic, whom we call the Talk Ten Tuesdays resident psychiatrist, will provide context and perspective on this tragedy.
Tuesday Special Report: Ivermectin: Julia K. Brodt, PhD, an educator, and former epidemiologist, will report on the use of ivermectin, a medication used to treat parasite infections in livestock, now being clandestinely used to treat and prevent COVID-19 in humans, although there is no credible scientific evidence to support its efficacy. Moreover, the Federal Drug Administration (FDA) reports that ivermectin is not approved for the treatment of any viral infection.
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.
Town Hall: Your questions will be answered live during this special interactive broadcast.

A Trending Issue: PSI Rates Expected to Increase Aug 31, 2021

Questions and concerns about the recent and significant updates to Patient Safety Indicators (PSI) by the Agency for Healthcare Research and Quality (AHRQ) has prompted the return of Dr. James Kennedy, a subject matter expert on PSIs, to the next live edition of Talk Ten Tuesdays.
The live broadcast will also feature these other segments:

Coding Report: Senior healthcare consultant and well-known national coding and health information management (HIM) leader Gloryanne Bryant will substitute for Laurie Johnson to report the latest coding news.
CDI Report: Nationally recognized clinical documentation improvement (CDI) expert Cheryl Ericson, clinical program manager for Iodine Software, will have the Talk Ten Tuesdays CDI Report.
RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington, D.C.
News Desk: Timothy 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.
Town Hall: Your questions will be answered live during this special interactive broadcast.

An Explosive Topic: Rates Expected to Increase for PSIs 8, 11 and 14 Aug 25, 2021

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:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the Talk Ten Tuesdays Coding Report, along with the broadcast’s weekly Listeners Survey.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
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.
Town Hall: Your questions will be answered live during this special interactive broadcast.

Important News for Coders: Quantifying the Sequelae Following Acute COVID-19 Aug 17, 2021

The rapidly expanding surge of COVID-19 infections is triggering a renewed look at the impact the virus is having on long-haulers. The pressing challenge is to understand the findings on the sequelae after recovery from COVID-19 – and what variations are expected to evolve.
Meanwhile, research reveals that about 14 percent of adults who had been infected with the virus developed at least one new clinical sequela requiring medical attention after recovery from COVID-19, although many specifics have yet to be quantified. Reporting our lead story during the next live edition of Talk-Ten-Tuesdays will be Axea Solutions founder and CEO Susan Gatehouse.
The live broadcast will also feature these other segments:

Tuesday Focus: Fixing Healthcare, Part II: Rose Dunn, former American Health Information Management Association (AHIMA) CEO, and current COO for First Class Solutions, will return to the broadcast with the final installment in her exclusive two-part series in which she offers ideas aimed at fixing healthcare.
Coding Report: Senior healthcare consultant and well-known national coding and health information management (HIM) leader Gloryanne Bryant will substitute for Laurie Johnson to report the latest coding news.
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.
Town Hall: Your questions will be answered live during this special interactive broadcast.

Pandemic Surge Expected to Add Chaos to HIPAA Claims Aug 10, 2021

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:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the Talk Ten Tuesdays Coding Report, along with the broadcast’s weekly Listeners Survey.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
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.
Town Hall: Your questions will be answered live during this special interactive broadcast.

Could New AHA Advice Raise Surgery Complication Rates? Aug 03, 2021

Surgery doesn't have to be complicated; it shouldn't automatically translate into a misadventure.
Recent American Hospital Association (AHA) advice has the potential to result in artificially elevated complication rates for surgery, however, jeopardizing your safety and performance profiles. Clinical accuracy of diagnoses is king, even in the operating room.
Reporting on this developing story during the next live edition of Talk Ten Tuesdays will be senior healthcare executive Allen Frady, who will reveal important information and provide tips on how to approach this conversation without accidentally veering into forbidden territory.
The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the Talk-Ten-Tuesdays Coding Report, along with the broadcast’s weekly Listeners Survey.
Tuesday Focus: Fixing Healthcare, Part I: Bureaucratic, redundant, labor-intensive, wasteful, costly things appear to characterize some healthcare operations. What are some solutions? Rose Dunn, former American Health Information Management Association (AHIMA) CEO, and COO for First Class Solutions, will return to the broadcast with an exclusive two-part series in which she offers ideas aimed at fixing healthcare.
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.

Where Did All the Money Go? Jul 27, 2021

"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:

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: Change Coping: Keeping your coding department up-to-date and current on changes and guidelines is always a challenge. Fortunately, there are easy lessons to learn as you’ll discover when Shannon DeConda, founder of the National Association of Medical Auditing Specialists (NAMAS) shares come very practical advice.
RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten 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.

Exclusive: AHIMA Reveals New CDI Brief Jul 20, 2021

The American Health Information Management Association (AHIMA) has just released a new practice brief focused on prospective clinical documentation integrity reviews and query alerts.
Being revealed for the first time during the next edition of Talk Ten Tuesdays, the practice brief was developed by AHIMA through a workgroup of clinical documentation integrity (CDI) industry experts. The free practice brief explores the need for prospective reviews and the impact they have on the CDI industry. The publication also provides information on the provider perspective and how to manage the data obtained in prospective reviews. Every CDI professional will benefit from the practice brief by recognizing the compliance standards that should be followed when performing prospective health record reviews.
The live broadcast will also feature these other segments:

CDI Report: Nationally recognized CDI expert Cheryl Ericson, clinical program manager for Iodine Software, will have the Talk Ten Tuesdays CDI Report.
Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the broadcast’s Coding Report, and its weekly Listeners Survey.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the News Desk.
Point of View: Dennis Jones, Patient Financial Services Administrator at Montefiore Nyack Hospital, will substitute for co-host Erica Remer, MD.

Virtual Care: New Issues for Coders Jul 13, 2021

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:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the Talk Ten Tuesdays Coding Report, along with the broadcast’s weekly Listeners Survey.
RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten 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.

To Query or Not to Query: That’s the Leading Question Jun 29, 2021

“Querying is the lifeline of clinical documentation integrity (CDI) professionals and many coding professionals,” wrote Cheryl Ericson in a recent edition of ICD10monitor. And yet the query process can be a time-consuming and sometimes arduous activity that often contributes to an inefficient CDI workflow.
One of the biggest hindrances to an efficient query process appears to hinge on misinformation regarding what is considered a leading or non-compliant query, specifically as it pertains to the timing of a query. Ericson, a senior healthcare consultant, will report on this lead story during the next live edition of Talk Ten Tuesdays, sorting through the confusion of the query process while helping you ensure that queries at your facility are compliant and non-leading.
The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the Talk Ten Tuesdays Coding Report, along with the broadcast’s weekly Listeners Survey.
Mental Health Report: To mask or not to mask, that is the question. Recent guidelines from the Centers for Disease Control and Prevention (CDC) say that fully vaccinated adults need not wear masks. That announcement, however, is creating confusion – and, among some individuals, a level of anxiety. Reporting on what is making folks anxious as the nation transitions from the pandemic and into summer will be H. Steven Moffic, MD: an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry, a prolific writer and speaker, and the Talk Ten Tuesdays resident psychiatrist.
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.

OIG Getting Under the Skin of Dermatologists: E&M Services and Modifier 25 Jun 22, 2021

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:

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: Homework: Many auditors and coders are working from home these days, and home has raised new obstacles and some new advantages to our daily routines. How to bring the home practicality into the coding and auditing work world will be Shannon DeConda, founder of the National Alliance of Medical Auditing Specialist (NAMAS).
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
Point of View: Dennis Jones, Patient Financial Services Administrator at Montefiore Nyack Hospital, will substitute for co-host Erica Remer, MD.

The Quest to Improve Quality: Auditing Low-Value Services Jun 15, 2021

The ongoing quest to improve quality includes the auditing of low-value services. During the next episode of Talk Ten Tuesdays, Susan Gatehouse, founder and CEO for Axea Solutions, will report on areas to reduce wasteful spending on services with little to no clinical benefit – all in the name of improving quality of care.
According to most industry definitions, low-value care involves those services that are medically unnecessary and provide no health benefits to patients.
The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the Talk Ten Tuesdays Coding Report, along with the broadcast’s weekly Listeners Survey.
Tuesday Focus: HIM Professionals Engaging Physicians (Part IV): Rose Dunn will continue with her series on how health information management (HIM) professionals, using their existing skill sets, can enhance physician practices in the outpatient environment.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
Developing Story: Nationally recognized professional coder, educator, and auditor Terry Fletcher will return to the broadcast to report on the continuing saga of the American Medical Association (AMA) versus the Centers for Medicare & Medicaid Services (CMS), concerning the use of the prolonged care code 99417.
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.

Outsourcing versus Offshoring: Old Issue, New Insights Jun 08, 2021

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:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the Talk-Ten-Tuesdays Coding Report, along with the broadcast’s weekly Listeners Survey.
Tuesday Focus: HIM Professionals Engaging Physicians (Part III): Rose Dunn will continue with her series on how health information management (HIM) professionals, using their existing skill sets, can enhance physician practices in the outpatient environment.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk-Ten-Tuesdays News Desk.
RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington.
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.

AMA 2021 CPT® Errata and Technical Corrections: Mitigating Shades of Grey May 25, 2021

The American Medical Association (AMA) CPT® Errata and Technical Corrections have clarified some grey areas found in the 2021 Evaluation and Management (E&M) Guidelines. But did the updates really help coders and physicians in better understanding how to apply the latest corrections?
Apparently, there’s still confusion, according to Terry Fletcher, a nationally recognized physician auditor and coder. Fletcher will return to the Talk Ten Tuesdays weekly broadcast to offer some working examples, as well as answer listener questions, in an effort to clear up the perplexities while providing insight on how to submit a clean office visit claim.
The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the Talk Ten Tuesdays Coding Report, along with the broadcast’s weekly Listeners Survey.
Tuesday Focus: Hospital at Home versus Hospital to Home: Are they not one in the same? Clearing up any confusion on this issue will be Tiffany Ferguson, CEO at Phoenix Medical Management, Inc.
Developing Story: Sepsis and New York: The Empire State Strikes Back: Dennis Jones, patient financial services administrator at Montefiore, Nyack, will report on why New York said “no way” to UnitedHealthcare.
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.

ICD-11 Prep: Examining Prominent Changes in Preparation for the Transition May 18, 2021

Healthcare providers nationwide are scanning the horizon for the first signs of ICD-11, which is slowly making its presence seen and felt.
However far in the future you might speculate the transition to ICD-11 to be, the reality is that preparation and planning will take time, and understanding the new concepts being introduced is a key starting point. And that will be where we start during the next live edition of Talk-Ten-Tuesdays; join Chuck Buck and Dr. Erica Remer when they welcome the return of Susan Gatehouse, founder and CEO of Axea Solutions, who will report the lead story.
The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the Talk Ten Tuesdays Coding Report, along with the broadcast’s weekly Listeners Survey.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
Mental Health Report: May is Mental Health Awareness Month, and here at Talk Ten Tuesdays, we continue to recognize the importance of this pressing national issue. Erin Head, senior healthcare consultant with Iron Mountain and coding auditor with Code and Comply Specialists, will join the broadcast to report on current challenges in behavioral health coding, focusing on telehealth coding best practices, plus key Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) guidelines, and the importance of psych history codes, and provider documentation improvement.
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 Pen is Mightier than the EMR May 11, 2021

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:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the Talk Ten Tuesdays Coding Report, along with the broadcast’s weekly Listeners Survey.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
Mental Health Report: May is Mental Health Awareness Month. The National Alliance on Mental Illness estimates that 1 in 5 U.S. adults experience mental illness each year, noting that 50 percent of all lifetime mental illness begins by the age of 15. Offering comment and context on the state of mental health in the United States will be Dr. H. Steven Moffic, award-winning author and internationally renowned psychiatrist.
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.

Why it’s important to get a handle on CPT® Errata May 04, 2021

It’s vitally important to remember that updates to the American Medical Association (AMA) CPT® code book might not be there when you need them.
But since January of this year, the AMA has been receiving provider feedback: essential information that now been incorporated in the AMA 2021 CPT® Errata and Technical Corrections. Navigating these changes during the next edition of Talk Ten Tuesdays will be nationally recognized physician auditor and coder Terry Fletcher, who will report on significant clarifications – including some evaluation and management (E&M) 2021 Office and Other Outpatient visit clarifications – designed to help practices square their visits with medical decision-making (MDM).
The live broadcast will also feature these other segments:

Tuesday Focus: HIM Professionals Engaging Physicians (Part II): Rose Dunn will continue with her series on how health information management (HIM) professionals, using their existing skill sets, can enhance physician practices in the outpatient environment.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington.
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 to Ensure Data Integrity While Protecting Your Organization’s Bottom Line - Part I Apr 27, 2021

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.

When Surgeons Have Had Enough— Modifying PSI-06 Criteria for AHRQ Apr 20, 2021

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:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the Talk Ten Tuesdays Coding Report, along with the broadcast’s weekly Listeners Survey.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
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.

This episode is sponsored by:
AHIMA, MRA and AHDAM

HIP Voices Apr 15, 2021

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

ICD-11: Where in the World is the U.S.? Apr 13, 2021

ICD10monitor and Talk Ten Tuesdays will continue their reporting on the advent of ICD-11 – particularly during April, when attention turns to the World Health Organization (WHO).
A key question that needs answering: where does the United States fall among the countries that are either preparing or even implementing the new update for the standard code set?
For a global perspective on ICD-11 and the nation’s position on the new code set, Margaret Skurka, a member of the International Federation of Health Information Management Associations (IFHIMA) and past president of the American Health Information Management (AHIMA),will share perspective on ICD-11 planning during the next edition of Talk Ten Tuesdays.
The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the Talk Ten Tuesdays Coding Report, along with the broadcast’s weekly Listeners Survey.
RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on two proposal rules posted by CMS.
Mental Health Report: Anti-Asian Discrimination: Nearly 3,800 incidents have been reported by the Stop Asian American Pacific Islander (AAPI) Hate reporting center from March 2020 through February 2021. There is an ICD-10 code to specify a diagnosis of being a victim of crime and terrorism. Reporting this troubling issue will be Dr. H. Steven Moffic, award-winning author and internationally renowned psychiatrist.
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.

ICD-11: The Journey of Adoption Begins Now—During World Health Week Apr 06, 2021

The World Health Organization (WHO) gave us the International Classification of Diseases (ICD), including several updates over the years, more recently versions 9 and 10.
And now on the horizon is version 11.
Thus, it is only fitting that Talk Ten Tuesdays would focus on the global accomplishments of the WHO this week, with the lead story for this upcoming edition focusing on the looming implementation of the new update for the standard code set. Leading off the reporting will be the broadcast’s special guest, Lorraine Fernandes, president of the International Federation of Health Information Management Associations (IFHIMA). Lorraine will report on the efforts by the organization to further advance the implementation of ICD-11.
The live broadcast will also feature these other segments:

CDI Report: Senior healthcare consultant and physician Alba Kuqi will make her Talk Ten Tuesdays debut with her report on clinical documentation integrity (CDI).
Coding Report: Gloryanne Bryant, senior healthcare consultant, will report on First Quarter Coding Clinic.
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.
RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
Attorney and physician John K. Hall will be substituting as guest host for the vacationing Dr. Erica Remer.

Why to Care About the Cures Act Mar 30, 2021

Implementation of the 21st Century Cures Act is set for Monday, April 5. In a nutshell, the legislation directs providers to cease all efforts of information blocking with respect to their electronic health records (EHRs), and to encourage and promote interoperability, allowing for communication and cooperation with third-party application program interfaces.
With respect to portions of clinical notes, there appear to be certain exceptions where physicians can block access, including psychotherapy notes, HIV testing results, and any notes that, in a physician’s judgement, could cause harm to an individual. Reporting our lead story on this topic during the next edition of Talk Ten Tuesdays will be nationally recognized professional auditor and coder Terry Fletcher.
The live broadcast will also feature these other segments:

Outpatient CDI Report: Colleen Deighan, senior consultant with 3M, will conclude her exclusive three-part series for ICD10monitor and Talk Ten Tuesdays on outpatient clinical documentation improvement (CDI), reporting on measures that require abstracting.
Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news and will also conduct the Talk Ten Tuesdays Listeners Survey.
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.

Biannual ICD-10 Implementation Dates Proposed: Weighing the Pros & Cons Mar 23, 2021

The Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention’s National Center for Health Statistics (CDC/NCHS) have announced a proposal for biannual ICD-10-CM and PCS updates.
The impact on business processes would be far-reaching – much of it good, and some possibly not so good, according to Susan Gatehouse, who will report this development as the lead story during the next live edition of Talk Ten Tuesdays. Gatehouse, the founder and CEO for Axea Solutions, will encourage listeners to respond during the public comment period being afforded by both agencies.
The live broadcast will also feature these other segments:

Outpatient CDI Report: Colleen Deighan, senior consultant with 3M, will continue with Part II in her three-part series on outpatient clinical documentation improvement (CDI), reporting on measures that require abstracting.
Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the newly proposed codes presented during last week’s Coordination and Maintenance Committee meeting. Johnson will also conduct the Talk Ten Tuesdays Listener Survey.
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 New Look at Outpatient CDI: An Exclusive Three-Part Series Mar 16, 2021

To improve patient care and create transparency, Medicare mandated a pay-for-quality reporting program for hospital outpatient services in 2009. The related measures can impact hospital payment if not met, thus creating financial incentives for hospitals to report them. The measures are intended to evaluate the regularity of outpatient treatments known to provide the best results for most patients with a particular condition.
During the next three broadcasts of Talk-Ten-Tuesdays, listeners will be introduced to these measures and learn how coding and documentation integrity professionals can get involved in reporting and analyzing the data. The exclusive three-part series will include the following:

Part 1: Hospital outpatient quality reporting program
Part 2: Measures that require abstracting
Part 3: Outcome-based measures

The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the newly proposed codes presented during last week’s Coordination and Maintenance Committee meeting. Johnson will also conduct the Talk Ten Tuesdays Listener Survey.
Mental Health Report: Residual Rage: Vaccine shortages, folks cutting in line to get vaccinated, and on-again, off-again guidance concerning opening schools, businesses, and even mask-wearing have all been major COVID-19-related issues. So it’s little wonder there’s pent-up pandemic anger and frustration. There is an ICD-10 code for irritability and anger, and Dr. H. Steven Moffic, award-winning author and internationally renowned psychiatrist, will discuss it – and how and why many of us feel today.
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.

Hitting the Reset Button on Revenue Integrity Mar 09, 2021

Whether you work for a full-scale enterprise or a smaller healthcare facility, the importance of revenue integrity programs is gaining increased importance, especially in the light of renewed auditing activities anticipated under the Biden Administration.
Beyond ensuring accurate billing and collection, revenue integrity should strengthen reimbursement performance and provide sound financial practices, according to Susan Gatehouse, founder and CEO for Axea Solutions, who will report on our lead story during the next edition of Talk Ten Tuesdays.
The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will continue her reporting on proposed codes expected to be discussed during the Coordination and Maintenance Committee meeting, which begins on Tuesday, March 9 and concludes Wednesday, March 10. Johnson will also conduct the Talk Ten Tuesdays Listener Survey.
Tuesday Focus: Congress passed the "No Surprises Act" at the end of 2020, but what does that mean for providers, exactly? Nationally recognized professional coder and auditor Terry Fletcher will share what the Act requires medical providers to do when seeing an out-of-network patient under a non-government payor, and how this will impact your practice revenue and patients. This new law is set to take effect on Jan. 1, 2022, so time is of the essence to work on compliance strategy.
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.

Exclusive Preview: Coordination and Maintenance Committee Meeting Mar 02, 2021

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:

RegWatch: Stanley Nachimson, former CMS career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on coding the consequences of COVID-19 vaccination

Vaccination Nation, Part IV – The Distribution Bottleneck Feb 23, 2021

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:

News Desk: Ronald Hirsch, MD will anchor the Talk Ten Tuesdays News Desk.
The Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report on the latest ICD-10 codes.

Exclusive: Vaccination Nation, Part III – The Inoculators Feb 16, 2021

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:

News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
The Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report on the latest ICD-10 codes.

Exclusive Town Hall: Vaccination Nation – Part II Feb 09, 2021

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:

News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
The Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report on the latest ICD-10 codes.

