Talk Ten Tuesdays

Latest Episodes:

Proposed E&M Changes: The Good, the Bad, and the Ugly Aug 21, 2018

Show notes

Backlash continues over the Centers for Medicare & Medicaid Services (CMS) proposed changes to evaluation and management (E&M) coding and reimbursement found inside the proposed 2019 Medicare Physician Fee Schedule.

But it’s not all bad news. On this edition of Talk Ten Tuesdays, when Sally Streiber, president of Practical Coding Solutions, LLC, returns to the broadcast and launch part one of her two-part series reviewing the proposed changes.

Sally will begin the first part of her series with the “ugly,” notably a 50 percent reduction of the less-expensive service when an E&M code and a procedure are billed on the same date of service. Sally will return on Aug. 28 with part two, reporting the good and the bad of other anticipated impacts.

Other segments to be featured on the broadcast include:

Talk Tuesdays News Desk: The NFL continues to make payouts for former players who have been diagnosed not only with chronic traumatic encephalopathy, but now Parkinson’s and amyotrophic lateral sclerosis (ALS), according to a recent news report by the Los Angeles Times. Senior healthcare consultant Laurie Johnson, an ICD10monitor contributor, reports on the clinical indicators of these two diagnoses in advance of the NFL season, which kicks off Sept. 6.

Mental Health Report: Feeling the heat? With unseasonably hot weather plaguing most of the U.S., physicians are feeling another kind of burn; burnout. A recent study reports that 52 percent of physicians feel burned out regularly. Returns to report on this topic will be nationally renowned psychiatrist H. Steven Moffic, MD, the Talk Ten Tuesdays resident psychiatrist.

TalkBack: Talk Ten Tuesdays co-hostErica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., reports on her personal role as a patient advocate for her ailing father. Joining the conversation will be Caitlin Donovan, director of outreach and public affairs for the National Patient Advocate Foundation.

Talk Ten Tuesdays. More than just talk.™

Are HIM Coding Professionals Qualified to Query for Clinical Validity? Part II Aug 14, 2018

Show notes

Nearly 30 days ago, we posed the question “Are HIM Coding Professionals Qualified to Query for Clinical Validity?” leading up to the July 17 edition of Talk Ten Tuesdays, and the responses continue to roll in, nearly unabated.

Specifically, we asked at that time, “are seasoned coding professionals competent or trained well enough to interpret clinical terms and concepts from the medical record?” And many of you responded with an unequivocal “yes.” As a consequence, we will proceed with Part II of this series, when we continue to explore reaction to this question – which, after decades, still remains contentious.

Reporting our lead story during this edition of Talk Ten Tuesdays will be Anny Pang Yuen, author, consultant, and founder of AP Consulting Associates, LLC.

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: Talk Ten Tuesdays legislative analyst Rhonda Taller has the latest news coming out of Washington, D.C. Rhonda is a member of the HIMSS professional development committee.

Tuesday Focus: The Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-Based Incentive Payment System (MIPS) can be complicated and confusing for medical practices. Nationally recognized coding authority Terry Fletcher reports on the need for providers to balance regulatory compliance with efficiency.

TalkBack: Talk Ten Tuesdays co-hostErica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., reports on the results of last Tuesday’s Talk Ten Tuesdays Listener Survey, asking if your facility has clinical documentation improvement (CDI) on the weekends.

Talk Ten Tuesdays. More than just talk.™

ICD-11: Hear the Latest Industry Buzz Aug 07, 2018

Show notes

There is a lot of buzz out in the industry about ICD-11, especially since the World Health Organization (WHO) released the new code set in June as first reported by ICD10monitor and Talk Ten Tuesday. Nevertheless, ICD-11 is a trending topic—a topic we will explore during this edition of Talk Ten Tuesdays. That’s when nationally recognized coding authority Rhonda Buckholtz will report on the need to make sure all of the coding options have been refined in ICD-10-CM in order to make coding more productive in ICD-11.

Other segments to be featured on the broadcast include:

Tuesday Focus: 2019 ICD-10-CM Official Guidelines: The FY2019 Official Guidelines have been released as reported by ICD10monitor. Gloryanne Bryant, past president of the California Health Information Association, reports on the new changes.

E and M Coding Update: Given the potential impact of major E and M changes in the 2019 Medicare Physician Fee Schedule proposed rule, Deborah Grider, senior healthcare consultant for Karen Zupko and Associates, reports on reaction to the E and M overhaul being proposed by the Centers for Medicare and Medicaid Services (CMS).

News Desk: Larry Field, DO, anchors the Talk TenTuesday News Desk with the very latest healthcare news. Field is the treasurer of the American College of Physician Advisors.
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.

