Talk Ten Tuesdays

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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.

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