Exclusive: Vaccination Nation – Part I Feb 02, 2021

The Centers for Disease Control and Prevention (CDC) is forecasting that there will be more than 500,000 deaths from the coronavirus in the U.S. by the third week of February. In the meantime, there has been a flurry of activity by major pharmaceutical companies to work together to help meet the huge demand for vaccines, all against the backdrop of an emerging trend: vaccine hesitancy. Driven by misinformation, lack of trust, and concerns about safety and efficacy, vaccine hesitancy is considered to be one of the top global health threats, according to the World Health Organization (WHO).
In the first portion of an exclusive series produced by ICD10monitor for Talk Ten Tuesdays, Erica Remer, MD will kick things off with a report on the subject, including a listener survey conducted during the live broadcast. Remer is a volunteer inoculator with the Medical Reserve Corps of the Cuyahoga County Board of Health.
The live broadcast will also feature these other segments:

COVID-19 Report: John Foggle, MD, a frontline physician caring for COVID-19 patients at Rhode Island’s alternative site field hospital as a member of Brown University’s emergency medicine department, will report on the latest news coming from the frontlines of America’s battle against the deadly coronavirus.
RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on how healthcare and politics are inextricably entwined.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk-Ten-Tuesdays News Desk.
The Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report on the latest ICD-10 codes.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report our lead story—the first installment in a three-part series on Vaccination Nation.

Exclusive: Improving Documentation for PSI-9 Jan 26, 2021

There has long been a focus on improving documentation for the purpose of maximizing the capture of complications and morbidities and major complications and morbidities (CCs and MCCs). As value-based purchasing is becoming more widely adopted, the importance of improving documentation is becoming more relevant. Case in point: the importance of coagulopathy documentation and its impact on perioperative hemorrhage and hematoma, a patient safety indictor (PSI-9).
Reporting our lead story during the next edition of Talk Ten Tuesdays will be Dr. Ahmed Abuabdou, Associate Chief Medical Officer and Associate Professor of Medicine at the University of Arkansas for Medical Sciences (UAMS) Medical Center.
The live broadcast will also feature these other segments:

Tuesday Focus: Telehealth: The proliferation of telehealth, now identified in the 2021 U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) Work Plan, means that you will need to be extra diligent when coding the service in order to be compliant, according to Terry Fletcher, nationally recognized professional auditor and coder, who will return to the broadcast to report on the topic with a focus on audio-only check-ins.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
The Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report on the latest ICD-10 codes.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on another thought-provoking topic that has captured her attention.

The Reality of Care Rationing Jan 19, 2021

The U.S. death toll from the coronavirus is approaching the number of Americans killed in World War II, and as America is experiencing another surge of infections, the once-unthinkable subject of rationing care is now being debated.
But how is care to be rationed? Is there a uniform guide for triaging care, as the availability of all beds, ICU beds, ventilators, and other hospital equipment is weighed, based on the acuity of each patient?
As John Zelem, MD wrote recently for RACmonitor, “we have entered a time in which drastic scenarios demand drastic measures (care rationing). We all look forward to the time when we can look back on these challenging times as a unique response to a fairly unique medical emergency.”
Reporting our lead story during the next live edition of Talk Ten Tuesdays will be Dr. Zelem, founder of Streamline Consulting Solutions.
The live broadcast will also feature these other segments:

CDI Report: Cheryl Ericson, clinical program manager for Iodine Software, will have the CDI Report, in which she is expected to ask if every item in the medical record is truly “documentation.”
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
The Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report on the latest ICD-10 codes.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on another thought-provoking topic that has captured her attention.

COVID-19 Relief Bill: Conversion Factor Increases Twice in One Week Jan 12, 2021

The Centers for Medicare & Medicaid Services (CMS) 2021 Final Rule and 2021 Medicare Physician Fee Schedule (MPFS) are effective Jan. 1, 2021, and both affect reimbursement.
But in a rare move, CMS increased the conversion factor (CF) in the MPFS twice in one week as a result of the COVID-19 relief bill, which added a hike of 3.75 percent.
For an update on the major CMS changes for 2021 that will affect your reimbursement under the Part B Physician Fee Schedule, tune in to the next live edition of Talk Ten Tuesdays, coming your way Tuesday, Jan. 12 from 10-10:30 a.m. EST. That’s when nationally recognized professional coder and auditor Terry Fletcher will join the broadcast to report on all the relevant details.
The live broadcast will also feature these other segments:

RegWatch: Stanley Nachimson, former CMS career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington, D.C.
SOAP Note: Shannon DeConda, founder of the National Alliance of Medical Auditing Specialists and a partner of DoctorsManagement, will provide a long-awaited update to the legendary SOAP (subjective, objective, assessment, and plan) note.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
The Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report on the latest ICD-10 codes.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk-Ten-Tuesdays co-host, will report on another thought-provoking topic that has captured her attention.

News Update: New Monoclonal Antibody Infusion Underway Dec 08, 2020

Out in the West Texas “town” of El Paso, a number of COVID-19 patients are being treated with a new monoclonal antibody infusion called bamlanivimab. Now in the second week of the operation being conducted in the El Paso Convention Center’s makeshift hospital, Dr. Edward Michelson, Chair of the Department of Emergency Medicine at Texas Tech University Health Sciences Center, reports that while treatments are underway, there hasn’t been enough time to gather data on the effects and outcomes. Dr. Michelson, who appeared on Talk Ten Tuesdays in October 2017, will return to the live broadcast this coming Tuesday with a live update on the new therapy.

Also on tap for the broadcast:

Tuesday Focus: New COVID-19 Codes: The Centers for Disease Control and Prevention (CDC) recently announced further additions to ICD-10-CM related to COVID-19. Additionally, the Centers for Medicare & Medicaid Services (CMS) has posted new guidelines for ICD-10 CM/PCS coding and an updated MS-DRGs, Version 38.1. Updates include new ICD-10-CM and PCS codes for COVID-19. Reporting our Tuesday Focus will be Susan Gatehouse, founder and CEO for Axea Solutions.
RegWatch: Stanley Nachimson, former CMS career professional-turned-well-known healthcare IT authority, will report on how healthcare and politics are inextricably entwined.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
The Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report on ICD-10 coding relative to infusion services.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on another thought-provoking topic that has captured her attention.

COVID Conundrum: Who’s Paying for Personal Protective Equipment? Dec 01, 2020

There’s a recently added CPT® code for personal protective equipment (PPE). But there’s a corresponding catch: who pays and who doesn’t, and what’s the best practice for handling the new normal in physician practices? Could the new code, 99072, although a payable service by Medicare, as well as commercial payers, wind up being a patient’s out-of-pocket expense?
Reporting our lead story during the next live edition of Talk Ten Tuesdays will be nationally recognized professional coder and auditor Terry Fletcher.
Also on tap for the broadcast:

News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
Tuesday Focus: Chronic care management (CCM) has taken on new importance in light of the coronavirus pandemic. Continuing his reporting on this topic will be Andrew Dombro, MD, co-founder of Clarity/CCM, LLC.
CDI Report: Senior healthcare consultant Cheryl Ericson will return to the broadcast with the Talk Ten Tuesdays CDI report.
The Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will have the latest ICD-10 coding news.

Exclusive Series: In Search of Solutions to COVID-19 False Positives Nov 24, 2020

Thanksgiving, the flu season, and a dramatic surge of the COVID-19 pandemic are converging at a time when the nation’s coronavirus death toll has reportedly exceeded 250,000, with more than 11 million confirmed cases.

With soaring infection rates come more testing, as well as more hospitalizations and deaths.

A focus on COVID-19 testing will come into sharp relief as Talk Ten Tuesdays concludes its exclusive three-part series on false-positive tests. During this episode, co-host Erica Remer, MD will reintroduce Andrew Cohen, PhD, who has been doing groundbreaking work on COVID-19 false positives.

Dr. Cohen will explore possible solutions to this daunting challenge.

Also on tap for the broadcast:

News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
Tuesday Focus: Shannon DeConda, founder of the National Alliance of Medical Auditing Specialists (NAMAS), will return to the broadcast with recommendations necessary to implement the new changes that become effective Jan. 1, 2021.
The Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report on ICD-10 coding relative to mental health issues and their physical manifestations.
Mental Health Report: H. Steven Moffic, MD, internationally renowned psychiatrist and Talk Ten Tuesdays resident psychiatrist, will offer tips to avoid tripping on political landmines during Thanksgiving dinner.

COVID-19 False Positives and Real-Life Implications for Long-term Care Nov 17, 2020

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:

News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk-Ten-Tuesdays News Desk.
The Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report on ICD-10 coding relative to mental health issues and their physical manifestations.

COVID-19 3-Part Series: False Impressions, Real-Life Implications Nov 10, 2020

As the nation is experiencing a dramatic surge in confirmed cases of COVID-19, the terms “false negative” and “false positive” accompany not only medical records, but also news media dispatches.
The public health establishment and the medical world have generally treated positive results of PCR-based tests for the virus that causes COVID-19 as if they are infallible. The evidence shows that this may not be true, and there are real-life implications of false positives – yet to date, there has been little media coverage of false-positive tests.
That is why Talk Ten Tuesdays Co-Host Erica Remer, MD will explore this unchartered territory in an exclusive three-part series on the weekly Internet radio broadcast. Joining Dr. Remer will be Andrew Cohen, PhD, who has been doing groundbreaking work on COVID-19 false positives.
Also on tap for the broadcast:

Chronic Care Management: Andrew H. Dombro, MD will join the broadcast and report on a new segment, Chronic Care Management. Dr. Dombro is the chief medical officer and co-founder of ClarityCCM, LLC.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report on ICD-10 coding relative to mental health issues and their physical manifestations.

Exclusive Live Open-Door Broadcast: Coding and Coping with Stress and Tension Nov 03, 2020

We are all participants in one of the most tumultuous times in the 21st century. A global pandemic rages throughout the United States and Europe, the consequences of which are tangible, but not yet fully quantified. A divisive political environment, exacerbated by 24/7 news and social media, has intensified our feelings about ourselves, our colleagues, neighbors, and family members. Stress and tension abound, of which the consequences are many, with depression and anxiety also taking a physical toll.

In light of all of this, Talk Ten Tuesdays is dedicating its live broadcast to an open-door forum, during which H. Steven Moffic, MD, one of America’s foremost psychiatrists and the broadcast’s resident psychiatrist, will answer your questions while providing strategies for how you can cope during these unsettling (albeit historical) times.

Also on tap for the broadcast:

RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, reports on how healthcare and politics are inextricably entwined.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, reports on ICD-10 coding relative to mental health issues and their physical manifestations.

Where in the World is ICD-11? Oct 27, 2020

Amid the global COVID-19 pandemic, the 2020 presidential campaign, coding updates, and a tangle of regulatory waivers, it’s important to not to lose sight of the fact that ICD-11 for the United States is on the horizon.
That’s why we asked Margaret Skurka, a voting member of the National Committee on Vital and Health Statistics (NCVHS) in Washington, D.C., who also sits at the table of the World Health Organization’s (WHO’s) Education and Implementation Committee, to report on the latest ICD-11 developments in the U.S. – and also to provide a global perspective on what other countries are doing, and where they are in the implementation process.
The podcast also features these other segments:

Tuesday Focus: 2021 E&M Guideline Changes: Shannon DeConda, founder of the National Alliance of Medical Auditing Specialists (NAMAS), will provide an update on the significant changes in the 2021 evaluation and management (E&M) guidelines.
Special Report: Telehealth: Nationally recognized professional coder and auditor Terry Fletcher will have an update on telehealth.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
The Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report on the latest coding news.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on another thought-provoking topic that has captured her attention.

America in the Grip of an Unrelenting COVID-19 Pandemic Oct 20, 2020

In the deadly throes of a global pandemic, Americans are struggling as they adjust to a confusing new normal. Halloween this year will portend an actual frightening threat. And America’s traditional Thanksgiving dinner will have an unwanted guest: COVID-19, the elephant in the room.

The coronavirus continues to dominate headlines, family dinner conversations, political debates, congressional hearings, and the news media. During this edition of Talk Ten Tuesdays, providing a physician’s perspective on the novel coronavirus, the disease that causes COVID-19, will be Dr. John Foggle, who returns to the broadcast to share his perspective. It’s a perspective earned from his consulting with the World Health Organization (WHO) in the South Pacific in January and February, then returning to the U.S. to treat COVID patients in the Northeast.

The live broadcast will also feature these other segments:

Mental Health Report: H. Steven Moffic, MD, an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry, returns to the broadcast in the first of a two-part series, reporting on medicine, politics, and healthcare. A prolific writer and speaker, Moffic received the one-time designation of being a Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
The Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, reports on the latest coding news.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, report on another thought-provoking topic that has captured her attention.

Coding Sequela to COVID-19: Part II Oct 13, 2020

Once a frequent flyer with all the attendant privileges, senior healthcare consultant Deborah Grider was abruptly grounded when COVID-19 curtailed her coast-to-coast consulting.

She first reported on her sequela from the coronavirus infection, the disease that causes COVID-19, for Talk Ten Tuesdays listeners in July. Now, she will return to the long-running broadcast to report on several other conditions that have arisen. About one in six people who have survived COVID-19 are expected to have long-lasting complications, including some that are life-threatening.

The live broadcast will also feature these other segments:

Tuesday Focus: Shannon DeConda, founder of the National Alliance of Medical Auditing Specialists (NAMAS), will provide an update on the significant changes in the 2021 evaluation and management (E&M) guidelines.
Tuesday Special Report: Julia K. Brodt, PhD, an educator and former epidemiologist, will provide a layperson’s background on antibodies, which are fundamental in the quest for a much-anticipated COVID-19 vaccine.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
The Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report on the latest coding news.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on another thought-provoking topic that has captured her attention.

Exclusive: Auditors Are Back with a Vengeance Oct 06, 2020

Given the importance of medical review activities relative to the program integrity efforts of the Centers for Medicare & Medicaid Services (CMS), and regardless of the status of the current federal public health emergency (PHE), providers can expect imminent pre- and post-payment reviews, plus audits by Supplemental Medical Review Contractors (SMRCs) and the Recovery Audit Contractors (RACs).
Reporting our lead story during this edition of Talk Ten Tuesdays will be nationally recognized professional coder and auditor Terry Fletcher.
The live broadcast will also feature these other segments:

Tuesday Focus: COVID-19 Update: Dr. John Foggle, Adjunct Associate Professor of Emergency Medicine at the Alpert Medical School of Brown University, provides an update on the pandemic that has claimed the lives of more than 205,000 in the U.S.
RegWatch: Stanley Nachimson, former CMS career professional-turned-well-known healthcare IT authority, reports on the latest regulatory news coming out of Washington, D.C.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
The Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, reports on the latest coding news

Dealing with Coding and Clinical Validation Denials with Medicare Advantage Organizations Sep 29, 2020

The Centers for Medicare & Medicaid Services (CMS) has ordered Medicare Advantage Organization (MAO), -hired subcontractors, to stop issuing “pseudo-denials” that require pseudo-appeals before the MAO considers the denial formalized.
Reporting our lead story during this edition of Talk Ten Tuesdays will be Dr. Edward Hu, system executive director of physician advisor services for UNC Health in North Carolina. Dr. Hu was one of several healthcare executives who convinced CMS to issue a recent memo outlining this change. Dr. Hu will explain the coding significance of this new directive, particularly as it relates to coding and clinical validation denials, which by definition occur retrospectively, and often after a claim was initially paid.
The live broadcast will also feature these other segments:

The Dunn Report: National health information management (HIM) expert and past president of the American Health Information Management Association (AHIMA), Rose Dunn, returns to the broadcast to report the best approach to dealing with line-item claim denials.
Mental Health Report: H. Steven Moffic, MD, one of America’s foremost psychiatrists, returns to the broadcast to report on how cataclysmic events, here at home and abroad, are impacting our mental health.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
The Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, returns to the broadcast to report on the need for facilities to develop their own coding guidelines.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on another thought-provoking topic that has captured her attention.

Site-Neutral Payments Expected to Trigger a Court Battle Sep 22, 2020

Battle lines in a budding court battle could be drawn soon.
A federal appeals court has reversed the decision of a lower court and upheld the action by the U.S. Department of Health and Human Services (HHS) to pay formerly grandfathered off-campus outpatient departments run by hospitals at the same, lower rate of physician clinics.
Experts believe that could mean a potential loss of $800 million to these already struggling hospitals, the finances of which have been especially hit hard during the COVD-19 pandemic. There is clearly a legal battle ahead. Reporting our lead story during the next edition of Talk Ten Tuesdays will be nationally recognized professional coder and auditor Terry Fletcher.
The live broadcast will also feature these other segments:

Tuesday Focus: Shannon DeConda, founder of the National Alliance of Medical Auditing Specialists and a partner of DoctorsManagement, will continue her series for ICD10monitor and Talk Ten Tuesdays in which she delves into the massive changes in the new American Medical Association (AMA) evaluation and management (E&M) documentation guidelines for 2021: changes that become effective Jan. 1, 2021.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk-Ten-Tuesdays News Desk.
The Coding Report: Winners and losers. Which proposed ICD-10 codes will become adopted, and which ones will fail? Linda Holtzman, founder of Clarity Coding and an avid follower of the CMS Coordination and Maintenance Committee, will handicap last week’s meeting.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on another thought-provoking topic that has captured her attention.

The Impact of COVID-19 on the Social Determinants of Health Sep 15, 2020

COVID-19 is disrupting the stability of food, shelter, and sleep. Stress levels are unthinkable.
The continuing pandemic, along with unemployment, racial injustice, and social isolation, is raising anxiety and depression to high levels as well. Moreover, it’s been reported that ongoing stress can decrease the body’s lymphocyte levels, making infection more likely. This cycle is evident among COVID patients.

Reporting on this untenable situation during the next edition of Talk Ten Tuesdays will be Sheryl Markowitz, senior vice president of clinical operations at Healthfirst of New York City, one of the largest Medicare and Medicaid providers in the greater metro area of the Big Apple. Ms. Markowitz will be reporting on how Healthfirst is responding to a significant increase in calls from members experiencing anxiety and depression by increasing outreach and availability of help.

The live broadcast will also feature these other segments:

Tuesday Focus: Vaccinating Kids: September is National Immunization Awareness Month, and recent action by the U.S. Department of Health and Human Services (HHS) has green-lighted children being vaccinated by state-licensed pharmacists – a move that has generated pushback, first from the American Academy of Pediatrics (AAP), and now, the American Medical Association (AMA) as well. Nationally recognized professional coder and auditor Terry Fletcher will have an update on this budding controversy.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
The Coding Report: Laurie Johnson will report on last week’s two-day meeting of the Centers for Medicare & Medicaid Services (CMS) Coordination and Maintenance Committee.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on another thought-provoking topic that has captured her attention.

Dateline Washington: IPPS Final Rule: Comment and Analysis Sep 10, 2020

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.

CMS Requires Positive COVID-19 Test Results for 20% Medicare Add-on Payment Sep 01, 2020

The Centers for Medicare & Medicaid Services (CMS) started rolling out post-payment audits again, as of Aug. 3, but now – after finding inconsistencies in the accuracy of some COVID-19 tests, and considering the fact that CMS has been paying an additional 20 percent to providers and facilities “treating patients with COVID or testing for COVID” – the agency has enacted a new mandate to qualify for the increased reimbursement.
During the next live edition of Talk Ten Tuesdays, Terry Fletcher, a nationally recognized professional coder and auditor, reports on the controversy surrounding our lead story.
The podcast also features these other segments:

RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, reports on the latest regulatory news coming out of Washington, D.C.
Tuesday Focus: 2021 E&M Guideline Changes: Grant Huang, a consultant and auditor for DoctorsManagement, will filling in for Shannon DeConda in her ongoing series about the significant changes in the 2021 E&M guidelines.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
The Coding Report: Cari Greenwood, an independent coding consultant, reports on a current healthcare coding issue that has national importance.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on another thought-provoking topic that has captured her attention.

