Talk Ten Tuesdays

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2019 ICD-10-PCS Codes: New Details Revealed in Recently Released Files Jun 05, 2018

Show notes

There are 78,881 ICD-10-PCS codes for fiscal year 2019. Of these there will be 392 new codes; eight revision titles; and 216 deleted codes, according to nationally recognized coding authority Gloryanne Bryant, who reports our lead story during this episode. The files, recently released by the Centers for Medicare & Medicaid Services (CMS), and first reported by ICD10monitor, contain information on the ICD-10-PCS updates that all hospital inpatient coding professionals are to use for discharges occurring from Oct. 1, 2018, through Sept. 30, 2019.

National Spotlight: Nonaccidental trauma (NAT): ICD10monitor contributor and Talk Ten Tuesdays co-host Erica Remer, MD, reports on a coding-clinical disconnect when documenting child abuse—a serious problem on many levels and a particular focus during this episode. Joining the discussion is Laura Hayman, RN, a clinical documentation integrity specialist with a Midwestern teaching facility which is a level 1 pediatric trauma center.
Tuesday Focus – SDoH: Ellen Fink-Samnick, an award-winning industry expert and author, reports on one of the hottest topics in healthcare—the Social Determinants of Health.
Talk Ten Tuesdays News Desk: Sherri Dumford, Director of External Affairs for the Healthcare Administrative Technology Association (HATA), reports on the X12 meeting in Florida. Chartered by the American National Standards Institute, the organization develops and maintains EDI standards that facilitate consistent electronic interchange of healthcare transactions.
TalkBack: Talk Ten Tuesdays co-host Dr. Erica Remer reports on news coming out of the recent national conference of the American College of Physician Advisors.

Talk Ten Tuesdays. More than just talk.™

Send in the Scribes: Medical Scribes to the Rescue May 22, 2018

Show notes

Smoldering below the surface is burnout, and it’s taking a toll on physicians. With increasingly high rates of reported physician suicides and an alarming decline in the volume of medical school applications, this situation could be the nation’s next healthcare crisis. The good news: A study published in April’s World Journal of Urology reported that using scribes in a urology practice significantly increased physician efficiency, work satisfaction, and revenue. Enter Talk Ten Tuesdays special guest Dr. Suzette Sutherland, associate professor in the department of urology at the University of Washington School of Medicine. Dr. Sutherland reported on her facility’s training program and how using scribes is improving efficiency but also improving physician-patient relationships, patient satisfaction, and provider satisfaction, leading to less physician burnout.

Other segments to be featured on the broadcast include:

Tuesday Focus - Risk Adjustment: We had two reports on this trending topic: Sheri Poe Bernard, author of the American Medical Association 2018 publication “Risk Adjustment Documentation and Coding,” joined the broadcast to discuss her new book. And also reporting on the Tuesday Focus on risk adjustment was Marie A. Morin, director at Alvarez and Marsal Healthcare Industry Group LLC. Marie reported on risk adjustment payment methodologies.
Talk Ten Tuesdays News Desk: Larry Field, DO, anchored the Talk Ten Tuesdays News Desk and presented the very latest healthcare news. Dr. Field is the treasurer of the American College of Physician Advisors.
Coding Report: Nationally recognized coding and documentation authority Terry Fletcher will continued her report on errors she is uncovering in a review of more than thousands of records. Terry shared her findings in the third of a four-part series on auditing issues in physician documentation she is reporting exclusively for ICD10monitor.
CDI Report: The ICD10monitor contributor Glenn Krauss, the CDI manager at University Health Systems Las Vegas, reported on how CDI supports the ancient oath: “First, do no harm.

Talk Ten Tuesdays. More than just talk.™

New ICD-10 Codes for Women May 15, 2018

Show notes

Whether it’s discussing equal pay for women healthcare professionals, uncovering #MeToo narratives in the medical profession, or examining studies comparing women physicians’ and surgeons’ outcomes favorably to men’s, there has never been a more important time for crucial conversations to take place about women’s health. And that is why National Women’s Health Week will be the subject of this special Talk Ten Tuesdays broadcast.

Other segments to be featured on the broadcast include:

Tuesday Focus: Lisa Banker, chief physician advisor and vice president for case management at McLeod Health in South Carolina, reported on her perspective on women’s health issues.
Talk Ten Tuesdays News Desk: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions LLC and ICD10monitor contributor, reported on the latest proposed codes for women’s health.
CDI Report: Kathy Murchland, manager of CDI for Kettering Health Network in Dayton, Ohio, reported on her career transition from an inpatient coder to successfully rebranding the facility’s CDI department as “Documentation Excellence.”
Women’s Health Report: Vinita Manoraj, MD CHCQM, medical director at Hackensack Meridian Health, reported on women’s health issues from her perspective.
TalkBack: Talk Ten Tuesdays co-hostErica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., reported on a disturbing news report about a medical student who was asked to perform a pelvic exam on a woman who had been anesthetized before having a surgical procedure.

