Talk Ten Tuesdays

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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.

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