EXCLUSIVE: Sleeping Patterns Gone Awry Amid the COVID-19 Pandemic Aug 25, 2020

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:

Special Report: Transgender Rights: On June 14, 2019, the U.S. Department of Health and Human Services (HHS) proposed what it described as “substantial revisions” to its regulations implementing Section 1557 of the Patient Protection and Affordable Care Act, prohibiting discrimination based on race, color, national origin, sex, age, and disability in health programs and activities receiving federal financial assistance. The new rules governing this, recently implemented, will narrow the scope of the existing HHS regulations. Nationally recognized professional coder and auditor Terry Fletcher provides the details on this important story.
Tuesday Focus: HHS Provider Relief Fund at Risk: The HHS Provider Relief Fund could be valued at $25 billion less than expected. Organizations without efficient processes in place may find themselves at a disadvantage. Reporting on this developing story is Susan Gatehouse, founder and CEO of Axea Solutions.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
The Coding Report: Laurie Johnson reports on a current healthcare coding issue that has national importance.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on another thought-provoking topic that has captured her attention.

EXCLUSIVE: Dissecting the 2021 OPPS Proposed Rule Aug 18, 2020

It’s out and it’s already creating controversy: the Centers for Medicare & Medicaid Services (CMS) Outpatient Prospective Payment System (OPPS) proposed rule, which becomes effective January 2021. The rule, issued Aug. 4, would eliminate the Medicare inpatient-only list of services while increasing the number of Ambulatory Surgical Center (ASC)-eligible procedures. The rule would also increase 340B payment cuts, and it looks to overhaul the hospital star-rating system.
It’s an interesting time for such changes, amid the impact of COVID-19. Dissecting the OPPS proposed rule during the next edition of Talk Ten Tuesdays will be Susan Gatehouse, founder and CEO of Axea Solutions.
The live broadcast will also feature these other segments:

CDI Report: Senior healthcare consultant Glenn Krauss, founder and creator of Core-CDI.com, files the CDI report, in which he’s expected to discuss what he calls the stagnation of clinical documentation integrity (CDI) as a result of visionary leadership being replaced by task leaders.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent anchor the Talk Ten Tuesdays News Desk.
The Coding Report: Laurie Johnson reports on a the upcoming coordination and maintenance meeting in September.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on another thought-provoking topic that has captured her attention.

COVID Counseling: Now a Payable Compliance Risk Aug 11, 2020

The Centers for Medicare & Medicaid Services (CMS) has announced two new payment initiatives, with one being the use of "counseling" to help stop the spread of COVID-19.
CMS will make payment available to physicians and providers to counsel patients at the time of COVID-19 testing about the importance of self-isolation after they are tested, and prior to the onset of symptoms. However, to get reimbursed for these services, there are protocols to follow, eligible providers to consider, and place-of-service rules. During the next live edition of Talk Ten Tuesdays, Terry Fletcher, nationally recognized professional coder and auditor, will report our lead story.
The live broadcast will also feature these other segments:

Tuesday Focus: COVID and Caregiver Parents: With schools opening, healthcare workers face a daunting dilemma as they plan for their children to return to class. The impact to healthcare workers, specifically those who are unable to work remotely while they home-school their children, is challenging, and it’s our Tuesday Focus that will be reported by Tiffany Ferguson.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
The Coding Report: Laurie Johnson will report on the recent announcement from the Centers for Disease Control and Prevention (CDC) that between August and November is when to expect more cases of a rare illness that causes permanent paralysis and respiratory failure in children – it’s known as acute flaccid myelitis (AFM).
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on another thought-provoking topic that has captured her attention.

E&M: The Good. The Bad and the Ugly Aug 04, 2020

COVID-19 is a disruptor of giant proportions. Case in point: The lead story for tomorrow’s Talk-Ten-Tuesdays was the ongoing COVID-19 pandemic, featuring Dr. John Foggle, who has spent the last three months working on the front lines in an urban, academic medical emergency department, treating COVID patients. Dr. Foggle had to cancel because he was asked to lecture on the deadly virus at Walter Reed National Medical Center.
So, given the attention being given to the coronavirus, it’s not surprising that evaluation and management (E&M) guideline changes for 2021 could be overlooked. That’s why we asked Shannon DeConda to share additional insight on these changes taking place in four short months.
The live broadcast will also feature these other segments:

Mental Health Report: Nationally renowned psychiatrist H. Steven Moffic, MD will report on burnout among frontline nurses caring for hospitalized patients suffering from the coronavirus, recognizing that more often than not, the focus on burnout has been among physicians.
RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington, D.C.
The Coding Report: Laurie Johnson will report on the coding news that’s in the nation’s spotlight.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.

EXCLUSIVE: Coding Sequela to COVID-19 Jul 28, 2020

One day she’s consulting in Los Angeles. The next day she’s back in Indiana, with upcoming client calls scheduled at hospitals and physician practices in nearly every U.S. city and small town. Her frequent flyer miles would qualify for a round-trip to Mars.
High-flying and always in demand as a speaker, Deborah Grider came crashing down, diagnosed with COVID-19 earlier this year. She’s recovering now – enough so that she wrote a personal account of her COVID ordeal for ICD10monitor. Grider will report on coding sequelae of COVID-19.
The podcast also feature these other segments:

CDI, Past, Present, and Future: The Series: Nationally recognized clinical documentation integrity (CDI) expert Cheryl Ericson, clinical program manager for Iodine Software, launches an exclusive new series for ICD10monitor and Talk Ten Tuesdays that traces the evolution of CDI, noting that although the practice has evolved, the metrics haven’t.
The Coding Report: Laurie Johnson reports on the coding news that’s in the nation’s spotlight.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
E&M 2021: Shannon DeConda, founder of the National Alliance of Medical Auditing Specialists and a partner of DoctorsManagement, begins a new series for ICD10monitor and Talk Ten Tuesdays in which she delves into the massive changes in the new American Medical Association (AMA) evaluation and management (E&M) documentation guidelines for 2021: changes that become effective just four short months from now.

Preventative Care vs E/M Problem-Oriented Services Jul 21, 2020

Choosing the proper office visit code can be confusing unless you fully understand rules between preventative medicine and evaluation and management (E&M) coding. Knowing the difference between preventive visits, with its many procedural services and bundled service codes, and E&M visits with its complicated coding and documentation guidelines, is imperative to correct office visit coding.
This week on Talk Ten Tuesdays we are joined by Healthcare Coding and Reimbursement Consultant and coding auditor Terry Fletcher, who reports on Preventative Medicine vs. E&M codes
The live broadcast will also feature these other segments:

The Coding Report: Laurie Johnson reports the OIG update for coding sever malnutrition.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
Tuesday Focus: Beth Wolf reports the latest on managed care denials for malnutrition.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays host, will report on another thought-provoking topic that has captured her attention.

Telehealth: Could this be the New Normal? Jul 14, 2020

The use of telehealth has surged during the coronavirus pandemic, with the technology spreading far and fast. Doctors and patients alike must be wondering, 'is the beginning of a whole new kind of doctor–patient relationship'? One that will transform health care systems? With the uptick in the use of telehealth the Office of Inspector General (OIG) and Center of Medicare and Medicaid Services (CMS) has added Telehealth to the list of audits due to data analysis and non-compliance.

Joining us this week for Talk Ten Tuesdays will be Terry Fletcher who discuss the downfalls and keeping Telehealth compliant and in perspective.

The the podcast features these other segments:

The Coding Report: Laurie Johnson reports on FY21 ICD-10-CM new codes and updated diagnosis guidelines.
News Desk: Timothy Powell, anchors the Talk Ten Tuesdays News Desk.
RegWatch: Stanley Nachimson has the latest regulatory news and reports on the recently published CMS rules on payments for ESRD.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays host, will report on another thought-provoking topic that has captured her attention.

The Ins and Outs of Outpatient CDI Programs Jun 30, 2020

Outpatient clinical documentation improvement (CDI) programs have moved into the mainstream, as hospitals and healthcare systems continue to embrace consulting companies’ push into the outpatient arena. As the CDI profession matures and the market for CDI consulting becomes more competitive and less lucrative, these companies have identified a new long-term revenue stream associated with consulting engagements, in addition to software.

Joining us this week onTalk Ten Tuesdays will be Glenn Krauss, CEO and Founder of Core- CDI, to discuss the effectiveness of outpatient clinical documentation improvement (CDI) programs.

The live broadcast will also feature these other segments:

Tuesday Focus: Gloryanne Bryant, reports on CPT codes for Remote Patient Monitoring in relation to COVID19.
The Coding Report: Laurie Johnson reports on coding obesity 3.
News Desk: Timothy Powell, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays host, will report on race desparities of COVID19.

Let’s Talk Data - HHS Issues Requirements of Additional Data and Timely Submission for COVID-19 Testing Jun 23, 2020

As the country begins to reopen, it is essential to have clear and accurate data for leadership to make informed decisions during the phased reopening. The U.S. Department of Health and Human Services (HHS) has recently announced guidelines for additional data to be reported to HHS by laboratories along with COVID-19 test results. These guidelines allow for standardization of reporting and ensure comprehensive and nearly real-time data for COVID-19 decision-makers.

During this episode of Talk Ten Tuesdays, Susan Gatehouse will discuss the disproportionate impact of COVID-19 on specific individuals, such as minorities and the elderly, and the need to provide more detailed data to public health experts on a real-time basis.

The podcast will also feature:

Tuesday Focus: Terry Fletcher, nationally recognized professional physician coder and auditor gives us tips and tricks on how to avoid an audit.
The Coding Report: June is Alzheimer's and brain awareness month, and Laurie Johnson briefs us on the stages of the disease.
News Desk: Timothy Powell, anchors the Talk Ten Tuesdays News Desk with a segment about Florida SNFs.
TalkBack: Erica Remer, MD reports on acute blood loss anemia

EXCLUSIVE: Treating ICU COVID-19 Patients: Lessons Learned About Teamwork Jun 16, 2020

umbersome yet secure, your PPE is firmly in place as you shadow Dr. David Jury, similarly attired, as he makes his rounds in the ICU, explaining to you the handoff from his overnight telemedicine colleague…

Join for a remarkable, albeit virtual, journey into an ICU unit at the famed Cleveland Clinic, as our Talk Ten Tuesdays special guest Dr. David Jury describes his role as an anesthesiologist and critical care physician dealing with COVID-19 patients.
“I love what I do,” Jury wrote in a recent essay for FrontLine Friday, published by RACmonitor. “I'm intellectually stimulated, emotionally rewarded, and challenged at the same time nearly every day. COVID-19 brings a new set of challenges to my occupation, but I can't imagine doing anything else.”
The live broadcast will also feature these other segments:

Tuesday Focus:Codes that Spark Interest: Gloryanne Bryant, nationally recognized health information management (HIM) authority, will report on two ICD-10-CM codes related to COVID-19 that are generating an unusual amount of attention.
The Coding Report: Laurie Johnson will report on the 2021 ICD-10-PSC codes released last week by the Centers for Medicare & Medicaid Services (CMS).
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 another thought-provoking topic that has captured her attention.

EXCLUSIVE: Post-Pandemic Payer Contracting Jun 09, 2020

When your team comes to the negotiating table with commercial payers this year, they’ll be doing so in the new normal: the coronavirus pandemic.

Whether contract negotiations come during or toward the end of this country’s most devasting healthcare crisis in a century, this will be a whole new ballgame. Having wreaked havoc on institutions, policies, and procedures, the lingering effect of the pandemic is expected to bring to the forefront unprecedented financial and public health challenges for both payers and providers, affecting the types of agreements both parties can strike.

Reporting our lead story is Terry Fletcher, nationally recognized professional physician coder and auditor. Fletcher will discuss points of negotiation and trends that could impact payor-provider negotiations.

The live broadcast will also feature these other segments:

Tuesday Focus: Susan Gatehouse reports on the need to focus on your compliance plan and isolate key areas related to COVID-19 to ensure fraud prevention and to help mitigate internal risks and external audit reporting.
Mental Health Report: H. Steven Moffic, MD reports on what he perceives as a “double whammy” on mental health: the confluence of the coronavirus pandemic and the impact of climate change on mental health.
The Coding Report: Laurie Johnson reports on the Inpatient Prospective Payment System (IPPS) final rule released last week by the Centers for Medicare & Medicaid Services (CMS).
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD reports on another thought-provoking topic that has captured her attention.

Physician Queries Pending COVID-19 Test Results Jun 02, 2020

“In my opinion, as a physician and an ex-physician advisor, I can categorically assure you that it would irritate a provider to get queried to confirm a diagnosis they had already made clinically and documented in a codable format,” writes Erica Remer, MD, Talk Ten Tuesdays program host-turned-correspondent, who will be reporting our lead story during this edition of Talk Ten Tuesdays. “I agree with developing facility-specific coding guidelines, but they should be sensible and reasonable,” Remer added.
The podcast also feature these other segments:

Tuesday Focus: Holly Louie reports on how coders are encountering inadequate physician documentation, flawed facility policies, and misinterpretations of guidelines, all of which are creating barriers, errors, and problems for accurate diagnosis reporting.
RegWatch: Stanley Nachimson reports on the latest regulatory news coming out of Washington, D.C.
The Coding Report: Laurie Johnson has an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
News Desk: Timothy Powell, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, returns to the broadcast to report on another thought-provoking topic that has captured her attention.

EXCLUSIVE: Missing in Action: Addendums to the Record May 19, 2020

If physician documentation is missing or does not support the level or evaluation and management (E&M) service billed, surgery performed, or durable medical equipment (DME) issued, an addendum should be requested from the physician. A valid addendum must be received before the claim is submitted.
Reporting our lead story during this of Talk Ten Tuesdays will be Terry Fletcher, nationally recognized professional physician coder and auditor. Fletcher reports on the need to know how to correctly make these changes, but also, to know the difference between a "late entry" and an addendum to a medical record – and how Medicare's Program Integrity Manual relates it to reimbursement, compliance, and best practices.
The podcast also feature these other segments:

CDI Report: Robert Kopec, MD, reports on when physician queries are appropriate during the current coronavirus pandemic. Dr. Kopec is the medical director of infection prevention and control at Morton Plant Mease in Florida.
The Coding Report: Laurie Johnson has an update on major MS-DRG adjustments found in the proposed IPPS rule.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, returns to the broadcast to report on another thought-provoking topic that has captured her attention.

EXCLUSIVE: Safeguarding COVID-19 Reimbursement May 12, 2020

Waivers, modifiers, lab tests, multiple diagnosis codes: they constitute layer upon layer of intricacies that could get in way of your reimbursement. That is why accurate COVID-19 coding cannot be overlooked when ensuring appropriate compensation and safeguarding claims against third-party payer audits.
Reporting our lead story during this edition of Talk Ten Tuesdays is Susan Gatehouse, founder and CEO of Axea Solutions.
The live broadcast will also feature these other segments:

COVID-19 Telehealth Update: CMS has issued two interim final rules, including expansion and relaxation of guidelines for telehealth services. The first was issued on March 30, the second on April 30. Kathy Pride, executive vice president of coding and documentation services for Panacea Health, will report on what has changed and where to look for guidance.
Mental Health Report: H. Steven Moffic, MD, returns to the broadcast to report on the impact of climate change on mental health – part of an exclusive series he is authoring for ICD10monitor.
The Coding Report: Laurie Johnson has an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
RegWatch: Stanley Nachimson joins the broadcast to give and update on the recently released IPPS proposed rule.
News Desk: Timothy Powell, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD returns to the broadcast to report on another thought-provoking topic that has captured her attention.

EXCLUSIVE: COVID-19 Report: Post-Pandemic Fraud and Abuse Coming Soon May 05, 2020

It’s coming. And it could soon be spreading, as is the coronavirus: healthcare fraud and abuse. After all, there’s lots of money involved, at a time when waivers have been issued and rules relaxed, as the nation’s healthcare system focuses on fending off COVID-19. These changes include FaceTime, Skype, and telephone calls being reimbursed as telehealth and telemedicine services: a factor that can lead to fraud and abuse on scale not likely to be seen ever before the deadly virus upended processes, practices, and lives.
The live broadcast will also feature these other segments:

RegWatch: Stanley Nachimson, reports on the latest regulatory news coming out of Washington, D.C.
Mental Health Report: H. Steven Moffic, MD, reports on the disparities in the delivery of mental healthcare, evoking the memory of late jazz legend Billie Holiday’s eerily prescient version of the song “Strange Fruit.”
The Coding Report: Laurie Johnson has an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
News Desk: Timothy Powell, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, returns to the broadcast to report on another thought-provoking topic that has captured her attention.

EXCLUSIVE BROADCAST: Under the COVID Spell: New Definition for PHI Apr 28, 2020

Most of us are working from home now. That’s quite amazing. During the month of July 2019, an estimated total of 4.7 million folks telecommuted, either full or part-time.
Fast forward to the national stay-at-home edict, and now, according to Global Workplace Analytics, those working at home could possibly number 75 million.
So, what new privacy concerns are emerging, with healthcare professionals now working remotely as a result of the lockdown? How is it possible to stay alert, fit, and nimble, while at the same time, being conscious of your work product?
Reporting our lead story during this edition of Talk Ten Tuesdays, while remaining in self-isolation, is Rose Dunn, past president of the American Health Information Management Association (AHIMA) and the chief operating officer for First Class Solutions.
The live broadcast will also feature these other segments:

Healthcare Data Report: Amid the coronavirus pandemic, the need for reliable health information has never been more immediate. Reporting the fourth iteration in his exclusive five-part series will by Joseph C. Nichols, MD, president of Health Care Data, who focuses on data analysis.
Tuesday Focus: How will you and your team manage the after-effects of coding and billing, as COVID-19 cases start to move through an organization’s billing cycle, while maintaining up-to-date information? Susan Gatehouse, founder and CEO of Axea Solutions, reports on this latest development brought about by the coronavirus.
The Coding Report: Laurie Johnson has an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, returns to the broadcast to report on another thought-provoking topic that has captured her attention.

EXCLUSIVE BROADCAST: CDI Increasing in Importance During the COVID-19 Pandemic Apr 21, 2020

The costs of managing prolonged ICU stays for COVID-19 patients, combined with lost revenue from decreased ambulatory visits and the cancellation of elective procedures, will have health systems and provider groups emerging from the ongoing pandemic with significant financial challenges.
It will be more important than ever to ensure that clinical documentation reflects the true complexity of care being delivered. Reporting our lead story during this edition of Talk Ten Tuesdays will be Matt Lambert, MD, an emergency medicine physician and the chief medical officer for Curation Health.
The live broadcast will also feature these other segments:

Mental Health Report: H. Steven Moffic, MD, one of America’s foremost psychiatrists, returns to the broadcast to report on the impact of climate change on mental health – part of an exclusive series he is authoring for ICD10monitor.
Tuesday Focus: The Centers for Medicare & Medicaid Services (CMS) recently announced expanded coverage for essential diagnostic services amid the COVID-19 pandemic. Susan Gatehouse, founder and CEO of Axea Solutions, reports on this latest development.
Coding Report: Laurie Johnson has an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will return to the broadcast to report on another thought-provoking topic that has captured her attention.

Medical Necessity versus Medical Decision-Making Apr 14, 2020

Medical decision-making (MDM) and medical necessity are not the same thing. MDM specifically refers to the complexity of establishing a diagnosis and/or selecting a management option. Medical necessity refers to the appropriateness of the service provided for a certain condition. But which determines how you get reimbursed, when many healthcare professionals use these terms interchangeably?
The live broadcast will also feature these other segments:

Mental Health Report: H. Steven Moffic, MD, one of America’s foremost psychiatrists, returns to the broadcast to report on how best to test your survival skills during this challenging time in our daily lives.
Tuesday Focus: Susan Gatehouse, founder and CEO of Axea Solutions, reports on the Families First Coronavirus Response Act enacted on March 18, the Act was passed in response to the COVID-19 pandemic.
The Coding Report: Laurie Johnson has an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, returns to the broadcast to answer many of the COVID-19 coding questions that came in from previous broadcasts.

EXCLUSIVE: World Health Day in the Midst of COVID-19 Apr 07, 2020

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:

RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional turned well-known healthcare IT authority, reports on the latest regulatory news coming out of Washington, D.C.
The Coding Report: Laurie Johnson has an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will return to the broadcast to report on another thought-provoking topic that has captured her attention.

