Talk Ten Tuesdays

Latest Episodes:

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

Show notes

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.

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

Show notes

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

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

Show notes

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.

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

Show notes

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.

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

Show notes

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.

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

Show notes

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.

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

Show notes

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.

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

Show notes

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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