Talk Ten Tuesdays. More than just talk.™

Stressing Out About the Z Codes: Healthcare’s New Imperative Jul 31, 2018

Show notes

Back in February, as reported by ICD10monitor, the American Hospital Association (AHA) changed coding rules, allowing case managers and social workers to assign Z codes—one of 88 assignable ICD-10 codes to report on claims for homelessness, low income, stressful work environment, low literacy, divorce, personal history of abuse, and many more. But not all healthcare professionals—including a number of physicians—are getting the message.

To help clear up the confusion, Ellen Fink-Samnick, a nationally recognized expert on social determinants of health (SDoH), will report our lead story.

Other segments to be featured on the broadcast include:

Talk Ten Tuesday News Desk: Timothy Powell, a nationally recognized expert on regulatory matters including the False Claims Act, ZPIC audits, and the OIG, will return to report on the latest healthcare news.

E&M Coding Update: Given the scale and potential impact of major E&M changes in the 2019 Medicare Physician Fee Schedule proposed rule, Grant Huang, director of content for DoctorsManagement, will report on the major overhaul being proposed by the Centers for Medicare & Medicaid Services (CMS).

Tuesday Focus: Malnutrition: Severe protein calorie malnutrition is under high scrutiny from CMS, U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG), and commercial insurers. Megan Cortazzo, MD, medical director of clinical documentation improvement and health information management at University of Pittsburg Medical Center, will report on why it is happening and how to ensure hospitals and providers get compensated for the services they are providing.

Talk Ten Tuesdays. More than just talk.™

Reporting Bronchoalveolar Lavage Documentation Nightmare for Docs, Quandary for Coders Jul 24, 2018

Show notes

Coding guidelines and advice are taking bronchoalveolar lavage (BAL) to a surgical DRG. Should the body part be the bronchus or the lung? Reporting our lead story is Erica Remer, MD and Inpatient Compliance Specialist Stacey Elliott. Both will discuss their concerns.

Other segments to be featured on the broadcast include:

Talk Ten Tuesdays News Desk: Timothy Powell, a nationally recognized expert on regulatory matters including the False Claims Act, ZPIC audits, and the OIG, reports on the latest healthcare news.

Dateline Washington: Talk Ten Tuesdays legislative analyst Rhonda Taller has the latest news coming out of Washington, D.C. Rhonda is a member of the HIMSS professional development committee.

CDI Report: The ICD10monitor contributor Glenn Krauss, the CDI manager at University Health Systems Las Vegas, reports on how CDI supports the revenue cycle.

Talk Ten Tuesdays. More than just talk.™

Click here to view handout from Ellen Fink-Samnick on SDoH

Are HIM Coding Professionals Qualified to Query for Clinical Validity? Jul 17, 2018

Show notes

Are seasoned coding professionals competent or trained well enough to interpret clinical terms and concepts from the medical record? Although they have been doing so for decades, the question continues to remain contentious.

Reporting our lead story during this edition of Talk Ten Tuesdays will be Debra Beisel Denton, who works at Maricopa Integrated Health System as the health information management (HIM) system coding educator.

Other segments to be featured on the broadcast include:

News Desk: Dennis Jones, the patient financial services administrator at Nyack Hospital in Nyack, N.Y., will anchor the Talk Ten Tuesdays News Desk.

Tuesday Focus: Shannon DeConda, a nationally recognized evaluation and management (E&M) coding authority, reports on the 2019 proposed Medicare Physician Fee Schedule released Thursday by the Centers for Medicare & Medicaid Services (CMS). DeConda is founder of the National Alliance of Medical Auditing Specialists (NAMAS).
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.
TalkBack: TalkTen Tuesdays co-hostErica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., reports on a current issue that caught her attention during her popular TalkBack segment.

Talk Ten Tuesdays. More than just talk.™

A Cautionary Tale: Text Messaging Medical Orders Jul 10, 2018

Show notes

Fast, convenient, and cutting-edge, the new trend of text-messaging medical orders is being met with mixed results. Some favor the ease and speed, while others are concerned that it could comprise patient safety while not accurately documenting patient care.

Reporting our lead story during the next edition of Talk Ten Tuesdays will be Rose Dunn, chief operations officer for First Class Solutions. Rose will report on findings of a survey focusing on texting of medical orders and the challenges this practice creates for the healthcare team. Finally, she’ll sum things up with what the Centers for Medicare & Medicaid Services (CMS) has to say about the practice.

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: Ellen Fink-Samnick, an award-winning industry expert and author, returns to report on the new Z codes described in the 2019 proposed Inpatient Prospective Payment System (IPPS).
Physician Burnout: Continuing our coverage of physician burnout will be former emergency department physician-turned-consultant Tracy Sanson, MD.
TalkBack: Talk Ten Tuesdays co-host Erica Remer, MD returns with another installment of her popular segment.