EXCLUSIVE: Social Determinants of Health and 2021 E&M Codes Mar 31, 2020

Eighty percent of what influences a person’s health is related to non-medical issues such as food, housing, upbringing, social support, and income. These socioeconomic and psychosocial circumstances are known as the social determinants of health (SdoH). With the goal of allowing physicians more time with their patients, the American Medical Association (AMA) has made significant revisions to the Office and Other Outpatient Services New and Established Evaluation & Management (E&M) categories for 2021.
During the next live edition of Talk Ten Tuesdays, Collen Deighan will report on what you need to know about this unique coding topic, and how the SDoH are addressed in the medical decision-making component of these revisions to drive proper payment and impact all patients’ health and well-being.
The live broadcast will also feature these other segments:

The Coding Report: Laurie Johnson will have an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
Tuesday Focus: Data Deep Dive: Dr. Joseph Nichols returns to the broadcast to report his third installment in his exclusive five-part series for ICD10monitor on healthcare data.
Special Report: COVID-19 has impacted the lives of people around the world. Over the past few weeks, many healthcare professionals and colleagues have had to switch to working remotely, from home on the fly. Working remotely has clarified what successful and sustainable remote work requires. Terry Fletcher will provide tips for those who are now working from home.
TalkBack: Erica Remer, MD, returns to the broadcast to discuss how to stay sane and well during quarantine.

Capturing Revenue for Care Management Services Mar 25, 2020

What are care management services, and are you capturing revenue associated with them?
Transitional care management (TCM), chronic care management (CCM), advance care planning (ACP), and behavioral health integration are among services you may already be providing for your patients. Good news: you can be paid for those services, as you’ll discover during the next live edition of Talk Ten Tuesdays when nationally-recognized professional physician coder and auditor Terry Fletcher reports our lead story.
The live broadcast will also feature these other segments:

The Coding Report: Laurie Johnson will have an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
Special Report: Amid the global pandemic of COVID-19, Dennis Jones of Montefiore Nyack Hospital gives us an update of the State of New York.
Tuesday Focus: Laurie Johnson will report on the outcome of the two-day virtual Coordination and Maintenance (C&M) that concluded on Wednesday.

C&M Virtual Meeting: Will there be an Official Code for EVALI? Mar 17, 2020

Will there be a code for EVALI? Or the use of e-cigarettes? Or one for the deadly coronavirus that the World Health Organization has now declared as a pandemic?
In light of the coronavirus outbreak, the ICD-10 Coordination and Maintenance Committee (C&M) meeting will be online only and convene Tuesday, March 17. The virtual meeting brings together representatives from the Centers for Medicare and Medicaid Services (CMS), the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS), various medical societies, medical device vendors, and the general public.
The live broadcast will also feature these other segments:

Tuesday Focus: Dr. Moffic, one of America’s foremost psychiatrists, continues his reporting on the rising world temperature and its impact on mental health.
Special Report: The World Health Organization has declared that the global coronavirus outbreak is now a pandemic. Given the international scope of the crisis and the vast amount of health data that will be exchanged, Lorraine Fernandes, president of the International Federation of Health Information Management Associations (IFHIMA), returns to report on patient privacy in this global pandemic.
News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, returns to the broadcast to report on another thought-provoking topic that has captured her attention.

Helping Transgender Patients Understand their Coverage and Rights Mar 10, 2020

There are HIPAA privacy rights that reach farther than those of the average patient. And there are privacy provisions in the Patient Protection and Affordable Care Act (PPACA) that prohibit discrimination against this population of patients.
But do these prevent discrimination against transgender patients? During this edition of Talk Ten Tuesdays, we asked nationally-recognized professional physician coder and auditor Terry Fletcher to report on the insurance policies from state to state on what cannot be automatically excluded.
The podcast also includes these other segments:

Special Report: Nationally prominent psychiatrist and author H. Steven Moffic, MD, returns to the broadcast to report on the intersection of the coronavirus and the rise of racism directed toward Asians and Asian-Americans.
The Coding Report: Laurie Johnson has an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
Tuesday Focus: Data Deep Dive: Dr. Joseph Nichols returns to the broadcast to report his second installment in his exclusive four-part series on healthcare data for ICD10monitor.
News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent anchors the Talk Ten Tuesdays News Desk.
RegWatch: Stanley Nachimson joins the broadcast to break down the OMB review of the CMS and ONC Interoperability rules that were released Monday March 9, 2020.

Patient Privacy and the International Response to Coronavirus Mar 03, 2020

With more cases of the novel coronavirus (COVID-19) being reported in countries outside of China, where the deadly virus has claimed the lives of a reported 2,771, world health leaders are preparing for a global pandemic that will provide a tsunami of health information for use by governments, world health agencies, and researchers, to hopefully control the future spread of the disease, develop vaccines, and share new learning to prevent future outbreaks.
That’s a good thing. But what about the privacy of that health information? Even in a crisis, health practitioners have a responsibility to protect privacy, which is a matter of trust between health professionals and the patient/consumer. And that is why we asked Lorraine Fernandes, president of the International Federation of Health Information Associates (IFHIMA), to report on this crucially important healthcare issue.
The live broadcast will also feature these other segments:

RegWatch: Stanley Nachimson reports on the latest regulatory news coming out of Washington, D.C.
The Coding Report: Laurie Johnson has an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
Tuesday Focus: March 1 through 7 is National Sleep Awareness Week, and that is why we asked Dr. Nick van Terheyden to report on the importance of sleep.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
TalkBack: Kathy Pride, senior vice president of coding and documentation services for Panacea Healthcare will discuss a current topic that’s surfaced on her radar.

Price Transparency is Coming to a Chargemaster Near You Feb 25, 2020

The Trump Administration has grand plans to make healthcare prices more transparent, hoping a little bit of light will help lower the high costs of U.S. healthcare.
In new regulations, the administration is requiring hospitals to disclose, for the first time, the prices they negotiated with health insurers for a wide range of services, as well as the prices they charge patients who are paying with their own money.
But is it going to make any difference? We ask nationally-recognized professional physician coder and auditor Terry Fletcher to check with some health policy experts for their opinions about the new price transparency regimes. Terry gives you the best and worst-case scenarios, as well as the more realistic predictions, as this new rule is enforced during 2020.
The podcast also features other segments:

Tuesday Focus: Is it extravasation or infiltration? Knowing the difference is important for coders – and, actually, all healthcare professionals. Susan Gatehouse, founder and CEO of Axea Solutions, explains why this really matters.
The Coding Report: Laurie Johnson has an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines. She also reports on the upcoming Coordination and Maintenance Committee scheduled for March 17 and 18 at the headquarters of the Centers for Medicare & Medicaid Services (CMS).
News Desk: Grant Huang, CPMA, CPC, a consultant for DoctorsManagement, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on another thought-provoking topic that has captured her attention.

Analyze This: Healthcare Data and Solastalgia on Mental Health Feb 18, 2020

Dr. Nichols, who is authoring an exclusive four-part series on healthcare data for ICD10monitor, reports on the crucial search for reliable health information, noting that without it, all stakeholders are at significant financial and/or personal health risks.
Dr. Moffic, one of America’s foremost psychiatrists, reports on the intriguing subject of solastalgia – the rising world temperature, and its impact on mental health. Dr. Moffic is writing an exclusive series on the topic for ICD10monitor, and Tuesday’s report will be his second in his remarkable series.
The podcast also features these other segments:

RegWatch: Stanley Nachimson reports on the latest Medicare Advantage news coming out of Washington, D.C.
The Coding Report: Laurie Johnson has an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on the latest with the Social Determinants of Health.

Million-Dollar Coding Mistakes – and How to Avoid Costly Errors Feb 11, 2020

While facilities and practices are concentrating on making critical changes in 2020 and 2021, it is important not to lose focus on the basics of correct coding. CPT® and ICD-10-CM coding errors can cost healthcare providers millions of dollars in lost revenue, but also, those errors can trigger compliance issues that could lead to audits.
Reporting our lead story during this edition of Talk Ten Tuesdays is a nationally recognized professional physician coder and auditor Terry Fletcher.
The podcast also features these other segments:

Special Report: The EHR Source of Truth: Is your organization’s electronic health record (EHR) the source of clinical truth? Exploring that question is Susan Gatehouse, founder and CEO of Axea Solutions, who reports on how documentation and coding audits can uncover deficits within an EHR.
Tuesday Focus: How does one avoid compromising on quality when faced with reimbursement cuts? It’s an issue that we hear about frequently, and that is why we asked Rhonda Buckholtz, chief executive officer for Century Vision Global, for her thoughts on this pervasive issue.
The Coding Report: Laurie Johnson reports on the deadly coronavirus that has resulted in a scurry of international activity – evacuees arriving from countries hit hard by the virus, and others being shunned, quarantined, and tracked. Meanwhile, Johnson will be reporting on the latest U.S. efforts to designate a code for this global health emergency.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on another thought-provoking topic that has captured her attention.

The Coding Dilemma: Reporting Deep-Tissue Pressure Injuries Feb 04, 2020

The release of the fiscal year (FY) 2020 Official Guidelines for Coding and Reporting (OCG) has resulted in confusion and apprehension surrounding the intent of the new guideline related to the new ICD-10-CM codes for pressure-induced deep-tissue damage or deep-tissue pressure injury (L89.-6).
The ambiguity stems from what appears to be conflicting advice found within the coding guidelines (I.C.12.a) regarding pressure ulcer stage codes, as you’ll learn when Lisa Baris, Director of Health Information Management (HIM) and Healthcare Clinical Documentation Improvement (CDI) for Nuance Communications reports our lead story during this edition of Talk Ten Tuesdays.
The podcast will also feature these other segments:

CDI Report: In order to effectively challenge DRG reassignments, facilities should retain a team of physicians that can review the cases and generate clinically robust appeal letters that adhere to the Official Guidelines for Coding and Reporting for ICD-10-CM/PCS and Coding Clinic. Dr. Wilbur Lo, chief medical and CDI officer for cdiWorks, returns to the broadcast to report on a successful appeal case involving physician CDI input and clinical validation of a pelvic abscess.
The Coding Report: Laurie Johnson reports on the World Health Organization’s decision to declare the deadly virus that has resulted in 170 deaths in China, a global emergency. The first person-to-person spread of the virus was reported in the U.S. this week.
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: Holly Louie, RN joins the podcast to cover the results from the National Coding Contest and how coding is getting worse.

Prior Authorization Headaches: A Pain Point for Providers and Practices Jan 28, 2020

With prior authorization (PA) posing a significant pain point for healthcare providers and a major headache for most practices, Talk Ten Tuesdays asked Terry Fletcher to report on this troubling issue, especially in light of the WEDI survey results posted this week, revealing that 84 percent of providers reported that the number of medical services requiring PA has increased.
The PA process, heavily dependent on manual tasks, has grown to become one of the biggest frustrations for physicians in group practices. During this Tuesday’s edition, you and your team will receive the latest update on how the Centers for Medicare & Medicaid Services (CMS), commercial payors, and other organizations are tackling this process to better serve patients.
The podcast will also feature these other segments:

Special Report: As organizations continue to evaluate the most efficient and cost-effective ways to streamline operations, there is increasing movement towards single-source physician and facility emergency department coding. Susan Gatehouse, founder and CEO of Axea Solutions, reports on some of the key considerations in assessing the viability of making this a successful transition.
The Coding Report: Laurie Johnson reports on the deadly virus that has sickened hundreds of people and spread throughout the world, forcing China to lock down three major cities with populations of more than 18 million. The first case in the U.S. arrived in Seattle this week.
Tuesday Focus: It’s Chronic Traumatic Encephalopathy (CTE) Week, and Karen Kinzle, will return to the broadcast with an update on the Patrick Risha CTE Awareness Foundation she founded five years ago to generate awareness of the degenerative brain disease found in athletes and military veterans.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on another thought-provoking topic that has captured her attention.

The Coding World in 2020: Part II Jan 21, 2020

Talk Ten Tuesdays is continuing its reporting on the unprecedented changes occurring this decade in the world of healthcare coding.
Coders and health information management (HIM) professionals need to retool in order to meet new challenges brought about by artificial intelligence, as well as by social and political changes already underway. With profound healthcare upheaval taking place here and globally, we asked Ginna Evans, the new president and board chair of the American Health Information Management Association (AHIMA), to share her 2020 agenda for the group, which represents more than 103,000 HIM specialists in the United States and around the world.
The live broadcast will also feature these other segments:

Special Report: Appropriate Use Criteria (AUC), a Medicare program becoming effective January 2021, is expected to be a huge undertaking for organizations reported by Susan Gatehouse, founder and CEO of Axea Solutions.
The Coding Report: Holly Louie, will report on the results of a recent national survey of coding accuracy.
Tuesday Focus: Lamon Willis, reports and gives guidance on steps coders can take to improve their job performance.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on Risk Adjustment and HCC models.

The Coding World in 2020: Look Ahead to ICD-10-CM Clinical Coding Challenges Jan 14, 2020

The coding world in 2020 will be a new landscape of challenges for coders as well as health information management (HIM) professionals. And to help you and your team prepare for what lies ahead in the New Year, Gloryanne Bryant, a well-known, national coding and HIM leader, returns to the Talk Ten Tuesdays broadcast with her report on six major issues confronting coders this year and beyond.
The podcast will also feature these other segments:

Tuesday Focus: Nationally recognized professional physician coder and auditor Terry Fletcher, a member of the ICD10monitor editorial board, reports how why “incident-to billing” is under siege – and could go the way of Google Glass.
The Coding Report: Laurie Johnson reports on the latest coding news that has been making headlines. Johnson is a nationally recognized coding authority and senior healthcare consultant at Revenue Cycle Solutions, LLC.
Mental Health and Climate Change: Nationally renowned psychiatrist and author H. Steven Moffic, MD, reports on an exclusive series on the impact of climate change on healthcare.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on the question 'Is Recording the Patient Encounter for Posterity a Good Idea?'.

In the Holiday Spirit of Giving: Free Advice to Avoid Claim Denials Dec 10, 2019

In the true holiday spirit of giving, during this edition of Talk Ten Tuesdays weekly broadcast will provide you and your team with some free advice on how to avoid claim denials – especially if you don’t have a robust claim denials management process.
Unfortunately, the majority of healthcare organizations encounter claim denials on a regular basis, often habitually. Though some claim denials may be unavoidable, ineffective claim denials management can result in even more lost revenue, as you’ll learn when Susan Gatehouse, founder and CEO of Axea Solutions, returns to the broadcast.
The live broadcast will also feature these other segments:

The Coding Report: Laurie Johnson reports on the latest coding news that has been making headlines. Johnson is a nationally recognized coding authority and senior healthcare consultant at Revenue Cycle Solutions, LLC.
Tuesday Focus: Mental Health: During this holiday season, you and others are likely looking forward to festivities with coworkers, friends, family, and extended family. But for others, this time of the year can trigger, or in some cases, acerbate, stress, anxiety, and depression. That is why we asked nationally prominent psychiatrist and author H. Steven Moffic to provide a prescription to relieve the holiday malaise some of you might be experiencing.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchor the Talk Ten Tuesdays News Desk.
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.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on another thought-provoking topic that has captured her attention.

Beyond CCs and MCCs: Say Hello to HCCs and APR-DRGs Dec 03, 2019

There was a time when the coin of the realm in the world of coding was knowledge of complications or comorbidities (CCs) and major complications or comorbidities (MCCs).
But 10 years later, the industry has changed rapidly, and to avoid going the way of the dinosaur, coders today need to embrace all patients’ refined diagnosis-related groups (APR-DRGs) and hierarchical condition categories (HCCs). A coder’s staying power lies beyond MS-DRGs, according to Kristi Pollard, who reports our lead story during this edition of Talk Ten Tuesdays.
The live broadcast will also feature these other segments:

The Coding Report: Laurie Johnson reports on the latest coding news that has been making headlines. Johnson is a nationally recognized coding authority and senior healthcare consultant at Revenue Cycle Solutions, LLC.
Tuesday Focus: A recent meta-analysis of studies published by the Journal of the American Medical Association (JAMA) on the effects of nutritional support on clinical outcomes is a trending topic in healthcare’s social media universe. We will have two reports on this topic: Molly Hegarty, founder and CEO of Junum, reports on possible revenue loss when the presence of a malnutrition diagnosis is not documented appropriately, and Dr. McClain Blanton, a physician advisor with the Brundage Group, reports on the clinical aspects of the study.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on another thought-provoking topic that has captured her attention.

Ten Going on Eleven: Help is Here Nov 26, 2019

As we conclude our month-long Talk Ten Tuesdays series, “Ten Going on Eleven,” we do so with a special appearance by Valerie Watzlaf, board president and chair of the American Health Information Management Association (AHIMA).
Valerie, vice chair of education and associate professor within the Department of Health Information Management in the School of Health and Rehabilitation Sciences at the University of Pittsburgh, will discuss how AHIMA is helping the health information management (HIM) profession prepare for the implementation of ICD-11.
The live broadcast will also feature these other segments:

The Coding Report: Ten Going on Eleven: Laurie Johnson will report on the need to be conversant with the new code changes, especially if there is no physical coding book. Johnson is a nationally recognized coding authority and senior healthcare consultant at Revenue Cycle Solutions, LLC.
Ten Going on Eleven: George Vancore, a system consultant for Florida Blue (Blue Cross Blue Shield of Florida), will report on ICD-11 implementation from the perspective of health plans.
CDI Report: Lamon Willis, director of coding for Velocity Healthcare Collaborative, will explain valid reasons for not necessarily believing DRG denials by auditors. In particular, he will report on the apparent conundrum between Sepsis-1, Sepsis-2, and Sepsis-3 – and how payers are trying to utilize what they perceive as a loophole regarding the variance between coding and clinical documentation.
News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent will anchor 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, will report on another thought-provoking topic that has captured her attention.

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.

Ten Going on Eleven: The Role of HCC Coding Nov 19, 2019

Exclusive reporting on ICD-11 and the need for early preparation for the new code set continues at ICD10monitor and Talk Ten Tuesdays.
Among those skills that will need to be honed is hierarchical classification category (HCC) coding. HCCs thrive on specificity. Although it was thought that ICD-10 delivered the ultimate level of specificity, ICD-11 is expected to surpass ICD-10 in that area. But HCCs require documentation, and the key looming question remains, at this time, unanswered: will the documentation rise to meet the specificity level needed under ICD-11?
Nationally recognized health information management (HIM) expert and past American Health Information Management Association (AHIMA) President Rose Dunn, the chief operating officer for First Class Solutions, will explore that issue during the next edition of Talk Ten Tuesdays.
The live broadcast will also feature these other segments:

Mental Health Report: Although the industry hasn’t turned the corner on reducing mental healthcare burnout, a nationally prominent psychiatrist and author H. Steven Moffic suggests a fresh new approach in the deploying “edge leaders.”
RegWatch: Stanley Nachimson, former CMS career professional turned well-known healthcare IT authority, returns to the broadcast to continue his reporting on regulatory news coming from Washington, D.C.
The Coding Report: Cari Underwood reports on significant changes in Chapter 12 Diseases of the Skin and Subcutaneous Tissue, including new codes for reporting diagnoses of deep tissue damage and a new guideline directing the assignment of these codes.
News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent anchors the Talk Ten Tuesdays News Desk and reports on the Google compliance cloud.
TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on a few thought-provoking topics that have captured her attention.

Ten Going on Eleven: Data Mining: A Must-Have Skill for Coders Nov 12, 2019

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:

Tuesday Focus: Debridement: Medicare’s definition of debridement is “the removal of foreign material and/or devitalized or contaminated tissue from or adjacent to a traumatic or infected wound until surrounding healthy tissue is exposed.” Nationally recognized professional physician coder and auditor Terry Fletcher, a member of the ICD10monitor editorial board, reports documentation essentials and coding errors for which to be alert.
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.
Ten Going on Eleven: The Coding Report: Laurie Johnson reports on the need to be conversant with ICD-11, especially if there is no physical coding book. Johnson is a nationally recognized coding authority and senior healthcare consultant at Revenue Cycle Solutions, LLC.
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 another thought-provoking topic that has captured her attention.