Talk Ten Tuesdays. More than just talk.™

Chief Complaint and the Medical Necessity Imperative May 08, 2018

Show notes

If there is no chief complaint, or no acute or chronic condition, auditors may not even continue with the record and negate its value altogether, according to nationally recognized coding and documentation authority Terry Fletcher, who is currently uncovering errors in an ongoing review of more than 1,000 records. During the next edition of Talk Ten Tuesdays, she will share her findings in the second of a four-part series on auditing issues in physician documentation.

Other segments to be featured on the broadcast include:

Tuesday Focus: There’s a strong emphasis to collect data about the opioid epidemic, specifically from individuals at risk or already addicted. But what are healthcare organizations doing with this information? Lesley Kadlec with the data analytics practice council at the American Health Information Management Association (AHIMA) reports on how the data can be used to respond to this crisis.
Coder Burnout: Confessions of a formerly burned-out coder will come from Kristi Pollard, a senior coding consultant at Haugen Consulting Group, who reports on 10 strategies to keep from feeling the burn.
Mental Health Report: Nationally renowned psychiatrist H. Steven Moffic, MD reported on new research that reveals burnout doesn’t just happen at work, but also at home. Dr. Moffic says that parental burnout can intertwine and interact with workplace burnout.
Talkback: Talk Ten Tuesdays co-host Erica Remer, MD returns with another installment of her popular segment.

Talk Ten Tuesdays. More than just talk.™

New ICD-10 Codes, New Challenges: Reporting on the IPPS Proposed Rule May 01, 2018

Show notes

Not wishing to disappoint, the 2019 Medicare Inpatient Prospective Payment System (IPPS) proposed rule, released on Tuesday, has something for everyone. For coders and clinical documentation integrity specialists (CDISs), there are proposed new codes and tweaks to the MS-DRG methodology as well as changes in New Technology add-on payments. Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions LLC and ICD10monitor contributor, will report on the latest proposal from the Centers for Medicare & Medicaid Services (CMS).

Other segments to be featured on the broadcast include:

Tuesday Focus: Charles Stellar, president and CEO of the Workgroup for Electronic Data Interchange, took time from his busy schedule to discuss solving the Interoperability issues in healthcare to assure that different information technology systems and software applications can communicate and exchange data.
News Desk: Charles Locke, MD, a senior physician advisor of care coordination and clinical resource management at Johns Hopkins and an assistant professor at the Johns Hopkins School of Medicine, reported on the news coming from the National Physician Advisor Conference in Greenville, North Carolina.
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. Most notably, he reports on the IPPS proposed rule on EHR Meaningful use for hospitals.
Coding Report: Nationally recognized coding and documentation authority Terry Fletcher continues reporting on errors she is uncovered in a review of more than 1,000 records. Terry will share her findings in the second of a four-part series on auditing issues in physician documentation.

Talk Ten Tuesdays. More than just talk.™

Auditing Issues Uncovered in Physician Documentation Apr 24, 2018

Show notes

It's auditing season, and nationally recognized coding and documentation authority Terry Fletcher will be reporting on errors she is uncovering in a review of more than 1,000 records. During this episode, she shares her findings in the first of a four-part series on auditing issues in physician documentation. While maintaining that CPT® and ICD-10 coding does become less risky when documentation is done properly, she offers corrective actions one can to take to prevent negative payer audits.

Other segments featured in this episode include:

News Desk: Larry Field, DO, anchors the Talk Ten Tuesdays News Desk and present the very latest healthcare news. Field is the treasurer of the American College of Physician Advisors.
CDI Report: The ICD10monitor contributor Glenn Krauss, the CDI manager at University Health Systems Las Vegas, reports on a holistic approach to documentation improvement versus a narrowly defined approach centering on diagnoses capture.
Mental Health Report: Mental and behavioral disorders have recently taken a spotlight in the forefront with recent events, and coding of these disorders can sometimes be tricky, as Rhonda Buckholtz reports. Buckholtz is the Chief Compliance Officer for Century Vision, LLC.
Talk Back: Dr. Erica Remer discusses the importance of teaching physicians clinical documentation.

Talk Ten Tuesdays. More than just talk.™

How Risk Adjustment and HCCs Are Impacting Coding and CDI Apr 19, 2018

Show notes

Are you hearing more about risk adjustment methodologies and Hierarchical Condition Categories (HCCs)? No doubt you are. That's because they impact coding, clinical documentation integrity activities and reimbursement. So what impact can you have on any of these issues? During this episode Marie A. Morin, director at Alvarez and Marsal Healthcare Industry Group LLC, reports on her experiences in assisting clients with risk assessment, coding and documentation practices.

Other segments featured in this episode include:

News Desk: Larry Field, DO, anchors the Talk Ten Tuesdays News Desk and presents the very latest healthcare news. Field is the treasurer of the American College of Physician Advisors.
The Coding Report: Nationally recognized author and consultant Deborah Grider, a senior healthcare consultant with Karen Zupko & Associates, reports on coding trigger point injections for pain management. Trigger point injection therapy is used for the treatment of myofascial pain syndrome (MPS).
Tuesday Focus: April is Child Abuse Prevention Month and ICD10monitor contributor Laurie Johnson, a senior healthcare consultant for Revenue Cycle Solutions, reports on using the ICD-10-CM Official Coding and Reporting Guidelines for the proper coding of child abuse and neglect—an epidemic which, according to the Center for Disease Control (CDC), accounted for 1,750 children expiring from abuse or neglect in 2016.

