Talk Ten Tuesdays

Latest Episodes:

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

Show notes

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

Show notes

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.

Telehealth: Myths and Truths Jul 26, 2022

Show notes

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.

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

Show notes

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.

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

Show notes

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

Show notes

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.

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

Show notes

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

Show notes

Listen to Mary's Bookclub, where Mary summarizes the books you can find at the MedLearn online bookstore!
In today's episode, Mary explains the importance of Coding Essentials for Laboratories. Listen in to find out why this textbook could be a great edition to add to your essential library.

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

Show notes

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.

Beware: Modifier 25 Could be DOA Jun 21, 2022

Show notes

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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