Ten Going on Eleven: The Train Has Left the Station Nov 05, 2019

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:

The CDI Report: Ten Going on Eleven: ICD-11 includes many new conditions that are not currently included in ICD-10. It’s never too early to start analyzing your facility’s current documentation to ensure it will meet the standard needed for ICD-11. Reporting on the clinical documentation integrity (CDI) implications of ICD-11 is Melanie Endicott, the vice president of health information management (HIM) excellence for the American Health Information Management Association (AHIMA).
The Coding Report: Ten Going on Eleven: Laurie Johnson reports on the need to be conversant with the new code changes, especially if there is no physical coding book. Johnson is a nationally recognized coding authority and senior healthcare consultant at Revenue Cycle Solutions, LLC.
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 another thought-provoking topic that has captured her attention.

Reasons Not to Believe DRG Denials Oct 29, 2019

“In the hospital setting, we see multiple insurance denials on a weekly basis,” Lamon Willis recently wrote in an article for ICD10monitor.
“Teams of people route them to various departments for analysis and review. I have staff members who review the APC and/or DRG, along with coding criteria, to determine if we have properly fulfilled our duties as coders and to support the appeals process for the organization,” he continued. “My staff and I agree on one thing at the very beginning, and that is: don’t believe the denial.”
During this edition of Talk Ten Tuesdays, Willis, director of coding for Velocity Healthcare Collaborative, explains valid reasons for not necessarily believing in DRG denials by auditors.
The live broadcast will also feature these other segments:

The Coding Report: Laurie Johnson, a senior healthcare consultant at Revenue Cycle Solutions, LLC, continues her exclusive reporting on the coding of e-cigarette lung injuries (vaping).
Tuesday Focus: Nationally recognized professional physician coder and auditor Terry Fletcher, a member of the ICD10monitor editorial board, reports how physicians and providers could have their Medicare enrollment revoked if they are affiliated with an organization directly or indirectly that has any history of "bad acts" with the program.
Five Looking at Ten: Deborah Grider, author, educator, and senior healthcare consultant for Karen Zupko and Associates, returns to the broadcast to report on coding lessons learned in ICD-10.
Five Looking at Ten: The WEDI Role: Stanley Nachimson reports on the role played by the Workgroup for Electronic Data Interchange (WEDI) in the run-up to ICD-10. Nachimson led the WEDI ICD-10 Implementation Timeline Initiative and co-chaired the ICD-10 Testing workgroup.
News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.

Five Looking at Ten: Lessons Learned Oct 22, 2019

Five Looking at Ten, the month-long series on ICD10monitor and Talk Ten Tuesdays that examines lessons learned since the nation’s healthcare system adopted ICD-10, will continue with a special guest appearance of Robert Tennant of the Medical Group Management Association (MGMA).
The broadcast also feature these other segments:

Five Looking at Ten: Clinical Audits: Nationally recognized health information management (HIM) authority Gloryanne Bryant reports on lessons learned from clinical coding audits and selecting a coding vendor.
Five Looking at Ten: The Coding Report: Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on lessons learned as the nation prepares for the transition from ICD-10 to ICD-11, as well as the prerequisite training.
Revenue Cycle Report: Tim Bavosi, vice president of consulting for RevSpring, reports on the root causes linked to claim denials.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor 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, continues her reporting on the recent CMS informational session on CCs and MCCs.

Do EHRs Contribute to Patient Deaths? Oct 15, 2019

There is ongoing concern that electronic health record (EHR) systems are one of the top contributing causes to patient deaths, complications, and erroneous care plans. During this edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher, a member of the ICD10monitor editorial board, reports on the growing issue of EHR-related errors.
The live broadcast will also feature these other segments:

The Coding Report: Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on coding for influenza since flu season officially started Oct. 1.
Tuesday Focus: Mortality versus Morbidity: The terms “mortality” and “morbidity,” along with “severity of illness (SOI),” are often interwoven. That’s wrong, as you’ll learn when Susan Gatehouse, CEO of Axea Solution, returns to the broadcast.
Five Looking at Ten: Out of the Blue (Early Payer Adoption): Join us for this month-long series on ICD10monitor and Talk Ten Tuesdays as we examine what lessons have been learned since the nation’s healthcare system adopted ICD-10 on Oct. 1, 2015. This Tuesday, George Vancore, system consultant for Florida Blue (Blue Cross Blue Shield of Florida) reports on the challenges during the run-up of ICD-10 of achieving end-to-end testing, from the physician’s desktop to the health plan and back.
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 an important topic that recently captured her attention. Download handout from this segment

Searching for Codes on Facebook Oct 08, 2019

There’s growing concern in the healthcare industry regarding offshore and untrained staff getting their CPT® and ICD-10 codes from non-verified Internet sites such as Facebook, Twitter, and other social media platforms.
This practice aligns with another troubling trend: the use of Google by folks leveraging the Internet for self-diagnosis, doing so with a misdirected sense of trust in all things online while hoping to reach their own conclusions about their illness.
During this edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher reports on how, in this day and age of limited time with doctors, this practice can undermine the role of the physician.
The episode will also feature these other segments:

The Coding Report: Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on the 2020 fiscal year’s proposed CC/MCC designation changes that did not happen in the Final Rule, but will be discussed during a listening session Oct. 8.
Five Looking at Ten: Guidelines and the Coding Clinic: Join us for this month-long series on ICD10monitor and Talk Ten Tuesdays as we examine what lessons have been learned since the nation’s healthcare system adopted ICD-10 on Oct. 1, 2015. This Tuesday, Gloryanne Bryant, a nationally recognized health information management (HIM) expert, reports on guidance from the official Coding Guidelines and the American Hospital Association’s (AHA’s) Coding Clinic.
The Dunn Report: National HIM expert and past American Health Information Management Association (AHIMA) President Rose Dunn returns to the broadcast with another installment in her series on how HIM can play a role in other areas of the revenue cycle.
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 an important topic that recently captured her attention.

Five Looking at Ten: Lessons Learned Oct 01, 2019

Five Looking at Ten is an upcoming month-long series on ICD10monitor and Talk Ten Tuesdays, through which we will examine what lessons have been learned since the nation’s healthcare system adopted ICD-10, which became effective Oct. 1, 2014. Each week, we will report on lessons learned as we approach year five – while at the same time, looking ahead to the implementation of ICD-11.

Joining us during this broadcast is our special guest is Denise Buenning, who, during the run-up to ICD-10, was the deputy director for the Centers for Medicare & Medicaid Services (CMS) Office of E-health Standards & Services.

The broadcast will also feature these other segments:

Five Looking at Ten - Coding Report: Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on lessons learned as the nation prepares for the transition from ICD-10 to ICD-11, as well as the prerequisite training.
- FY20 IPPS Proposed Rule: https://www.govinfo.gov/content/pkg/FR-2019-05-03/pdf/2019-08330.pdf
- ICD-10-CM Impact File: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software.html.
Five Looking at Ten - The CDI Report: Donna Rugg, American Health Information Management Association (AHIMA) director of HIM Practice Excellence, Terminology Mapping, Coding, and Data Standards, reports on lessons learned with clinical documentation integrity under ICD-10.
- International Classification of Diseases 11th Revision
  https://icd.who.int/en
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, will discuss the need for healthcare professionals to tear down silos and work in a spirit of collaboration.

Late Signatures for Medical Services: Can You Still Bill and Get Paid? Sep 24, 2019

The Centers for Medicare & Medicaid Services (CMS) has published rules and guidance on the topic of a "completed medical record." But what if the provider didn't sign off on the note or authenticate it in the electronic health record (EHR) until after the fact? Is the record still considered complete, for billing and reporting purposes?
During this edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher reports on the need for complete medical records, including the proper documentation and a dated physician signature.
This podcast also features the following segments:

The Coding Report: Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, hasTalk Ten Tuesdays coding report.
The CDI Report: Susan Gatehouse, CEO of Axea Solutions, returns to the broadcast to report on the challenges associated with the proper reporting and documenting of the social determinants of health (SdoH).
News Desk: 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, discusses the need for healthcare professionals to tear down silos and work in a spirit of collaboration.

New ICD-10 Codes Coming Your Way Sep 17, 2019

What new codes are coming your way? The ICD-10 Coordination and Maintenance Committee (C&M) met for two days this past week to discuss requests for ICD-10 code changes.
Laurie Johnson, an ICD10monitor editorial member and senior healthcare consultant for Revenue Cycle Solutions, LLC, reports on the public forum held Monday and Tuesday at the headquarters of the Centers for Medicare & Medicaid Services (CMS).
This episode also features these other segments:

Tuesday Focus: Addicted Nation—Two major news stories this week underscored a nation whose citizens are caught in the grip of addiction: the tentative settlement agreement involving Purdue Pharma, makers of OxyContin, and the announcement that the federal government is considering a ban of flavors used in e-cigarettes in response to a surge in underage vaping. Six vaping deaths and some 450 possible cases of lung infection related to vaping have been reported nationwide. Nick van Terheyden, MD, AKA, “The Incrementalist,” returns to report on addiction and Laurie Johnson reports on coding issues surrounding vaping.
The Coding Report: Nationally recognized health information management (HIM) expert Gloryanne Bryant reports live from the national convention of the American Health Information Management Association (AHIMA) on red flags in coding compliance.
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 a timely subject that has captured her attention.

Smoking Cessation Programs: Coding for Reimbursement Sep 10, 2019

Is your facility currently providing smoking cessation counseling and treatment? Did you know you can bill and get reimbursed for your services? It isn't just part of your standard evaluation and management (E&M) encounter. But who is covered? What are the CPT® and ICD-10-CM codes? What is the reimbursement and rules for payment?
Nationally recognized professional physician coder and auditor Terry Fletcher reports on the latest information about revenue opportunities for all specialty providers involved in smoking cessation programs.
The broadcast will also feature these other segments:

RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, reports on the latest regulatory news coming out of Washington, D.C.
The CDI Report: Mel Tully, vice president of clinical services and education at Nuance Communications’ health division, reports on the benefits of artificial intelligence (AI)-driven clinical documentation integrity (CDI) programs.
News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent anchor 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, once again brings back sepsis for Sepsi Awareness Month.

Time-Based E&M Coding and Reporting Aug 27, 2019

There are rules to follow when you are using "time" as your element of support for any evaluation and management (E&M) encounter. If a physician elects to report the level of care based on counseling and/or coordination of care, then a number of factors must be in the patient's medical record.
During this edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher discusses the American Medical Association’s (AMA’s) rules, the position taken by Medicare, and how the electronic medical record (EMR) can actually assist you in your efforts.
But should time really be the new standard for supporting your patient encounters?
The broadcast also features these other segments:

Coding Report: Speaking of E&M coding, 2020 proposed Medicare Physician Fee Schedule (MPFS) shows a significant shift from the 2019 version. Sally Streiber, president of Practical Coding Solutions, explores the changes, including removal of 99201, how levels of service may be selected, and what “time” may mean in the future.
Tuesday Focus: Susan Gatehouse, CEO of Axea Solutions, returns to the broadcast to continues her reporting on the need to focus technology advancements on real transformation rather than transactional efficiency.
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, discusses the recent decision by a Texas federal judge to dismiss a False Claims Act lawsuit alleging that Dallas-based Baylor Scott & White Health overbilled Medicare by improperly upcoding claims.

ICD-10-CM Coding for Transgender Patients Aug 20, 2019

Gender dysphoria is quickly moving into America’s healthcare lexicon as LGBTQ+ families are rising in number at historic rates, prompting the emergence of alternative medical clinics that are providing services for the transgender patient community. As a result, coders have questions – specifically, about ICD-10-CM diagnosis codes.
During this edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher explains what codes to choose, how to understand them, and how to apply them to this new population of patient encounters.
The live broadcast will also feature these other segments:

Coding Report: Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on the latest development in the baffling condition known as acute flaccid myelitis (AFM).
CDI Report: Gloryanne Bryant, nationally recognized health information management leader, author, and clinical coding and documentation expert, reports on the MS-DRG updates as found in the 2020 Inpatient Prospective Payment System (IPPS) Final Rule.
Tuesday Focus: Susan Gatehouse, CEO of Axea Solutions, reports on the need to focus technology advancements on real transformation rather than transactional efficiency.
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, continues her discussion of SEP-1.

The Art of the Physician Query Aug 13, 2019

So how do you as a coding professional ensure your physician queries are effective and compliant? First, it’s important to understand when to query a physician, how to submit a query and the best way to get a reply from your provider.
During the next edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher will provide insight into this important and powerful communication tool.
The live broadcast will also feature these other segments:

The Coding Report: Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, will have the Talk Ten Tuesdays coding report.
Tuesday Focus: Rhonda Buckholtz, chief compliance officer for Century Vision Global, will report on the use of evidence-based medicine to influence CDI improvements.
News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent will anchor the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will discuss the contentious subject of SEP-1.

Burnout: Information for Coders and CDI Specialists Aug 06, 2019

As reported by ICD10monitor, the World Health Organization (WHO) has classified physician burnout as an occupational phenomenon, while noting that it is not a medical diagnosis.
There are some estimates that more than half of physicians have experienced burnout. But what do coders and clinical documentation integrity specialists (CDISs) need to know about burnout among their physicians?
Reporting our lead story during this edition of Talk Ten Tuesdays will be Megan Cortazzo, MD, Medical Director for Clinical Documentation Improvement and Health Information Management at UPMC and Assistant Professor of Physical Medicine and Rehabilitation. Joining the conversation on burnout will be nationally prominent psychiatrist H. Steven Moffic, MD.
The live broadcast will also feature these other segments:

The Coding Report: Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, has the Talk Ten Tuesdays coding report.
RegWatch: Stanley Nachimson, former 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.

Patient-Focused Coding: Using Codes to Tell the Patient’s Story Jul 30, 2019

Has the art of telling the patient’s story through coding been lost?
So ponders Kristi Pollard, a senior coding consultant for the Haugen Group, who reports this intriguing story in this edition of Talk Ten Tuesdays. Pollard is expected to explain that, first and foremost, coders are storytellers who convey each patient’s medical story through codes.
The podcast also features these other segments:

The Coding Report: Laurie Johnson, a senior healthcare consultant at Revenue Cycle Solutions, LLC, discusses World Hepatitis day on the Talk Ten Tuesday coding report.
The Dunn Report: National health information management (HIM) expert and past American Health Information Management Association (AHIMA) President Rose Dunn returns to the broadcast with the sixth installment in her series on how HIM can play a role in other areas of the revenue cycle.
Tuesday Focus: Rhonda Buckholtz, chief compliance officer for Century Vision Global, reports on a mystery code – actually, a diagnosis code – that could trigger an audit that could lead to a complete refund.
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 emergency room critical care time documentation.

Avoiding Confusion over Critical Care Services Jul 23, 2019

What may seem relatively straightforward to some coders has been a headache, presenting confusion and ambiguity, for others, when it comes to charging for critical care services. During this edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher will focus not only on coding but also documentation compliance when reporting such services.

The broadcast also features these other segments:

The Revenue Cycle Report: Bonnie S. Cassidy, nationally renowned health information management (HIM) authority, reports on the importance of ICD-10 coding in the revenue cycle.
Dateline Washington: Leslie Krigstein, vice president of congressional affairs for the College of Health Information Management Executives (CHIME), reports on the latest healthcare news coming out of Washington, D.C.
News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, discuss' the need for physicians to take care of the whole patient, without a preoccupation with DRGs and CC/MCCs.

2019 ICD-10-CM/PCS Coding Clinic Update Jul 16, 2019

The ICD-10-CM/PCS update to the American Hospital Association’s (AHA’s) Coding Clinic for the second quarter of 2019 has been published, and there is plenty of news to report.
Each quarter, new advice and guidance are published by the AHA to address questions and challenges associated with clinical coding. The AHA Coding Clinic on ICD-10-CM/PCS is an “official” coding resource, and as such, it is recognized by regulators and auditors alike.
Reporting our lead story during thisTalk Ten Tuesdays is nationally recognized health information management leader, author, and clinical coding and documentation expert Gloryanne Bryant.
The broadcast also features these other segments:

Tuesday Focus: A new national collaborative to advance interoperable social risk and protective factor documentation, titled The Gravity Project, was launched May 2, 2019. The Robert Wood Johnson Foundation has funded this partnering with the SIREN: the University of California San Francisco’s Social Interventions Research and Evaluation Network, along with EMI Advisors LLC. Reporting of the work of The Gravity Project is EMI Project Manager Evelyn Gallego.
Coding Report: Melinda Battaile, physician advisor for CDI at Vidan Health, report on how a provider used a 2003 Coding Clinic to decrease reimbursement when both acute kidney injury (AKI) and dehydration were present on admission and established to be a coequal diagnosis.
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 clinical validation denials for cerebral edema.

Are HIM Coding Professionals Qualified to Query for Clinical Validity? Part III Jul 09, 2019

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:

Tuesday Focus: S. Diane Iverson, a case manager at a major teaching hospital in Baltimore, reports on The Gravity Project as it relates to the social determinants of health (SdoH).
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 pitfalls of voice recognition.

Serious Issues with Cloning Around Jul 02, 2019

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.

A Physician’s Prescription for Avoiding ICD-10 Codes for Sleep Disorders Jun 25, 2019

There are a plethora of ICD-10 codes for sleep disorders – as many codes for these diagnoses as sheep jumping over a fence. And with the approach of summer, there is the concordant expectation of summer insomnia.
“Sleep is not just a pillar of health, it is the foundation to health,” writes Nick van Terheyden, aka “Dr. Nick the Incrementalist,” founder of Incremental Healthcare, who reports our lead story.
Dr. Nick discusses the importance of sleep, which he describes as offering “the incredible benefits of this amazing new treatment that allows you to live longer, improves your memory, makes you more creative and slimmer, (and) decreases (risk of) cancer, dementia, infections, heart disease, strokes, and diabetes.”
The live broadcast will also feature these other segments:

The Coding Report: Laurie Johnson report on ICD-10 coding for sleep disorders. Sleep disorders can be coded based on interruption in sleep patterns to substances that interrupt sleep. Johnson is a senior healthcare consultant at Revenue Cycle Solutions, LLC.
Tuesday Focus: Inaccurate ICD-10 coding reported by Holly Louie, past president of the Healthcare Business and Management Association. Louie, who continues her exploration of this important subject, will also report on her recent meeting with officials at the Centers for Medicare & Medicaid Services (CMS).
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, continues her reporting on the recent ACDIS conference.

States Receive Low Scores in the 2019 Scorecard on State Health System Performance Jun 18, 2019

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:

The Revenue Cycle Report: Bonnie S. Cassidy, nationally renowned health information management (HIM) authority, reports on the importance of ICD-10 coding in the skilled nursing facility (SNF) revenue cycle for FY 2020.
Dateline Washington: Leslie Krigstein, vice president of congressional affairs for the College of Health Information Management Executives (CHIME), reports on the latest healthcare news coming out of Washington, D.C.
News Desk: John K. Hall joins the broadcast to discuss the latest news on TPE audits.
TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, continues her reporting on the recent ACDIS conference.

Coding and Documenting Anticoagulation Management Jun 11, 2019

Along with one of the most common blood-thinning medications in the world, taken daily to prevent blood clots, comes frequent checks called “pro-times” or international normalized ratio (INR) monitoring.
This has been taken for granted in the past, as the work involved for the physician to monitor such patients at least monthly (and sometimes more often) can be costly for a medical practice. However, in 2018, as Medicare continues to reinforce support for primary care and certain medical specialties like cardiology, anticoagulation management is now a payable service, which may be available for work that is already being done in your practice.
During this edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher reports on the importance of documentation to capture the new CPT® codes for home and outpatient INR monitoring services.
This broadcast will also feature:

The Coding Report: The Centers for Medicare & Medicaid Services (CMS) Inpatient Prospective Payment System (IPPS) proposed changes for acute-care hospitals in the 2020 fiscal year include discussions of complication or comorbidity (CC) and major complication or comorbidity (MCC) adjustments. Nationally recognized health information management (HIM) leader and past president of the California Health Information Management Association, Gloryanne Bryant, reports this developing story.
The Dunn Report: National HIM expert and past American Health Information Management Association (AHIMA) President Rose Dunn returns to the broadcast with her fifth installment in her series on how HIM can play a role in other areas of the revenue cycle.
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, offers her unique blend of analysis and commentary on a current healthcare issue.

