Talk Ten Tuesdays

Latest Episodes:

Myocardial Infarctions: The Impact on Mortality Rates Mar 20, 2018

Show notes

We will continue to focus on cardiology during this episode, as Jeffrey E. Epstein, MD, FACPA, appears as a special guest along with Glenn Krauss. Together the pair co-authored a paper titled "Physician Documentation Impacts Hospital Mortality Rates for Acute Myocardial Infarctions."

Dr. Epstein reports on the need for better physician documentation to achieve better clinical outcomes – and why the challenge, of course, is physician education.

Other segments featured in this episode include:

News Desk: Senior healthcare coding educator and consultant Laurie Johnson anchors the Talk Ten Tuesdays News Desk, reporting on the latest ICD-10 headline news.
CDI Report: The aforementioned Glenn Krauss, the CDI manager at University Health Systems Las Vegas, has the CDI Report.
Coding Report: Nationally recognized coding authority Terry Fletcher returns to report on coding for supervised exercise therapy.
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.™

The Continuous Challenge to Code and Document COPD Compliantly Mar 13, 2018

Show notes

Chronic obstructive pulmonary disease (COPD) continues to be a challenge to code and document – its coding in particular, and its sequencing, can be difficult. As a medical diagnosis, COPD is one of the most frequently searched terms on the Internet.

Shedding light on this subject during this episode of Talk Ten Tuesdays is Nelly Leon-Chisen, the director of coding and classification for the American Hospital Association (AHA).

Last Tuesday and Wednesday, the federal ICD-10 Coordination and Maintenance Committee (C&M) met to hear from proposals for new code topics. During this episode we will also have two reports on this major healthcare event, which was held at the Centers for Medicare & Medicaid Services (CMS) headquarters in Baltimore. Reporting on the proposals are Linda Holtzman, the founder of Clarity Coding, and coding educator and consultant Laurie Johnson.

Other segments featured in this episode include:

News Desk: The aforementioned Laurie Johnson anchors the Talk Ten Tuesdays news desk.
Mental Health Report: Talk Ten Tuesdays resident psychiatrist H. Steven Moffic, MD, reports on major sports story involving the self-disclosure of NBA basketball star Kevin Love that he suffers from panic attacks. Yes, there is a code for panic disorder.
TalkBack:Talk Ten Tuesdays co-host Erica Remer, MD, discusses a coding-clinical disconnect in the Official Guidelines regarding poisoning versus adverse effects.

Talk Ten Tuesdays. More than just talk.™

Live Reporting on the ICD-10 Coordination and Maintenance Committee Mar 06, 2018

Show notes

The federal ICD-10 Coordination and Maintenance Committee (C&M) is scheduled to meet Tuesday and Wednesday, March 6 and 7, to discuss proposals for diagnosis code topics, with the conversation to be led by the Centers for Disease Control and Prevention (CDC).

Join Chuck Buck and Erica Remer, MD during this episode, as coding educator and consultant Laurie Johnson reports on the ongoing deliberations during the C&M meeting, which will take place at the headquarters of the Centers for Medicare & Medicaid Services (CMS) in Baltimore. Johnson is a senior consultant for Revenue Cycle Solutions, LLC.

Other segments featured in this episode include:

CDI Report: Terrance Govender, MD, reports on three key initiatives for improving physician education for clinical documentation improvement (CDI). Dr. Govender is currently the vice president of medical affairs for ClinIntell, Inc.
Live from HIMSS: HIMSS18, which begins Sunday in Las Vegas, will continue through the next week. And Tim McMullen, executive director of the Healthcare Administrative Technology Association, will have a live report from the event, considered by many to be the largest annual healthcare conference in North America.
Physical 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, makes her debut appearance on Talk Ten Tuesdays and offers listeners important tips to stay healthy. Thieman is the founder and president of SelfCare for Healthcare.

Talk Ten Tuesdays. More than just talk.™

Baltimore’s Best and Brightest Breaks Down Barriers in Health Feb 27, 2018

Show notes

February is Black History Month, and Talk Ten Tuesdays is recognizing it with an appearance by Dr. Crystal Watkins, who shares thoughts about her ascension from an African-American student in the Baltimore City Public Schools to becoming an MD, PhD, neuroscientist, and finally director of The Memory Clinic at Sheppard Pratt Health System.

