The panic was widespread. Rumors were flying. Cellphone alarms were sounding. From large hospital conference rooms to upholstered cubicles, everyone seemed to have the same sense of disbelief and mounting frustration: Acentra Health (previously Kepro) had announced a new appeal process for Medicare patients – specifically, those whose status changed from inpatient to observation. Among those who maintained a sense of composure was healthcare regulatory guru Ronald Hirsch, MD. Dr. Hirsch, a popul...
Oct 29, 2024•29 min•Season 13Ep. 620
The Rules of Engagement for medical coding and clinical documentation integrity (CDI) are based on four authoritative sources: the ICD-10-CM/PCS Official Coding Guidelines, the American Hospital Association (AHA) Coding Clinic Advice, the American Health Information Management Association (AHIMA) Standards of Ethical Coding, and practice briefs. These are, in the words of senior healthcare consultant Gloryanne Bryant, “the Big Essentials.” Bryant, past president of the California Health Informat...
Oct 22, 2024•31 min•Season 13Ep. 619
The American Hospital Association’s (AHA’s) Coding Clinic edition for the fourth quarter of 2024 has been published, and it includes several key changes of which providers nationwide should take heed. And that is why the producers of ICD10monitor have invited renowned subject matter expert Dr. James S. Kennedy to delve into the details and provide you with cautionary insights. Also during the broadcast, these instantly recognizable panelists will report more news during their segments: • The Cod...
Oct 15, 2024•31 min•Season 13Ep. 618
Health and longevity are within reach for everyone, no matter from where you’re starting. And it’s never too late to begin. During the next live edition of Talk Ten Tuesdays, Dr. Nick van Terheyden will cover some key areas upon which to focus so you can start bringing about improvements in your life by making small, consistent changes that are expected to lead to lasting improvements in your well-being. Over the course of the next few coming Tuesdays, Dr. Nick will dive deeper into these areas ...
Oct 08, 2024•30 min•Season 13Ep. 617
The Centers for Medicare & Medicaid Services (CMS) has released the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code updates for the 2025 fiscal year (FY). The FY 2025 ICD-10-CM updates introduce more than 300 code changes, including 252 new codes, 13 deletions, and 36 revisions, reflecting ongoing advancements in clinical documentation and disease specificity. These code changes will go into effect for discharges on Oct. 1, 2024. During the ne...
Oct 01, 2024•29 min•Season 13Ep. 616
Sleep is essential for all living organisms, from jellyfish to humans, and even bacteria have phases that resemble rest. Experiments show that severe sleep deprivation is lethal, as seen in rats, fruit flies, and Randy Gardner's 1964 11-day sleepless experiment. But what does it mean for you? Join Dr Nick as he explores a natural experiment in sleep deprivation that resulted in slashing fitness and aerobic capacity. The impact of just one bad night of sleep was staggering and the clear message i...
Sep 26, 2024•30 min•Season 13Ep. 615
Elusive and seemingly unattainable, the crux of medical record coding essentially can be distilled into these apparently irreconcilable elements—accuracy, speed and knowledge. Overlay on this current situation the incessant need to be aware of constant updates, inevitable staffing changes, the apparent searching for some 74,000 codes and the ensuing financial impact your organization undoubtedly experiences, then you know the challenges you and your colleagues face daily. Keenly aware of these o...
Sep 17, 2024•31 min•Season 13Ep. 614
Ships and airplanes apparently vanish into thin air. Mystery abounds. It’s the legendary Bermuda Triangle. But wait! Might there also be a healthcare Bermuda Triangle? Internationally renowned psychiatrist Dr. H. Steven Moffic will make the case for just that during the next live edition of Talk Ten Tuesdays. Dr. Moffic will report on the three key legs of this pressing issue. September is National Suicide Awareness Month. Next Sept. 11 marks the 23rd anniversary of the 9/11 attacks, after which...
Sep 10, 2024•29 min•Season 13Ep. 613
As senior healthcare leaders and stakeholders continue to look for ways to reduce coding and clinical documentation integrity (CDI) resource expenditures, making the business case for new technology such as artificial intelligence (AI) has never been more essential than it is right now. That is why the ICD10monitor producers of the popular Talk Ten Tuesday live Internet weekly broadcast have asked subject matter expert Cassi Birnbaum to be the special guest during the next live edition. Birnbaum...