Coding Accuracy Assessment: Part II Jun 04, 2019

The cascading implications of inaccurate ICD-10 coding are explored during this edition of Talk Ten Tuesdays. We are revisiting this timely and important subject, featured during the May 21 edition of the broadcast. Guest co-host Holly Louie returns to continue her reporting on how coding inaccuracies impact compliance and payment issues.
The live broadcast will also feature these other segments:

Tuesday Focus: The trend of mobile monitoring and moving the intensive care monitoring unit out into the community to improve care, thus allowing people to age safely and gracefully in their homes, will be reported on when Nick van Terheyden, MD, AKA, “The Incrementalist,” returns to the broadcast.
RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional turned well-known healthcare IT authority, reports on the latest regulatory news coming out of Washington, D.C.
News at 11: Rhonda Buckholtz, chief compliance officer for Century Vision Global, reports on the new codes for corneal dystrophy in ICD-11.
Mental Health Report: A recent Journal of the American Medical Association (JAMA) study shows that the suicide rate among girls 10 to 14 has been increasing faster than it has for boys in the same age bracket. Providing context and insight into this disturbing trend will be a nationally renowned psychiatrist and author H. Steven Moffic, MD.
The Coding Report: Laurie Johnson will report on burnout, since the topic is now an official diagnosis in ICD-11, according to the World Health Organization (WHO). Johnson is a senior healthcare consultant at Revenue Cycle Solutions, LLC.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.

Coding Accuracy Assessment: The News not Good May 21, 2019

Central Learning is a web-based coding assessment and education application. Since 2016, the company has conducted an annual national coding review to measure ICD-10 coding accuracy and production.
The initial intent was to evaluate how coding accuracy and production fared using ICD-10, as compared to ICD-9. The common industry accuracy benchmark under ICD-9 was 95 percent.
The findings in 2018 indicated that the industry at large still lags far behind past expectations. In addition, as production under ICD-10 increases, accuracy decreases. Reporting our lead story during the next edition of Talk Ten Tuesdays will be Holly Louie, past president of the Healthcare Business and Management Association (HBMA) and guest co-host.
The live broadcast will also feature these other segments:

Tuesday Focus: Justin Hammerling, president of Kapios Health and vice president of ProMedica, reports on the disconnect between doctors and coders when scheduling inpatient surgeries.
The CDI Report: Dr. James Kennedy, physician, certified coder, and clinical documentation improvement (CDI) specialist, reports on strategies you can use to appropriately upgrade your action plan for coding additional inpatient diagnoses.
Coding Life in Transition: Nationally recognized professional physician coder and auditor Terry Fletcher reports on coding for transitional care management (TCM) for patients with medical and/or psychosocial problems requiring moderate or high-complexity medical decision-making.
Revenue Cycle Report: Bonnie S. Cassidy, nationally renowned health information management (HIM) authority, reports on why the mid-revenue cycle has traditionally been under-resourced.
News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent anchors the Talk Ten Tuesdays News Desk.

Advanced Care Planning: Now is Always a Good Time to Plan May 14, 2019

Physicians and mid-level providers are having some serious conversations with patients regarding advanced care planning (ACP) – meaning the discussion of a serious illness and the next steps they need to take regarding advanced directives, hospice, skilled nursing, pre, and post-death arrangements, and more.
These discussions are now payable under most health insurance plans, including Medicare, but you need to be walked through the steps of these important conversations first, then consider the options, for coding, billing, and reimbursement. Most practices have been providing this important service for years, but have never charged for it.
Nationally recognized professional physician coder and auditor Terry Fletcher will be reporting our lead story during this edition of Talk Ten Tuesdays, she will discuss ACP directives and regulatory insight you need to get started.
The live broadcast will also feature these other segments:

Tuesday Focus: The American Hospital Association’s (AHA’s) quarterly ICD-10-CM/PCS Coding Clinic addresses questions and challenges associated with clinical coding and helps ensure that compliant coding is practiced. The ICD10monitor webcast series on this topic updates coders with the latest information. Reporting on the most recent update is Gloryanne Bryant.
The Coding Report: Laurie Johnson, a senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on the latest coding news.
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, will offer her unique blend of analysis and commentary on a current healthcare issue.

Computer-Assisted Coding and Artificial Intelligence: The Same, or Different? May 07, 2019

If there’s an industry buzzword that is heard most often in today’s healthcare discourse, it might be “artificial intelligence” (AI).
And just as the advent of the computer presaged concerns about job loss, the same could be said today about AI, especially when it comes to coding. But before AI came into vogue, computer-assisted coding (CAC) and the use of natural language processing (NLP) appeared to be a potential job killer.
Reporting on AI and CAC during this edition of Talk Ten Tuesdays is Lamon Willis, Director of Coding for Velocity Healthcare Collaborative in central Georgia.
The live broadcast will also feature these other segments:

The Coding Report: Laurie Johnson continues her reporting on the proposed 2020 Inpatient Prospective Payment System, proposed procedure codes and also has an update on the dramatic surge in the outbreak of measles in the U.S. Johnson is a senior healthcare consultant at Revenue Cycle Solutions, LLC.
Tuesday Focus: Death by shootings, accidents and illnesses leave survivors in the throes of grief. And while grief is real, there’s confusion in the coding world (DSM 5 and ICD-10) about when grieving is a normal human process and when it turns into something pathological. Reporting this complex issue is nationally renowned psychiatrist H. Steven Moffic.
News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent anchor 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 a timely subject that have caught her attention she’s like to share with listeners.

2020 IPPS Proposed Rule: Context, Perspective, and Analysis Apr 30, 2019

Proposed changes to the Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System were posted late Tuesday by the Centers for Medicare & Medicaid Services (CMS).
And while the dust has yet to settle, the proposals are sending shockwaves through the coding and clinical documentation integrity (CDI) communities. Context, perspective, and analysis of the proposed IPPS rule will be provided during the next edition of Talk Ten Tuesdays.
The live broadcast will also feature these other segments:

The Coding Report: Laurie Johnson reports on the proposed coding changes outlined in the IPPS rule. Johnson is a senior healthcare consultant at Revenue Cycle Solutions, LLC.
RegWatch: Stanley Nachimson, former CMS career professional turned well-known healthcare IT authority, provides much-needed context on the proposed rule.
News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent anchors the Talk Ten Tuesdays News Desk.
The Dunn Report: National health information management (HIM) expert and past American Health Information Management Association (AHIMA) President Rose Dunn returns to the broadcast with another edition of her series on how HIM can play a role in other areas of the revenue cycle.
TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, offers her unique blend of analysis and commentary on the proposed IPPS rule.

Peer-to-Peer Reviews: Virtually Speaking Apr 23, 2019

The patient’s physician requests the treatment advice of another physician consultant, but without a face-to-face encounter with the patient and that consultant. Is this a billable situation? Traditionally No. But since 2018 and even now, more specifically, CPT® codes in 2019, "virtual" peer reviews are a covered benefit for most payers. This is new territory when it comes to insurance coverage, especially since these services are not subject to telehealth rules or restrictions Medicare has put on other telemedicine services. What’s the solution? Nationally recognized professional physician coder and auditor Terry Fletcher will be analyzing this situation when she reports our lead story during this edition of Talk Ten Tuesdays.
The broadcast will also feature these other segments:

Tuesday Focus: Rhonda Buckholtz, chief compliance officer for Century Vision Global, reports why the need for creating a culture of compliance in coding and documentation is so important.
The Coding Report: Laurie Johnson reports on the release of the proposed 2020 Inpatient Prospective Payment System for inpatient rehabilitation facility (IRF). Johnson is a senior healthcare consultant at Revenue Cycle Solutions, LLC.
News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent will anchor 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, continues her reporting on the conference she attended called, “Electronic Health Records and Patient Safety: Legal Challenges and Solutions.”

Removing the Speed Bumps from ICD-11 Adoption: Part II Apr 16, 2019

Fresh from her meeting last week at the World Health Organization (WHO) Morbidity Reference Group in Malmo, Sweden, Margaret Skurka returns to Talk Ten Tuesdays this Tuesday to report on ICD-11 – the new code set that is expected to be released next month by the WHO. Skurka reports on how countries are approaching the implementation of ICD-11. (see ICD11 training videos)

Skurka is the past president of the International Federation of Health Information Management Associations, IFHIMA, and the current IFHIMA/AHIMA representative to the WHO Family of International Classifications Education and Implementation Committee. That committee does work on ICD-11, as well as on improving the quality of coded data internationally while recognizing coders around the world.

This broadcast will also feature these other segments:

Tuesday Focus: Reporting on the challenges associated with ICD-10-PCS coding of cardiovascular surgery is senior healthcare consultant Kristi Pollard, who is with the Haugen Consulting Group. Read Kristi's article that relates to her segment.
The ICD-10 Coding Report: Laurie Johnson reports on the latest ICD-10 codes that are making national news. Johnson is a nationally recognized coding authority and senior healthcare consultant at Revenue Cycle Solutions, LLC.
Dateline Washington: Leslie Krigstein, vice president of congressional affairs for the College of Health Information Management Executives (CHIME), reports on the latest healthcare news coming out of Washington, D.C.
News Desk: Timothy Powell, a compliance expert, and ICD10monitor national correspondent will anchor 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 another thought-provoking topic that has captured her attention.

2020 Changes in Risk-Adjusted Reimbursement Apr 09, 2019

What’s next, when it comes to risk-adjusted reimbursement?

Home health is next. Just like diagnosis-related groups (DRGs) and hierarchical condition categories (HCCs), the patient-driven groupings model (PDGM) represents another tremendous opportunity for the health information management (HIM) professional because of the nationwide demands for ICD-10 expertise.

The Centers for Medicare & Medicaid Services (CMS) is moving home health agencies away from a volume-based payment model and toward this new value-based payment system. During this edition of Talk Ten Tuesdays, where we hear from Bonnie S. Cassidy, past president of the American Health Information Management Association (AHIMA), who will share important news on the PDGM program.

The broadcast will also feature these other segments:

CDI Report: Glenn Krauss, nationally recognized clinical documentation improvement (CDI) expert, reports on the top 25 DRGs with improper payment due to insufficient documentation, medical necessity, and coding – and how while optimization through queries might help, the bottom line is getting paid.
News Desk: Timothy Powell, a compliance expert, and ICD10monitor national correspondent anchors the Talk Ten Tuesdays News Desk.
Coding Report: Senior healthcare consultant Laurie Johnson returns to the broadcast to report on the diseases and the corresponding codes that are making the news.
TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., and Talk Ten Tuesdays co-host, will report on the development of the DRG: the backbone of the current prospective payment system.

Materials from Dr. Remer's segment

CDI in the UAE: AHIMA World Congress Apr 02, 2019

Clinical documentation integrity (CDI) is seen through an international lens as the contributions of the American Health Information Management Association’s (AHIMA’s) World Congress are recognized during this edition of Talk Ten Tuesdays. The broadcast will usher in the global celebration, coming just in advance of World Health Day on April 7.

Joining the broadcast will be Alexandre Bouché, who created a new international arm of AHIMA –- the AHIMA World Congress (AWC) –- to help its members achieve their full potential and professional recognition in the Middle East, Southeast Asia, and European markets.

This broadcast will also feature these other segments:

CDI Report: Dr. Wilbur Lo provides an overview of the methodology of International-Refined (IR-DRGs). Dr. Lo also reports on how providers in the United Arab Emirates (UAE) are experiencing additional annual revenue, improved patient care and quality of data outcomes based on a gap analysis performed by AWC.
News Desk: Timothy Powell, a compliance expert, and ICD10monitor national correspondent anchors the Talk Ten Tuesdays News Desk.
RegWatch: Leading healthcare technology consultant Stanley Nachimson returns with his popular segment, through which he reports on the latest regulatory changes coming out of Washington, D.C.
TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on opioids – a topic that continues to generate national attention.

Surprise Balance Billing Issues: Part II Mar 26, 2019

Surprise balance billing is an issue that is not only generating national interest but also legislative engagement on the state level. In Part I of this series, Holly Louie, past president of the Healthcare Business and Management Association, reported on such billing related to insurance company denials. For Part II, Matthew Albright, former Director of the Administrative Simplification Group at the Centers for Medicare & Medicaid Services (CMS), reports on billing laws on the state level, as well as billing protections by the U.S. Senate.

Albright examines trends in surprise balance billing laws being seen passed in the states, specifically with regard to reimbursement benchmarks. And touches on what states are considering balance bill laws in their 2019 legislative sessions and what the status is on the U.S. Senate’s bipartisan efforts in this area.

The broadcast will also feature these other segments:

The ICD-10 Coding Report: Nationally recognized coding authority Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, will be reporting on latest coding news.
CDI Report: Mel Tully, vice president of clinical services and education for the healthcare division of Nuance Communication, will report on compliance issues associated with clinical documentation integrity.
News Desk: Timothy Powell, a compliance expert, and ICD10monitor national correspondent will anchor the Talk Ten Tuesdays News Desk.
The Dunn Report: National health information management (HIM) expert and past American Health Information Management Association (AHIMA) President Rose Dunn returns to the broadcast with a series on how HIM can play a role in other areas of the revenue cycle.
TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., and Talk Ten Tuesdays co-host, once again reports on SIRS, Sepsis, and Rule No. 1.

Removing the Speed Bumps from ICD-11 Adoption Mar 19, 2019

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:

Coding Report: World Kidney Day was celebrated on March 13, 2019. Laurie Johnson provides some information about chronic kidney disease and its complications along with the coding of this chronic condition. Johnson is a nationally recognized coding authority and senior healthcare consultant at Revenue Cycle Solutions, LLC.
News Desk: As expected, the American Medical Association’s (AMA’s) CPT® editorial board last month approved major changes to documentation and code selection guidelines for evaluation and management (E&M) codes. The changes were announced last week and are expected to become effective in 2021. Reporting this developing story from the Talk Ten Tuesdays News Desk will be Dr. Jeffrey Lehrman, a practicing podiatrist, and consultant to the Health Policy and Practice Department of the American Podiatric Medical Association.
Tuesday Focus: Virtual check-ins are the new Centers for Medicare & Medicaid Services (CMS) communications technology-based payable service. Reporting this important story is nationally recognized professional physician coder and auditor Terry Fletcher.
TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on the events that took place during this week’s national conference of the American College of Physician Advisors.

Welcome, Madam President Mar 12, 2019

We are honored to welcome the President and Chair of the 2019 American Health Information Management Association (AHIMA) Board of Directors, Valerie Watzlaf, Ph.D. to this edition of Talk Ten Tuesdays.

Dr. Watzlaf is vice chair of education and associate professor within the Department of Health Information Management (HIM) in the School of Health and Rehabilitation Sciences (SHRS) at the University of Pittsburgh. She also holds a secondary appointment in the Graduate School of Public Health. In those capacities, she teaches and performs research in the areas of HIM, epidemiology, quality improvement, statistics, and long-term care. Welcome, Dr. Watzlaf.

This broadcast will also feature these other segments:

The ICD-10 Coding Report: Chronic conditions have been in the news lately and Laurie Johnson reports on the ten most expensive conditions with regards to ICD-10 codes as well as clinical documentation and HCC impacts. Johnson is a nationally recognized coding authority and senior healthcare consultant at Revenue Cycle Solutions, LLC.
News Desk: Timothy Powell, a compliance expert, and ICD10monitor national correspondent anchors the Talk Ten Tuesdays News Desk.
RegWatch: Leading healthcare technology consultant Stanley Nachimson returns with his popular segment, through which he reports on the latest regulatory changes coming out of Washington, D.C.
GuestTalk: Holly Louie, past president of the Healthcare Business and Management Association and the compliance officer for Professional Management, Inc. (PMI), will report on healthcare billing issues that have captured her attention of late.
Click here to view the link mentioned by Stanley Nachimson in his segment RegWatch

Advocating for CDI Mar 05, 2019

As the clinical documentation integrity (CDI) industry continues to grow beyond the traditional inpatient setting, the American Health Information Management Association (AHIMA) is working to provide best-practice resources to provider stakeholders from across the continuum of care. Sharing an update on AHIMA’s advocacy during this edition of Talk Ten Tuesdays will be Tammy Combs, the Association’s director of HIM practice excellence.

The live broadcast will also feature these other segments:

The ICD-10 Coding Report: Nationally recognized coding authority Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on the proceedings taking place during the first day of the Centers for Medicare & Medicaid Services (CMS) Coordination and Maintenance Committee meeting, which was scheduled to get underway Tuesday morning at CMS headquarters in Baltimore.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
SDoH Update: Returning to the Talk Ten Tuesdays broadcast to report on the developing story of social determinants of health (SDoH) will be nationally recognized SDoH authority, author, and educator Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP, the founder of EFS Supervision Strategies, LLC.
TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on a current healthcare issue that has caught her attention during her popular TalkBack segment.

Reporting and Coding Separate Procedures: What Coders Need to Know Feb 26, 2019

Many procedures in the CPT® codebook are designated "separate procedures," but that doesn't mean you can report those procedures "separately" in every case, according to nationally recognized professional coding expert Terry Fletcher, who returns to Talk Ten Tuesdays to offer insight into this topic.
Join Dr. Erica Remer and Dr. Juliet Ugarte Hopkins as they host the podcast, which also features these other segments:

The ICD-10 Coding Report: Nationally recognized coding authority Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on latest coding news.
News Desk: Timothy Powell, a compliance expert, and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
The Dunn Report: National health information management (HIM) expert and past American Health Information Management Association (AHIMA) President Rose Dunn returns to the podcast with a series on how HIM can play a role in other areas of the revenue cycle.
Guest Talk: Juliet Ugarte Hopkins, MD, CHCQM, physician advisor for case management, utilization, and clinical documentation at ProHealth Care, co-hosts the podcast along with Dr. Erica Remer, who is substituting for Talk Ten Tuesdays publisher and host Chuck Buck.

New Patient versus Established Patient: The Coder’s Dilemma Feb 12, 2019

Knowing how to distinguish new patients from established patients, apart from ensuring that coding guidelines are being followed, enables you to be reimbursed for the additional work that new patient visits warrant. Moreover, in some cases, not distinguishing new patients from established patients can amount to shortchanging yourself, as you will learn during this edition of Talk Ten Tuesdays, when Terry Fletcher returns to the broadcast to report on evaluation and management (E&M) coding.
Other segments to be featured on the broadcast include:

The I 10 Coding Report: Yellow fever has been reported in the Americas, and this can be prevented – a warning for people who are planning trips to the Caribbean or Latin America. Nationally recognized coding authority Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on this new travel advisory.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
Dateline Washington: Talk Ten Tuesdays legislative analyst Rhonda Taller has the latest news coming out of Washington, D.C. Rhonda is a member of the HIMSS professional development committee.
Tuesday Focus: Sepsis 2 versus Sepsis 3 The Healthcare Association of New York State (HANYS) and Greater New York Hospital Association (GNYHA) were scheduled to meet with New York’s Department of Health (DOH) on Feb. 12 to discuss the health plans' continued use of the Sepsis 3 definition for reviewing claims. New York continues to use the Sepsis 2 definition. Dennis Jones, the administrator of patient financial services for Montefiore Nyack Hospital, reports on the backstory.
Guest Talk: Holly Louie, past president of the Healthcare Business and Management Association and the compliance officer for Professional Management, Inc. (PMI), reports on healthcare billing issues that have captured her attention of late.

ICD-11: It’s Coming – So Start Planning Now Feb 05, 2019

Although still lingering on the horizon, much like a coming storm, ICD-11 is fast approaching – which is why the new code set is on the radar screen at the American Health Information Management Association (AHIMA). In fact, AHIMA reports that it has begun conducting research aimed at addressing coding in order to determine how productivity, accuracy, and quality can be improved across all settings.

Reporting on ICD-11 and how AHIMA is preparing its members for the next coding milestone during the next edition of Talk Ten Tuesdays will be Julie Dooling, AHIMA’s director of health information management (HIM) practice excellence.

Other segments to be featured on the broadcast include:

The I-10 Coding Report: Are there codes for the extreme cold weather that’s impacting much of the nation? Nationally recognized coding authority Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, will be reporting on ICD-10 coding for this freezing cold, specifically, associated conditions and external cause codes.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk-Ten-Tuesdays News Desk.
RegWatch: Leading healthcare technology consultant Stanley Nachimson will return with his popular segment, through which he reports on the latest regulatory changes coming out of Washington, D.C.
TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on coding cardiac arrest and will highlight her reporting with a listener poll.