Dr. Watkins' appearance coincides with news that the American Hospital Association (AHA) this past week announced that it will allow notes from social workers and registered nurses to be considered as social determinants of health (SDoH), this on the heels of a USA Today report this week that Baltimore has the highest per-capita murder rate in the nation.

Using the statistics derived from ICD-10 codes might be a useful way in which data can help combat underlying issues, as you will hear when SDoH advocate Diane Iverson, RN, an emergency room nurse in Baltimore, also joins the broadcast.

Other segments featured in this episode 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.
Focus on Heart Disease: Given that February is American Heart Month, Talk Ten Tuesdays continues its focus on heart disease when nationally recognized healthcare coding consultant, educator, and auditor Terry Fletcher reports on "assumptive" coding – wherein, under certain situations, interpretations can cause confusion in code selection.

Talk Ten Tuesdays. More than just talk.™

Changes to the NCD for Chronic Heart Failure Patients Receiving ICDs Feb 20, 2018

Show notes

Every patient receiving an implantable cardioverters defibrillators (ICDs) for primary prevention will be required to have an encounter for shared decision-making using an evidence-based decision tool, according to the Centers for Medicare & Medicaid Services (CMS). ICDs are often implanted in patients with chronic heart failure whose life expectancy is limited and whose quality of life tends to decline as their heart failure worsens.

CMS released a final decision memo for changes to the national coverage determination (NCD) for ICDs last Friday during American Heart Month. Reporting on this breaking news is Ronald Hirsch, MD, a RACmonitor contributing editor and the vice president of the Regulations and Education Group at R1 Physician Advisory Services.

Other segments featured in this episode 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.
CDI Report: Total Knee Replacement: Lisa Banker, chief physician advisor and vice president for case management at McLeod Health in South Carolina, reports on how her facility approaches total knee replacement. In her role, Dr. Banker serves as a physician leader.
Coding Report: California Health Information Association Past President Gloryanne Bryant returns to report on the availability of three programs from the Centers for Medicare & Medicaid Services (CMS) to promote awareness of heart disease.
Mental Health Report: Last Wednesday's shooting at a Florida high school – the 17th incident of gunfire at an American school this year – brings us to the subject of mental health. H. Steven Moffic, MD, the nationally renowned psychiatrist, reflects on the issue of mental health.

Talk Ten Tuesdays. More than just talk.™

How Cardiology Diagnosis Coding Will be Impacted in 2018 Feb 13, 2018

Show notes

February is American Heart Month, and in recognition of this national focus, this episode of Talk Ten Tuesdays will center on how cardiology diagnosis coding for myocardial infarction (MI) is being impacted in 2018. There are now five types of MI code categories. Joining the podcast as our special guest is Terry Fletcher, who reports on these new options and how they will impact your reimbursement.

Other segments featured in this episode 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.
CDI Report: AHIMA Past President Charlotte Barrett, now assistant vice president of the health information integrity division at the University of Miami UHealth System, goes over the Talk Ten Tuesdays CDI Report.
Tuesday Focus: Former AHIMA President Rose Dunn, chief operations officer for First Class Solutions, reports on the latest developments surrounding ICD-11.
President's Message: Newly elected AHIMA President and Chair, Diann Smith, offers her vision for the American Health Information Management Association in 2018.

Talk Ten Tuesdays. More than just talk.™

Medical Necessity vs. Medical Decision-Making Feb 06, 2018

Show notes

Are medical decision-making and medical necessity one in the same? Often, bad advice tends to circulate regarding how to select the correct evaluation and management (E&M) codes.

Healthcare attorney David Glaser was the first to break a news story involving Highmark’s recent policy – evidently recently rescinded – that required physicians to use medical decision-making as a key component of coding. Reporting our lead story during this edition of Talk Ten Tuesdays is David Glaser, who is joined by Betsy Nicoletti, a national consultant on physician coding and founder of Coding Intel.