Coding Report: Nationally recognized coding and documentation authority Terry Fletcher reports on the controversy surrounding medical necessity versus medical decision-making (MDM).

Talk Ten Tuesdays. More than just talk.™

The New Reality: ICD-11 Codes Jun 26, 2018

Show notes

ICD-11 codes are becoming healthcare’s new reality since the new code set was released this week by the World Health Organization (WHO) and reported on by ICD10monitor.

And already important questions are emerging.

Will it be possible to have a paper ICD-11 book? Will there be more electronic tools available to assist with understanding the new classification? These and other topics are covered by the WHO’s Robert Jakob, the special guest on this edition of Talk Ten Tuesdays. Calling in live from Geneva, Dr. Jakob also reports on the major changes to the classification that will be formally presented at the World Health Assembly next May for adoption by member states, effective as soon as Jan. 1, 2022.

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.

Tuesday Focus: Ellen Fink-Samnick, an award-winning industry expert and author, reports on a recent study at McLean Hospital that reveals how age, socioeconomic status, and other factors might contribute to social isolation and poorer mental health.
Special Report: Catherine Harrison-Restelli, MD, medical director for hospital services at Sheppard Pratt Health System, reports on integrating mental health into primary care.

Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions LLC and an ICD10monitor contributor, reports further on the recently posted ICD-11 codes.

Talk Ten Tuesdays. More than just talk.™

Coding and Documenting Sexual Harassment Jun 19, 2018

Show notes

In the era of #metoo, a new national study – “Sexual Harassment of Physicians Report 2018” – was published this week by Medscape, reporting that more than 10 percent of female physicians have experienced workplace sexual harassment.

Continuing its reporting on women’s health issues, and in particular gender wage disparity, Talk Ten Tuesdays will delve into this topical social issue that has until recently been an underreported in healthcare.

Also weighing in on this matter is special guest Kimberly Templeton, MD, immediate past president of the American Medical Women’s Association and professor of orthopedic surgery at the University Kansas Medical Center.

Other segments to be featured on the broadcast include:

News Desk: Larry Field, DO, anchors the Talk Ten Tuesdays News Desk with the his experiences with harassment in the workplace. Field is the treasurer of the American College of Physician Advisors.

CDI Report: Adele Towers, MD, associate professor of medicine and psychiatry and senior clinical advisor at the University of Pittsburgh Medical Center, returns after a long absence with the Talk Ten Tuesday CDI report.
Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions LLC and an ICD10monitor contributor, reports on coding and documenting sexual harassment.

TalkBack: Talk Ten Tuesdays co-hostErica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., will return to the broadcast with her popular TalkBack segment.

Talk Ten Tuesdays. More than just talk.™

Introducing the Hybrid CDI Jun 12, 2018

Show notes

University of Pittsburgh Medical Center (UPMC) is a world-renowned healthcare provider and insurer based in Pittsburgh, Penn. With more than 30 academic, community, and specialty hospitals, 600 doctors’ offices in outpatient sites, and more than 4,600 physicians, operating an array of rehabilitation, retirement, and long-term care facilities, UPMC relies on technology to help enhance its coding and clinical documentation improvement (CDI) program. And the latest reiteration of its CDI program, called Hybrid CDI, constitutes a system that combines off-site as well as on-site clinical documentation integrity specialists.

To learn more about this promising approach, we asked Megan Cortazzo, MD, an assistant professor of physical medicine and rehabilitation at UPMC, to be our special guest on this edition of Talk Ten Tuesdays. Dr. Cortazzo also serves as the medical director of CDI and health information management (HIM) for the UPMC System.

Other segments to be featured on the broadcast include:

News Desk: Gloryanne Bryant, past president of the California Health Information Association and an ICD10monitor contributor shares the latest news on the release of FY2019 ICD-10-CM Code Changes.

Case Management Report: Nationally recognized case management expert and author Stefani Daniels returns to Talk Ten Tuesdays to report on the hot topic of length of stay (LOS). Daniels is the founder and partner of Phoenix Medical Management, Inc.
Coding Report: Nationally recognized coding and documentation authority Terry Fletcher highlights her findings from her four-part series on auditing issues in physician documentation she uncovered in her exclusive reporting for ICD10monitor.

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.

Mental Health report: Nationally renowned psychiatrist and Talk Ten Tuesday contributor H. Steven Moffic, MD, reports on recent celebrity deaths, physician burnout and physician suicide.

Talk Ten Tuesdays. More than just talk.™

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