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. ...
Aug 28, 2018•32 min•Ep. 338
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 serie...
Aug 21, 2018•28 min
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 o...
Aug 14, 2018•27 min•Ep. 336
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 pr...
Aug 07, 2018•30 min•Ep. 335
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 natio...
Jul 31, 2018•29 min•Ep. 334
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 late...
Jul 24, 2018•29 min•Ep. 332
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:...
Jul 17, 2018•30 min•Ep. 332
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 th...
Jul 10, 2018•31 min•Ep. 331
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 fro...
Jun 26, 2018•30 min•Ep. 330
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 Kimbe...
Jun 19, 2018•8 min•Ep. 329
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, c...
Jun 12, 2018•33 min•Ep. 328
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 discharg...
Jun 05, 2018•29 min•Ep. 327
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 g...
May 22, 2018•29 min•Ep. 326
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 Foc...
May 15, 2018•29 min•Ep. 325
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 featur...
May 08, 2018•29 min•Ep. 324
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...
May 01, 2018•31 min•Ep. 323
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. Oth...
Apr 24, 2018•31 min•Ep. 322
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 i...
Apr 19, 2018•30 min•Ep. 321
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...
Apr 10, 2018•30 min•Ep. 320
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 P...
Apr 03, 2018•29 min•Ep. 319
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,...
Mar 27, 2018•28 min•Ep. 318
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: New...
Mar 20, 2018•30 min•Ep. 317
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 Main...
Mar 13, 2018•30 min•Ep. 316
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 Medi...
Mar 06, 2018•30 min•Ep. 315
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 ...
Feb 27, 2018•29 min•Ep. 314
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 nat...
Feb 20, 2018•29 min•Ep. 313
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 ...
Feb 13, 2018•29 min•Ep. 312
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 join...
Feb 06, 2018•29 min•Ep. 311
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. Hol...
Jan 30, 2018•29 min•Ep. 310
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 f...
Jan 23, 2018•30 min•Ep. 309