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.
CDI Report: Nationally recognized clinical documentation improvement (CDI) expert Stefani Daniels returns to Talk Ten Tuesdays with yet another CDI report. Daniels is the founder and partner of Phoenix Medical Management, Inc.
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.™

Unraveling the Mystery of OB Coding Jan 30, 2018

Show notes

Renal disease has been complicating obstetrics coding. For the first time on Talk Ten Tuesdays, two subject matter experts delve into this subject, which is rife with confusion and contradiction.

The key question is this: is renal disease a medical condition caused by the pregnancy, or a preexisting medical condition complicating the pregnancy? That is why we asked Linda Holtzman from Clarity Coding, Inc., to help explain when to use O26 and O99 codes. Podcast co-host Dr. Erica Remer and Ms. Holtzman resolve this question once and for all.

Other segments to be featured on the broadcast include:

News Desk: Dennis Jones, the director of patient financial services at Nyack Hospital in Nyack, N.Y., anchors Talk Ten Tuesdays News Desk with the very latest healthcare news.
Dateline Washington: Talk Ten Tuesdays legislative analyst Rhonda Taller discusses the latest news coming out of Washington, D.C.
TalkBack: Talk Ten Tuesdays co-host Erica Remer, MD, sets up questions surrounding coding renal disease in pregnancy by reviewing last week’s listener survey on OB coding.

Talk Ten Tuesdays. More than just talk.™

Coding and Documenting Chronic Conditions Jan 23, 2018

Show notes

Coding chronic conditions and co-morbidities is becoming increasingly critical as the healthcare landscape shifts toward value-based care, which attempts to advance the triple aim of providing better care for individuals, improving population health management strategies, and reducing healthcare costs. Reporting our lead story on this edition of Talk Ten Tuesdays is Machaelle Diaz, senior program manager for coding quality review and education at McKesson Specialty Health.

Other segments to be featured in this episode include:

News Desk: Senior healthcare consultant Laurie Johnson, who several years ago broke the national story about there not being an ICD-10 code for chronic traumatic encephalopathy (CTE), returns to the podcast with an update on this condition.
Tuesday Feature: With Super Bowl LII scheduled to take place on Sunday, Feb. 4 in Minneapolis, we asked the co-founder of the Patrick Risha CTE Awareness Foundation Douglas Zegel to provide context for what his foundation describes as an epidemic.
Coding Report: California Health Information Association Past President Gloryanne Bryant returns to the podcast to report on the importance of healthcare quality and data as key elements in the coded data that comes from clinical documentation.
TalkBack: After adding her two cents about chronic conditions, Talk Ten Tuesdays co-host Erica Remer, MD, returns to a subject that appears to be fraught with confusion – OB coding – by introducing a listener poll on the same subject for discussion on January 30 Talk Ten Tuesdays.

Talk Ten Tuesdays. More than just talk.™

Six New Perspectives for Coding and CDI Programs Jan 16, 2018

Show notes

Senior healthcare consultant Michelle Wieczorek returns to discuss six ideas she says will improve performance indicators for coding and clinical documentation integrity (CDI) departments.

Wieczorek, who is a senior manager in the DHG Healthcare CFO advisory team, also discusses the ever-increasing importance of Hierarchical Condition Categories (HCCs) in the world of value-based care.

Other segments to be featured this episode include:

Tuesday Feature: Celebrated health information management (HIM) leader Bonnie Cassidy reports on major healthcare trends, including privacy, security, and a reduction in workforce in the HIM/CDI (clinical documentation improvement) industry.
DocTalk: Nationally renowned psychiatrist H. Steven Moffic reports on a most unusual diagnosis for mental behavior - a diagnosis so new that it was just approved by the World Health Organization for inclusion in ICD-11.
RegWatch: Healthcare industry expert Stanley Nachimson of Nachimson Advisors covers the latest regulatory and policy news from Washington, D.C.
CDI Report: Glenn Krauss, managing director of clinical services for Precision Health Systems, reports on why CDI programs often fail to engage physicians effectively as willing participants.
TalkBack: Talk Ten Tuesdays co-host Erica Remer, MD joins the conversation on the shift in focus of CDI.

Talk Ten Tuesdays. More than just talk.™