Talk Ten Tuesdays

Latest Episodes:

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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.

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