Sepsis-3 versus Sepsis-2: In Search of an Offramp Jan 29, 2019

The fallout continues over the recent announcement by UnitedHealthcare (UHC) that it would not use Sepsis-3 when reviewing claims to validate sepsis for payment from providers in the Empire State. New York state law defines sepsis with systemic inflammatory response syndrome (SIRS) criteria, otherwise known as Sepsis-2.

Reporting on Sepsis-3 during the next edition of Talk Ten Tuesdays will be broadcast co-host Erica Remer, MD, founder and president of Erica Remer, MD, Incorporated. Dr. Remer will share insights from a targeted sepsis project that should help clarify how your facility should approach sepsis.

Other segments to be featured on the broadcast include:

Coding Report: The upcoming Super Bowl LIII on Feb. 3 reminds many of the consequences of chronic traumatic encephalopathy (CTE). Nationally recognized coding authority Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on CTE.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
The Dunn Report: National health information management (HIM) expert and past American Health Information Management Association (AHIMA) President Rose Dunn returns to the broadcast with a series on the revenue cycle and how HIM can play a role in other areas of the revenue cycle.
Tuesday Focus: The Patient Protection and Affordable Care Act: A federal judge in Texas, U.S. District Judge Reed O'Connor, recently struck down the Affordable Care Act as unconstitutional, ruling that the individual mandate could not be severed from the rest of 44th President Barack Obama's landmark healthcare law. Pending appeal, however, the law remains in place. And what that means for coders will be reported on by Terry Fletcher, a nationally recognized professional provider coding authority.

Code or Not to Code: Revisiting ICD-10-CM Guidelines Jan 22, 2019

"The assignment of a diagnosis code is based on the provider’s diagnostic statement that the condition exists. The provider’s statement that the patient has a particular condition is sufficient. Code assignment is not based on clinical criteria used by the provider to establish the diagnosis." — ICD-10-CM guideline I.A. 19
This guideline is frequently cited as the reason coders list diagnoses because the doctor said so. But is the doctor’s say-so enough? Reporting on this recurring issue during the next edition of Talk-Ten-Tuesdays will be broadcast co-host Erica Remer, MD, founder and president of Erica Remer, MD, Incorporated.
Other segments to be featured on the broadcast include:

Coding Report: It’s the flu season in the United States, with most activity expected to peak between now and February. Nationally recognized coding authority Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, will be reporting on this developing story.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk-Ten-Tuesdays News Desk.
HIM Report: Julie Dooling, American Health Information Management Association (AHIMA) director of Health Information Management (HIM) Practice Excellence, will report on the Government Accountability Office (GAO) investigation of the different approaches being used and challenges being faced by hospitals seeking to achieve accurate patient matching.
Tuesday Focus: CMS Advanced Practitioner Professional (NPP) Billing: Many providers are still struggling with the NPP billing rules from the Centers for Medicare & Medicaid Services (CMS). Author and educator Deborah Grider, senior healthcare consultant for Karen Zupko and Associates, will report on the need for greater understanding of this complex issue.

Social Determinants of Health: Healthcare Issues Outside Your Hospital Are Affecting What Happens Inside Jan 15, 2019

Social determinants of health (SdoH) are swamping hospitals like rising rivers following a storm. A reported $1.7 trillion in healthcare costs are now attributed to 5 percent of the nation’s population, with a majority of that sum related to the SdoH.
And while the focus has been largely on the most vulnerable and disenfranchised members of populations, the new face of SDoH is evolving as a consequence of an increase of natural and manmade disasters, as well as new attention being given to longstanding issues such as rural health, human trafficking, business closures, and loss of pensions for an increasing number of older adults.
Returning to Talk Ten Tuesdays to report on this developing story is nationally recognized SDoH authority, author, and educator Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP, the founder of EFS Supervision Strategies, LLC.
Other segments to be featured on the broadcast include:

Coding Report: Coders will be dealing with new payment models in 2019, including one for skilled nursing facilities (SNFs) expected to be released on Oct. 1. Nationally recognized coding authority Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports this developing story.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
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.
DocTalk: Talk Ten Tuesdays guest co-host Juliet Ugarte Hopkins, MD, CHCQM, physician advisor of case management, utilization, and clinical documentation at ProHealth Care, reports on the collaboration between coding, clinical documentation integrity, and physician advisors when facing clinical validation denials.

Mystery Disease: Latest Update on AFM Dec 12, 2018

The mystery continues.

At the time of this report there were a reported 116 confirmed cases of acute flaccid myelitis (AFM) across 31 states, with the most cases reported in Colorado (15) and Texas (14). Plus, there are another 170 possible cases that haven’t been confirmed.

AFM is similar to polio and leads to a sudden onset of paralysis. This condition mostly affects children younger than 4. These patients experienced a viral illness with fever and cough 3-10 days prior to the paralysis onset.

Returning to Talk Ten Tuesdays to report on this developing story will be Jennifer P. Rubin, MD, attending physician in the neurology division of Northwestern University’s Feinberg School of Medicine.

Other segments to be featured on the broadcast include:

Tuesday Focus: There’s a reported fine line between coding for moderate sedation and monitored general sedation. Exploring this seemingly unchartered territory is Terry Fletcher, a nationally recognized professional physician coding consultant, educator, and auditor.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
Dateline Washington: Talk Ten Tuesdays legislative analyst Rhonda Taller has the latest news coming out of Washington, D.C. Rhonda is a member of the HIMSS professional development committee.
TalkBack: Talk Ten Tuesdays co-host Erica 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.

Perilous Compliance Challenges Facing Today’s New Coders Dec 04, 2018

Never before has the responsibility of an organization to provide clear, facility-specific guidelines and in-depth training for coders been more apparent than it is today – especially now with the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) poised to conduct diagnosis-related group (DRG) validation audits. Reporting our lead story during this edition of Talk Ten Tuesdays will be Cari Greenwood who will discuss how your team should intensify training –- particularly when it comes to assigning correct codes for high-frequency, problem-prone, and high-cost diagnoses.

Other segments to be featured on the broadcast include:

News Desk: Mary A. Inman, partner at Constantine Cannon’s London office, reports on the expected dismissal of the $188.1 million False Claims Act lawsuit filed by Med Analytics, LLC against Providence Health, now Providence St. Joseph, for allegedly upcoding various diagnoses.
RegWatch: Leading healthcare 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.
Tuesday Focus: The Office of Disease Prevention and Health Promotion (ODPHP), on behalf of the Federal Interagency Steering Committee for Adverse Drug Events, recently released its final version of the National Action Plan for Adverse Drug Event Prevention (ADE Action Plan). Reporting on this developing story will be Ronald Hirsch, MD, vice president of R1 Physician Advisory Services.
CDI Report: ICD10monitor contributor Glenn Krauss continues his reporting on clinical documentation integrity, but this time, he will focus on the recent decision by HHS OIG to conduct DRG validation audits.
TalkBack: Talk Ten Tuesdays co-host Erica 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.

To Link, or not to Link: That is the Question for Physician Documentation Nov 27, 2018

Are you experiencing this dilemma at your facility? You ask your physicians to add linking verbiage to their documentation for accuracy, which in turn has a negative impact on their publicly reported scores regarding complications and other metrics. Should physicians exclude the linking verbiage? Should they enter “as expected,” or should they simply avoid addressing these issues? Reporting on this complex issue during the next edition of Talk Ten Tuesdays will be Sharon Savinsky, clinical documentation improvement specialist (CDIS) team manager at Winchester Medical Center in Winchester, Va.

Other segments to be featured on the broadcast include:

News Desk: Laurie Johnson will anchor the Talk Ten-Tuesdays News Desk. Johnson is a senior healthcare consultant with Revenue Cycle Solutions, LLC and an ICD10monitor contributor.
Coding Report: Although the Centers for Medicare & Medicaid Services (CMS) has released the final rule on the 2019 Medicare Physician Fee Schedule (MPFS), Dr. Jeffrey Lehrman will report on one issue that CMS did not include in its extensive update.
Tuesday Focus: Alarms are being sounded because of the clinical and privacy issues being raised as a result of offshore coding. Terry Fletcher, a nationally recognized professional physician coding consultant, educator and auditor, will report this developing story.
TalkBack: Talk Ten Tuesdays co-host Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., will report on the recent decision by U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) to conduct DRG validation audits.

The Enigma of Sepsis: Providers vs. Payers Nov 13, 2018

When it comes to defining sepsis, who wins? Is it providers, who rely on the current definition of sepsis as “life-threatening organ dysfunction caused by a dysregulated host response to infection?” Or do payers prevail – the ones who control the reimbursement? And under what circumstances would you ever side with a carrier that has denied a claim of sepsis?

Reporting our lead story during this edition of Talk Ten Tuesdays will be Roland Dale, responsible for denials prevention, for Hardin Medical Center, who shares his experience in these situations while offering important and timely advice.

Other segments to be featured on the broadcast include:

News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
Dateline Washington: Talk Ten Tuesdays legislative analyst Rhonda Taller has the latest news coming out of Washington, D.C. Rhonda is a member of the HIMSS professional development committee.
Tuesday Focus: The Centers for Medicaid & Medicare Services (CMS) last week released the final rule on the 2019 Medicare Physician Fee Schedule (MPFS) and the Quality Payment Program (QPP). Reporting this developing story is Dheeraj Mahajan, MD, president and CEO of Chicago Internal Medicine Practice and Research (CIMPAR, SC), who leads its affiliated group of companies.
TalkBack: Talk Ten Tuesdays co-host Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., will report on the Global Leadership Initiative on Malnutrition (GLIM) during her popular TalkBack segment.

Physician Burnout and PTSD: How Traumatic Events Impact Care Nov 06, 2018

The tragic events that shocked the nation’s collective conscience on an otherwise peaceful recent Saturday morning call to mind the intersection of physician burnout and post-traumatic stress syndrome.

With physician burnout reported to be widespread and suicides among physicians escalating at an alarming rate, do disasters – both natural and manmade – disproportionately impact the profession? Or are there other conflicts endemic to healthcare that tear at the emotional and mental health of physicians, thus creating a sense of helplessness?

Reporting on our lead story during this edition of Talk Ten Tuesdays will be Dr. Tracy Sanson, a practicing emergency physician, consultant, and educator on leadership development and medical education. A national and international speaker, Dr. Sanson also serves as a core faculty member for the American College of Emergency Physicians.

Other segments to be featured on the broadcast include:

CDI Report: What does the future of clinical documentation integrity (CDI) look like? Mel Tully, vice president of clinical services and education for the healthcare division of Nuance Communication, reports on the evolution of CDI as an integrated, interdisciplinary function impacting patient care.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesday News Desk.
Tuesday Focus: Julie Dooling, a director at the American Health Information Management Association (AHIMA), reports on health information management challenges and tips for hospitals and other healthcare organizations in the aftermath of a hurricane, specifically in light of the devastation recently brought by Hurricane Michael.
RegWatch: Leading healthcare technology consultant Stanley Nachimson returns to the broadcast to report on the final rules for the Medicare Physician Fee Schedule and the Quality Payment Program (QPP) that were released by the Centers for Medicare & Medicaid Services (CMS) on Thursday.
TalkBack: Talk Ten Tuesdays co-host Erica 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.

ICD-10 Official Guidelines versus Coding Clinic for ICD-10-CM-PCS Oct 30, 2018

The FY 2019 Official Guidelines for Coding and Reporting versus the American Hospital Association (AHA) third-quarter Coding Clinic: when it comes to coding body mass index (BMI), there’s a contradiction.

The Guidelines say BMI codes should only be assigned when the associated diagnosis meets the definition of a reportable diagnosis. AHA guidance states that obesity is always coded, even without supporting clinical significance. What’s a coder to do?

During this edition of Talk Ten Tuesdays, James Kennedy, MD offers timely and practical advice on how to handle and resolve this issue.

Other segments to be featured on the broadcast include:

Coding Report: ICD-11 is being touted for its complexity and granularity, as you’ll learn when national health information management (HIM) expert and past American Health Information Management Association (AHIMA) President Rose Dunn returns to the broadcast.
CDC Report: It’s flu season, and the Centers for Disease Control and Prevention (CDC) is recommending an annual influenza vaccination for patients six years and older. But is there more to be done? Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC and an ICD10monitor contributor, reports the latest news from the CDC.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesday News Desk.
Tuesday Focus: Telemedicine is at a tipping point, expanding far beyond interactions between physicians and patients into entirely new ways to deliver healthcare and practice medicine. Where do ICD-10 and CPT® fit into this virtual delivery of medicine? That’s the question, and nationally recognized professional physician coding authority Terry Fletcher has the answers.

Understanding the Definition of Sepsis-3: The Sepsis Saga Continues Oct 23, 2018

UnitedHealthcare (UHC) has thrust Sepsis-3 into the national healthcare conversation with its recent announcement that come Jan. 1, 2019 it use the SEP-3 definition to determine if a diagnosis of sepsis is clinically validated, advising that the Sequential (sepsis-related) Organ Failure Assessment (SOFA) score is to be used to determine if sepsis is present. Although the definition of Sepsis-3 was announced in February 2016, its acceptance has become more widespread as you learn when Dr. Edward Hu addresses this timely subject during this edition of Talk Ten Tuesdays. Dr. Hu is the executive director of Inpatient Physician Advisor Services for the University of North Carolina Health Care System and president of the American College of Physician Advisors.

Other segments to be featured on the broadcast include:

Coding Report: The fourth-quarter 2018 issue of AHA’s (the American Hospital Association’s) Coding Clinic for ICD-10-CM/PCS has been released. Gloryanne Bryant reports on its significance.
News Desk: Canada is now the second country following Uruguay to legalize the sale and recreational use of marijuana, although medical marijuana has been legal since 2001. Following up on an ICD10monitor exclusive story on medical marijuana on Oct. 9, is Timothy Powell, compliance expert and ICD10monitor national correspondent.
Tuesday Focus: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC and an ICD10monitor contributor, reports on acute flaccid myelitis (AFM), a polio-like condition that mostly affects children. Joining the discussion is also Jennifer P. Rubin, MD, attending physician, Division of Neurology, Assistant professor of Pediatrics, Northwestern University Feinberg School of Medicine
TalkBack: Talk Ten Tuesday co-host Erica Remer, MD reports on the first of her two-part series on diabetic foot ulcers versus pressure ulcers.

Third-Quarter AHA Coding Clinic: A Developing Story Oct 16, 2018

The third-quarter 2018 issue of AHA’s (the American Hospital Association’s) Coding Clinic for ICD-10-CM/PCS has been released, and during this edition of Talk Ten Tuesdays, Gloryanne Bryant will report on its significance.

Other segments to be featured on the broadcast include:

News Desk: Daniel Zirkman, MD, anchors the Talk Ten Tuesdays News Desk with the very latest news on hospitals in the disaster zone, coping with the aftermath of Hurricane Michael. Zirkman rode out Hurricane Florence from his hospital, CarolinaEast Health System, in New Bern, North Carolina, where he is chief physician advisor.
Tuesday Focus: Rhonda Buckholtz, chief compliance officer for Century Vision Global, reports on a recent study her organization undertook involving certified coders and clinical documentation integrity specialists (CDISs).
Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC and an ICD10monitor contributor, reports on the very public health issue being faced by radio personality Marty Griffin of KDKA. Griffin recently announced to his listening audience that he has cancer related to human papilloma virus (HPV), which infects 80 million people, according to the Centers for Disease Control and Prevention (CDC).
CDI Report: ICD10monitor contributor Glenn Krauss continues his reporting on clinical documentation integrity, but this time, Krauss will focus on what he describes as the “query quagmire,” in which too much emphasis is placed upon the query process without changing physician patterns of documentation.
Parting Shot: Guest co-host Deborah Grider, consultant, educator and AMA author, reports on the recurring issue of cloned documentation.

ICD-10 Coding of Medicinal Marijuana: Developing Story Oct 09, 2018

Medical marijuana allows chronically ill patients to relieve painful, often debilitating symptoms legally instead of taking pills that many claim are mostly unhelpful. So why are there are no valid codes for submission for payment in the Current Procedural Terminology® (CPT), Healthcare Common Procedural Coding System (HCPCS), or National Drug Code (NDC) for medical marijuana?

The current state of claims payments for medical marijuana clearly has yet to be defined. So, what is the answer? Reporting this timely story during this edition of Talk Ten Tuesdays will be Terry Fletcher, a nationally recognized professional physician coding expert.

Other segments to be featured on the broadcast include:

News Desk: Larry Field, DO, anchors the Talk Ten Tuesdays News Desk with the very latest healthcare news. Field is the treasurer of the American College of Physician Advisors.
Tuesday Focus: Two new studies point to the alarming issue of physician burnout. The Journal of the American Medical Association (JAMA) reported that resident physicians’ symptoms of burnout and career choice regret have become increasingly prevalent. And the Physician’s Foundation’s 2018 Survey of America’s Physicians reported that physicians feeling burned out increased from 74 percent in 2016 to 77.8 percent in 2018. We report on this topic with two perspectives: Physician Michael Salvatore with Beebe Healthcare, and H. Steven Moffic, nationally renowned psychiatrist, will both share their reactions to this epidemic.
TalkBack: Talk Ten Tuesdays co-host Erica 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.

New ICD-10 Codes Address Human Trafficking Oct 02, 2018

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.™

Fourth Universal Definition of Myocardial Infarction: The Coder and the Cardiologist Sep 25, 2018

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.™

2019 IPPS Updates: Reviewing Major Disease Category 18 Sep 18, 2018

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™

ICD-10 Coordination and Maintenance Committee Meeting: Live Reporting Sep 11, 2018

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.

Proposed E&M Changes: The Good, the Bad, and the Ugly (Part II) Aug 28, 2018

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.

Proposed E&M Changes: The Good, the Bad, and the Ugly Aug 21, 2018

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.™

Are HIM Coding Professionals Qualified to Query for Clinical Validity? Part II Aug 14, 2018

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.™

ICD-11: Hear the Latest Industry Buzz Aug 07, 2018

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.
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.

Talk Ten Tuesdays. More than just talk.™

Stressing Out About the Z Codes: Healthcare’s New Imperative Jul 31, 2018

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.™

Reporting Bronchoalveolar Lavage Documentation Nightmare for Docs, Quandary for Coders Jul 24, 2018

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 HIM Coding Professionals Qualified to Query for Clinical Validity? Jul 17, 2018

Are seasoned coding professionals competent or trained well enough to interpret clinical terms and concepts from the medical record? Although they have been doing so for decades, the question continues to remain contentious.

Reporting our lead story during this edition of Talk Ten Tuesdays will be Debra Beisel Denton, who works at Maricopa Integrated Health System as the health information management (HIM) system coding educator.

Other segments to be featured on the broadcast include:

News Desk: Dennis Jones, the patient financial services administrator at Nyack Hospital in Nyack, N.Y., will anchor the Talk Ten Tuesdays News Desk.

Tuesday Focus: Shannon DeConda, a nationally recognized evaluation and management (E&M) coding authority, reports on the 2019 proposed Medicare Physician Fee Schedule released Thursday by the Centers for Medicare & Medicaid Services (CMS). DeConda is founder of the National Alliance of Medical Auditing Specialists (NAMAS).
RegWatch: Leading 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.
TalkBack: TalkTen Tuesdays co-hostErica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., reports on a current issue that caught her attention during her popular TalkBack segment.

Talk Ten Tuesdays. More than just talk.™

A Cautionary Tale: Text Messaging Medical Orders Jul 10, 2018

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).
Physician Burnout: Continuing our coverage of physician burnout will be former emergency department physician-turned-consultant Tracy Sanson, MD.
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.™

The New Reality: ICD-11 Codes Jun 26, 2018

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.™

Coding and Documenting Sexual Harassment Jun 19, 2018

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.™

Introducing the Hybrid CDI Jun 12, 2018

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.™

2019 ICD-10-PCS Codes: New Details Revealed in Recently Released Files Jun 05, 2018

There are 78,881 ICD-10-PCS codes for fiscal year 2019. Of these there will be 392 new codes; eight revision titles; and 216 deleted codes, according to nationally recognized coding authority Gloryanne Bryant, who reports our lead story during this episode. The files, recently released by the Centers for Medicare & Medicaid Services (CMS), and first reported by ICD10monitor, contain information on the ICD-10-PCS updates that all hospital inpatient coding professionals are to use for discharges occurring from Oct. 1, 2018, through Sept. 30, 2019.