Talk Ten Tuesdays. More than just talk.™

Wage Disparity and the Gender Gap: Probable Causes for Burnout? Apr 10, 2018

Show notes

The recent Doximity research study that revealed an average national wage gap between male and female physicians of $105,000 was greeted by some healthcare professionals as "old news," while to others it seemed one more thread in the national fabric of the discussion on women's rights in the era of #metoo. Yet this income disparity could also contribute to physician burnout—a diagnosis that is higher among female physicians than their counterparts.

In 2017, the national gender gap for physicians increased, as female doctors earned 27.7 percent less than their male counterparts—an even bigger gap than the national average, according to the Doximity survey.

This news comes at a time when the topic of women's rights both in and out of the workplace has never been more volatile, and women's voices are being heard as never before. There has even been movement toward reviving the Equal Rights Amendment, with the Nevada Legislature last year becoming the first to ratify the ERA after the expiration of the original deadline—45 years after Congress submitted the amendment to the states. New ERA legislation is currently pending in several other states.

Discussing the gender gap and wage disparities in medicine during this episode is Dr. Juliet Ugarte Hopkins, a physician advisor for case management, utilization, and clinical documentation at ProHealth Care, Inc. in Wisconsin.

Other segments featured in this episode include:

News Desk: Gloryanne Bryant, past president of the California Health Information Association and an ICD10monitor contributor, reports on coding Parkinson's Disease, which is in the nation's spotlight as April is National Parkinson's Awareness Month.
Women's Health Report: LeAnn Thieman, former nurse and nationally acclaimed author who co-authored the New York Times best-seller Chicken Soup for the Nurse's Soul, returns to Talk Ten Tuesdays to report on burnout among nurses. Thieman is the founder and president of SelfCare for Healthcare.
Mental Health Report: Nationally renowned psychiatrist and Talk Ten Tuesdays contributor H. Steven Moffic, MD, reports on burnout among female physicians.
TalkBack: Co-host Erica Remer, MD, herself a former emergency medicine physician turned healthcare consultant, relates her own experience in a gender wage discrepancy dispute with a former employer.

Talk Ten Tuesdays. More than just talk.™

MIPS: Maligned and Misunderstood Apr 03, 2018

Show notes

Maligned and misunderstood, the Merit-Based Incentive Payment System (MIPS) is under assault, as industry experts are urging officials at the U.S. Department of Health and Human Services (HHS) to consider repealing the program.

Yet March 31 was when eligible clinicians were to submit their quality data by for the value-based reimbursement program. Delivering an update on MIPS during this episode is nationally recognized revenue cycle authority Lyman Sornberger, chief strategy officer for Capio Partners.

Other segments featured in this episode include:

News Desk: Larry Field, DO, anchors the Talk Ten Tuesdays News Desk and presents the very latest healthcare news. Field is the treasurer of the American College of Physician Advisors.
Coding Report: Senior healthcare coding educator and consultant Laurie Johnson reports on the ICD-10 code proposals put forth during the recent Coordination and Maintenance Committee meeting.
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.
Type 2 Myocardial Infarctions: Dr. Erica Remer foregoes her usual TalkBack segment to help try resolve the latest confusion behind elevated troponins and Type 2 MI.

Talk Ten Tuesdays. More than just talk.™

Medicare Beneficiaries to be Carded Mar 27, 2018

Show notes

Medicare beneficiaries will soon be receiving from the Centers for Medicare & Medicaid Services (CMS) new identification cards—cards that will use a unique and what CMS describes as a "randomly-assigned number" called a Medicare Beneficiary Identifier (MBI). The new number replaces the Social Security-based Health Insurance Claim Number (HICN). The new cards, scheduled to be mailed next month, are designed to help combat identity theft and fraud. Reporting our lead story is author, educator,d and consultant Duane Abbey, PhD, president of Abbey and Abbey Consultants, Inc.

Other segments featured in this episode include:

News Desk: Lorraine Martinez returns to report on how patients and hospitals are coping since Hurricane Maria devastated Puerto Rico six months ago.
Dateline Washington: Talk Ten Tuesdays legislative analyst Rhonda Taller reports the latest news coming out of Washington, D.C. Rhonda is a member of the HIMSS professional development committee.
Coding Report: Senior healthcare coding educator and consultant Laurie Johnson continues her reporting on the outcome of the recent ICD-10 Coordination and Maintenance Committee.
Billing Report: Holly Louie, past president of the Healthcare Business and Management Association (HBMA) and compliance officer for Practice Management Inc., a multi-specialty billing company in Boise, Idaho, describes her frustrations in dealing with CMS and the Medicare Administrative Contractors on their contrary directives.
TalkBack: Co-host Dr. Erica Remer explains why, in her opinion, coders are the last line of defense for making the right DRG choice.

Talk Ten Tuesdays. More than just talk.™

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