National Spotlight: Nonaccidental trauma (NAT): ICD10monitor contributor and Talk Ten Tuesdays co-host Erica Remer, MD, reports on a coding-clinical disconnect when documenting child abuse—a serious problem on many levels and a particular focus during this episode. Joining the discussion is Laura Hayman, RN, a clinical documentation integrity specialist with a Midwestern teaching facility which is a level 1 pediatric trauma center.
Tuesday Focus – SDoH: Ellen Fink-Samnick, an award-winning industry expert and author, reports on one of the hottest topics in healthcare—the Social Determinants of Health.
Talk Ten Tuesdays News Desk: Sherri Dumford, Director of External Affairs for the Healthcare Administrative Technology Association (HATA), reports on the X12 meeting in Florida. Chartered by the American National Standards Institute, the organization develops and maintains EDI standards that facilitate consistent electronic interchange of healthcare transactions.
TalkBack: Talk Ten Tuesdays co-host Dr. Erica Remer reports on news coming out of the recent national conference of the American College of Physician Advisors.

Talk Ten Tuesdays. More than just talk.™

Send in the Scribes: Medical Scribes to the Rescue May 22, 2018

Smoldering below the surface is burnout, and it’s taking a toll on physicians. With increasingly high rates of reported physician suicides and an alarming decline in the volume of medical school applications, this situation could be the nation’s next healthcare crisis. The good news: A study published in April’s World Journal of Urology reported that using scribes in a urology practice significantly increased physician efficiency, work satisfaction, and revenue. Enter Talk Ten Tuesdays special guest Dr. Suzette Sutherland, associate professor in the department of urology at the University of Washington School of Medicine. Dr. Sutherland reported on her facility’s training program and how using scribes is improving efficiency but also improving physician-patient relationships, patient satisfaction, and provider satisfaction, leading to less physician burnout.

Other segments to be featured on the broadcast include:

Tuesday Focus - Risk Adjustment: We had two reports on this trending topic: Sheri Poe Bernard, author of the American Medical Association 2018 publication “Risk Adjustment Documentation and Coding,” joined the broadcast to discuss her new book. And also reporting on the Tuesday Focus on risk adjustment was Marie A. Morin, director at Alvarez and Marsal Healthcare Industry Group LLC. Marie reported on risk adjustment payment methodologies.
Talk Ten Tuesdays News Desk: Larry Field, DO, anchored the Talk Ten Tuesdays News Desk and presented the very latest healthcare news. Dr. Field is the treasurer of the American College of Physician Advisors.
Coding Report: Nationally recognized coding and documentation authority Terry Fletcher will continued her report on errors she is uncovering in a review of more than thousands of records. Terry shared her findings in the third of a four-part series on auditing issues in physician documentation she is reporting exclusively for ICD10monitor.
CDI Report: The ICD10monitor contributor Glenn Krauss, the CDI manager at University Health Systems Las Vegas, reported on how CDI supports the ancient oath: “First, do no harm.

Talk Ten Tuesdays. More than just talk.™

New ICD-10 Codes for Women May 15, 2018

Whether it’s discussing equal pay for women healthcare professionals, uncovering #MeToo narratives in the medical profession, or examining studies comparing women physicians’ and surgeons’ outcomes favorably to men’s, there has never been a more important time for crucial conversations to take place about women’s health. And that is why National Women’s Health Week will be the subject of this special Talk Ten Tuesdays broadcast.

Other segments to be featured on the broadcast include:

Tuesday Focus: Lisa Banker, chief physician advisor and vice president for case management at McLeod Health in South Carolina, reported on her perspective on women’s health issues.
Talk Ten Tuesdays News Desk: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions LLC and ICD10monitor contributor, reported on the latest proposed codes for women’s health.
CDI Report: Kathy Murchland, manager of CDI for Kettering Health Network in Dayton, Ohio, reported on her career transition from an inpatient coder to successfully rebranding the facility’s CDI department as “Documentation Excellence.”
Women’s Health Report: Vinita Manoraj, MD CHCQM, medical director at Hackensack Meridian Health, reported on women’s health issues from her perspective.
TalkBack: Talk Ten Tuesdays co-hostErica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., reported on a disturbing news report about a medical student who was asked to perform a pelvic exam on a woman who had been anesthetized before having a surgical procedure.

Talk Ten Tuesdays. More than just talk.™

Chief Complaint and the Medical Necessity Imperative May 08, 2018

If there is no chief complaint, or no acute or chronic condition, auditors may not even continue with the record and negate its value altogether, according to nationally recognized coding and documentation authority Terry Fletcher, who is currently uncovering errors in an ongoing review of more than 1,000 records. During the next edition of Talk Ten Tuesdays, she will share her findings in the second of a four-part series on auditing issues in physician documentation.

Other segments to be featured on the broadcast include:

Tuesday Focus: There’s a strong emphasis to collect data about the opioid epidemic, specifically from individuals at risk or already addicted. But what are healthcare organizations doing with this information? Lesley Kadlec with the data analytics practice council at the American Health Information Management Association (AHIMA) reports on how the data can be used to respond to this crisis.
Coder Burnout: Confessions of a formerly burned-out coder will come from Kristi Pollard, a senior coding consultant at Haugen Consulting Group, who reports on 10 strategies to keep from feeling the burn.
Mental Health Report: Nationally renowned psychiatrist H. Steven Moffic, MD reported on new research that reveals burnout doesn’t just happen at work, but also at home. Dr. Moffic says that parental burnout can intertwine and interact with workplace burnout.
Talkback: Talk Ten Tuesdays co-host Erica Remer, MD returns with another installment of her popular segment.

Talk Ten Tuesdays. More than just talk.™

New ICD-10 Codes, New Challenges: Reporting on the IPPS Proposed Rule May 01, 2018

Not wishing to disappoint, the 2019 Medicare Inpatient Prospective Payment System (IPPS) proposed rule, released on Tuesday, has something for everyone. For coders and clinical documentation integrity specialists (CDISs), there are proposed new codes and tweaks to the MS-DRG methodology as well as changes in New Technology add-on payments. Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions LLC and ICD10monitor contributor, will report on the latest proposal from the Centers for Medicare & Medicaid Services (CMS).

Other segments to be featured on the broadcast include:

Tuesday Focus: Charles Stellar, president and CEO of the Workgroup for Electronic Data Interchange, took time from his busy schedule to discuss solving the Interoperability issues in healthcare to assure that different information technology systems and software applications can communicate and exchange data.
News Desk: Charles Locke, MD, a senior physician advisor of care coordination and clinical resource management at Johns Hopkins and an assistant professor at the Johns Hopkins School of Medicine, reported on the news coming from the National Physician Advisor Conference in Greenville, North Carolina.
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. Most notably, he reports on the IPPS proposed rule on EHR Meaningful use for hospitals.
Coding Report: Nationally recognized coding and documentation authority Terry Fletcher continues reporting on errors she is uncovered in a review of more than 1,000 records. Terry will share her findings in the second of a four-part series on auditing issues in physician documentation.

Talk Ten Tuesdays. More than just talk.™

Auditing Issues Uncovered in Physician Documentation Apr 24, 2018

It's auditing season, and nationally recognized coding and documentation authority Terry Fletcher will be reporting on errors she is uncovering in a review of more than 1,000 records. During this episode, she shares her findings in the first of a four-part series on auditing issues in physician documentation. While maintaining that CPT® and ICD-10 coding does become less risky when documentation is done properly, she offers corrective actions one can to take to prevent negative payer audits.

Other segments featured in this episode include:

News Desk: Larry Field, DO, anchors the Talk Ten Tuesdays News Desk and present the very latest healthcare news. Field is the treasurer of the American College of Physician Advisors.
CDI Report: The ICD10monitor contributor Glenn Krauss, the CDI manager at University Health Systems Las Vegas, reports on a holistic approach to documentation improvement versus a narrowly defined approach centering on diagnoses capture.
Mental Health Report: Mental and behavioral disorders have recently taken a spotlight in the forefront with recent events, and coding of these disorders can sometimes be tricky, as Rhonda Buckholtz reports. Buckholtz is the Chief Compliance Officer for Century Vision, LLC.
Talk Back: Dr. Erica Remer discusses the importance of teaching physicians clinical documentation.

Talk Ten Tuesdays. More than just talk.™

How Risk Adjustment and HCCs Are Impacting Coding and CDI Apr 19, 2018

Are you hearing more about risk adjustment methodologies and Hierarchical Condition Categories (HCCs)? No doubt you are. That's because they impact coding, clinical documentation integrity activities and reimbursement. So what impact can you have on any of these issues? During this episode Marie A. Morin, director at Alvarez and Marsal Healthcare Industry Group LLC, reports on her experiences in assisting clients with risk assessment, coding and documentation practices.

Other segments featured in this episode include:

News Desk: Larry Field, DO, anchors the Talk Ten Tuesdays News Desk and presents the very latest healthcare news. Field is the treasurer of the American College of Physician Advisors.
The Coding Report: Nationally recognized author and consultant Deborah Grider, a senior healthcare consultant with Karen Zupko & Associates, reports on coding trigger point injections for pain management. Trigger point injection therapy is used for the treatment of myofascial pain syndrome (MPS).
Tuesday Focus: April is Child Abuse Prevention Month and ICD10monitor contributor Laurie Johnson, a senior healthcare consultant for Revenue Cycle Solutions, reports on using the ICD-10-CM Official Coding and Reporting Guidelines for the proper coding of child abuse and neglect—an epidemic which, according to the Center for Disease Control (CDC), accounted for 1,750 children expiring from abuse or neglect in 2016.

Talk Ten Tuesdays. More than just talk.™

Wage Disparity and the Gender Gap: Probable Causes for Burnout? Apr 10, 2018

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:

News Desk: Gloryanne Bryant, past president of the California Health Information Association and an ICD10monitor contributor, reports on coding Parkinson's Disease, which is in the nation's spotlight as April is National Parkinson's Awareness Month.
Women's Health Report: LeAnn Thieman, former nurse and nationally acclaimed author who co-authored the New York Times best-seller Chicken Soup for the Nurse's Soul, returns to Talk Ten Tuesdays to report on burnout among nurses. Thieman is the founder and president of SelfCare for Healthcare.
Mental Health Report: Nationally renowned psychiatrist and Talk Ten Tuesdays contributor H. Steven Moffic, MD, reports on burnout among female physicians.
TalkBack: Co-host Erica Remer, MD, herself a former emergency medicine physician turned healthcare consultant, relates her own experience in a gender wage discrepancy dispute with a former employer.

Talk Ten Tuesdays. More than just talk.™

MIPS: Maligned and Misunderstood Apr 03, 2018

Maligned and misunderstood, the Merit-Based Incentive Payment System (MIPS) is under assault, as industry experts are urging officials at the U.S. Department of Health and Human Services (HHS) to consider repealing the program.

Yet March 31 was when eligible clinicians were to submit their quality data by for the value-based reimbursement program. Delivering an update on MIPS during this episode is nationally recognized revenue cycle authority Lyman Sornberger, chief strategy officer for Capio Partners.

Other segments featured in this episode include:

News Desk: Larry Field, DO, anchors the Talk Ten Tuesdays News Desk and presents the very latest healthcare news. Field is the treasurer of the American College of Physician Advisors.
Coding Report: Senior healthcare coding educator and consultant Laurie Johnson reports on the ICD-10 code proposals put forth during the recent Coordination and Maintenance Committee meeting.
RegWatch: Leading healthcare technology consultant Stanley Nachimson returns with his popular segment, RegWatch, through which he reports on the latest regulatory changes coming out of Washington, D.C.
Type 2 Myocardial Infarctions: Dr. Erica Remer foregoes her usual TalkBack segment to help try resolve the latest confusion behind elevated troponins and Type 2 MI.

Talk Ten Tuesdays. More than just talk.™

Medicare Beneficiaries to be Carded Mar 27, 2018

Medicare beneficiaries will soon be receiving from the Centers for Medicare & Medicaid Services (CMS) new identification cards—cards that will use a unique and what CMS describes as a "randomly-assigned number" called a Medicare Beneficiary Identifier (MBI). The new number replaces the Social Security-based Health Insurance Claim Number (HICN). The new cards, scheduled to be mailed next month, are designed to help combat identity theft and fraud. Reporting our lead story is author, educator,d and consultant Duane Abbey, PhD, president of Abbey and Abbey Consultants, Inc.

Other segments featured in this episode include:

News Desk: Lorraine Martinez returns to report on how patients and hospitals are coping since Hurricane Maria devastated Puerto Rico six months ago.
Dateline Washington: Talk Ten Tuesdays legislative analyst Rhonda Taller reports the latest news coming out of Washington, D.C. Rhonda is a member of the HIMSS professional development committee.
Coding Report: Senior healthcare coding educator and consultant Laurie Johnson continues her reporting on the outcome of the recent ICD-10 Coordination and Maintenance Committee.
Billing Report: Holly Louie, past president of the Healthcare Business and Management Association (HBMA) and compliance officer for Practice Management Inc., a multi-specialty billing company in Boise, Idaho, describes her frustrations in dealing with CMS and the Medicare Administrative Contractors on their contrary directives.
TalkBack: Co-host Dr. Erica Remer explains why, in her opinion, coders are the last line of defense for making the right DRG choice.

Talk Ten Tuesdays. More than just talk.™

Myocardial Infarctions: The Impact on Mortality Rates Mar 20, 2018

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:

News Desk: Senior healthcare coding educator and consultant Laurie Johnson anchors the Talk Ten Tuesdays News Desk, reporting on the latest ICD-10 headline news.
CDI Report: The aforementioned Glenn Krauss, the CDI manager at University Health Systems Las Vegas, has the CDI Report.
Coding Report: Nationally recognized coding authority Terry Fletcher returns to report on coding for supervised exercise therapy.
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.

Talk Ten Tuesdays. More than just talk.™

The Continuous Challenge to Code and Document COPD Compliantly Mar 13, 2018

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:

News Desk: The aforementioned Laurie Johnson anchors the Talk Ten Tuesdays news desk.
Mental Health Report: Talk Ten Tuesdays resident psychiatrist H. Steven Moffic, MD, reports on major sports story involving the self-disclosure of NBA basketball star Kevin Love that he suffers from panic attacks. Yes, there is a code for panic disorder.
TalkBack:Talk Ten Tuesdays co-host Erica Remer, MD, discusses a coding-clinical disconnect in the Official Guidelines regarding poisoning versus adverse effects.

Talk Ten Tuesdays. More than just talk.™

Live Reporting on the ICD-10 Coordination and Maintenance Committee Mar 06, 2018

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.

Other segments featured in this episode include:

CDI Report: Terrance Govender, MD, reports on three key initiatives for improving physician education for clinical documentation improvement (CDI). Dr. Govender is currently the vice president of medical affairs for ClinIntell, Inc.
Live from HIMSS: HIMSS18, which begins Sunday in Las Vegas, will continue through the next week. And Tim McMullen, executive director of the Healthcare Administrative Technology Association, will have a live report from the event, considered by many to be the largest annual healthcare conference in North America.
Physical Health Report: LeAnn Thieman, former nurse and nationally acclaimed author who co-authored the New York Times best-seller Chicken Soup for the Nurse's Soul, makes her debut appearance on Talk Ten Tuesdays and offers listeners important tips to stay healthy. Thieman is the founder and president of SelfCare for Healthcare.

Talk Ten Tuesdays. More than just talk.™

Baltimore’s Best and Brightest Breaks Down Barriers in Health Feb 27, 2018

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:

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.
Focus on Heart Disease: Given that February is American Heart Month, Talk Ten Tuesdays continues its focus on heart disease when nationally recognized healthcare coding consultant, educator, and auditor Terry Fletcher reports on "assumptive" coding – wherein, under certain situations, interpretations can cause confusion in code selection.

Talk Ten Tuesdays. More than just talk.™

Changes to the NCD for Chronic Heart Failure Patients Receiving ICDs Feb 20, 2018

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:

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.
CDI Report: Total Knee Replacement: Lisa Banker, chief physician advisor and vice president for case management at McLeod Health in South Carolina, reports on how her facility approaches total knee replacement. In her role, Dr. Banker serves as a physician leader.
Coding Report: California Health Information Association Past President Gloryanne Bryant returns to report on the availability of three programs from the Centers for Medicare & Medicaid Services (CMS) to promote awareness of heart disease.
Mental Health Report: Last Wednesday's shooting at a Florida high school – the 17th incident of gunfire at an American school this year – brings us to the subject of mental health. H. Steven Moffic, MD, the nationally renowned psychiatrist, reflects on the issue of mental health.

Talk Ten Tuesdays. More than just talk.™

How Cardiology Diagnosis Coding Will be Impacted in 2018 Feb 13, 2018

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:

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.
CDI Report: AHIMA Past President Charlotte Barrett, now assistant vice president of the health information integrity division at the University of Miami UHealth System, goes over the Talk Ten Tuesdays CDI Report.
Tuesday Focus: Former AHIMA President Rose Dunn, chief operations officer for First Class Solutions, reports on the latest developments surrounding ICD-11.
President's Message: Newly elected AHIMA President and Chair, Diann Smith, offers her vision for the American Health Information Management Association in 2018.

Talk Ten Tuesdays. More than just talk.™

Medical Necessity vs. Medical Decision-Making Feb 06, 2018

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:

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.
CDI Report: Nationally recognized clinical documentation improvement (CDI) expert Stefani Daniels returns to Talk Ten Tuesdays with yet another CDI report. Daniels is the founder and partner of Phoenix Medical Management, Inc.
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.

Talk Ten Tuesdays. More than just talk.™

Unraveling the Mystery of OB Coding Jan 30, 2018

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:

News Desk: Dennis Jones, the director of patient financial services at Nyack Hospital in Nyack, N.Y., anchors Talk Ten Tuesdays News Desk with the very latest healthcare news.
Dateline Washington: Talk Ten Tuesdays legislative analyst Rhonda Taller discusses the latest news coming out of Washington, D.C.
TalkBack: Talk Ten Tuesdays co-host Erica Remer, MD, sets up questions surrounding coding renal disease in pregnancy by reviewing last week’s listener survey on OB coding.

Talk Ten Tuesdays. More than just talk.™

Coding and Documenting Chronic Conditions Jan 23, 2018

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:

News Desk: Senior healthcare consultant Laurie Johnson, who several years ago broke the national story about there not being an ICD-10 code for chronic traumatic encephalopathy (CTE), returns to the podcast with an update on this condition.
Tuesday Feature: With Super Bowl LII scheduled to take place on Sunday, Feb. 4 in Minneapolis, we asked the co-founder of the Patrick Risha CTE Awareness Foundation Douglas Zegel to provide context for what his foundation describes as an epidemic.
Coding Report: California Health Information Association Past President Gloryanne Bryant returns to the podcast to report on the importance of healthcare quality and data as key elements in the coded data that comes from clinical documentation.
TalkBack: After adding her two cents about chronic conditions, Talk Ten Tuesdays co-host Erica Remer, MD, returns to a subject that appears to be fraught with confusion – OB coding – by introducing a listener poll on the same subject for discussion on January 30 Talk Ten Tuesdays.

Talk Ten Tuesdays. More than just talk.™

Six New Perspectives for Coding and CDI Programs Jan 16, 2018

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:

Tuesday Feature: Celebrated health information management (HIM) leader Bonnie Cassidy reports on major healthcare trends, including privacy, security, and a reduction in workforce in the HIM/CDI (clinical documentation improvement) industry.
DocTalk: Nationally renowned psychiatrist H. Steven Moffic reports on a most unusual diagnosis for mental behavior - a diagnosis so new that it was just approved by the World Health Organization for inclusion in ICD-11.
RegWatch: Healthcare industry expert Stanley Nachimson of Nachimson Advisors covers the latest regulatory and policy news from Washington, D.C.
CDI Report: Glenn Krauss, managing director of clinical services for Precision Health Systems, reports on why CDI programs often fail to engage physicians effectively as willing participants.
TalkBack: Talk Ten Tuesdays co-host Erica Remer, MD joins the conversation on the shift in focus of CDI.

Talk Ten Tuesdays. More than just talk.™

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