Aug 27, 2024•30 min•Season 13Ep. 612
Recognizing that preventable medical errors, infections, and injuries are estimated to account for the deaths of 250,000 people annually, the Centers for Medicare & Medicaid Services (CMS) has expanded public reporting by hospitals on rates of patient safety events. Furthermore, CMS recently introduced the Patient Safety Structural Measure, effective 2025. Reporting on the details of this new initiative during the next edition of Talk Ten Tuesdays will be Leah Binder, president and CEO for T...
Aug 20, 2024•29 min•Season 13Ep. 611
The Centers for Medicare & Medicaid Services (CMS) Outpatient Prospective Payment System (OPPS) Proposed Rule includes proposed policies that align with several key goals for the agency, one of which is promoting safe, effective, patient-centered care. CMS has several quality measure changes being proposed to the Hospital Outpatient Quality Reporting (OQR) program within the OPPS Proposed Rule. During the next live edition of the long-running and popular Internet broadcast ICD10monitor, Coll...
Aug 13, 2024•29 min•Season 13Ep. 610
News reports, essays, and technical papers continue to laud the efficacy of generative article intelligence (AI) in healthcare. But what about AI and its application to the revenue cycle? Cassi Birnbaum, formerly the administrative director at Stanford Medicine Health Care, is set to return to Talk Ten Tuesday with an exclusive report on how AI can be used in managing and processing unstructured data across clinical notes, insurance claims, diagnostic images, medical charts, and more. And, given...
Aug 06, 2024•32 min•Season 13Ep. 609
The summer is here, and it’s raining codes. There are ICD-10 codes, CPT® codes, and the Z codes. Plus, coming up is the 2025 Inpatient Prospective Payment System (IPPS) Final Rule, which is expected to contain some new codes and deletions of others, for an expected net total increase of ICD-10 codes. In preparation, the producers at ICD10monitor have dedicated this next upcoming live edition of Talk Ten Tuesday as the “National Coding Roundup.” Also during the broadcast, these instantly recogniz...
Jul 30, 2024•31 min•Season 13Ep. 608
As global temperatures soar and heatwaves become more frequent, the connection between climate change and rising heat is undeniable. The results are not limited to uncontrolled wildfires but extend to widespread health consequences of excess heat from immediate threats like heat exhaustion and heat stroke to the exacerbation of chronic conditions such as cardiovascular and respiratory diseases. Vulnerable populations, including the elderly, children, and outdoor workers, face heightened risks, w...
Jul 23, 2024•30 min•Season 13Ep. 607
The Centers for Medicare & Medicaid Services (CMS) has released the Outpatient Prospective Payment System (OPPS) Proposed Rule for the 2025 calendar year (CY). This published information outlines significant changes impacting Medicare payment policies for hospital outpatient services. Key proposals include adjustments to payment rates, updates to the Inpatient-Only (IPO) List, and revisions to the Ambulatory Payment Classification (APC) groups. The rule also introduces measures related to ta...
Jul 16, 2024•31 min•Season 13Ep. 606
What is “Chevron deference?” And why is it important – especially to health information management (HIM) professionals? And who among the most learned and wise HIM professionals is arguably best qualified to report on this otherwise arcane judicial principle? That would be the legendary Rose T. Dunn. Dunn has offered to speak on this topic during the next edition of Talk Ten Tuesdays and is expected to highlight examples that are sure to resonate with HIM professionals. Rose is the former interi...
Jul 09, 2024•34 min•Season 13Ep. 605
Where in the world is G2211? Both payers and providers still report lack of information from the Centers for Medicare & Medicaid Services (CMS) about use of this code. If you remember, CMS promised stakeholders an FAQ document back in January. To date it has not been released. And yet, knowing how to document the service is probably the most-asked question when it comes to this code. Currently there are no specific documentation guidelines from CMS, but there are best-practice tips based on ...
Jul 02, 2024•30 min•Season 13Ep. 604
Each year the Medicare Payment Advisory Commission, MedPAC, provides Congress a report on the Medicare fee-for-service (FFS) payment systems, the Medicare Advantage (MA) program, and the Medicare prescription drug program (Medicare Part D). Within the MedPAC report is also the often (until now) under-reported Chapter 12. During the next live edition of Talk Ten Tuesdays, Colleen Ejak, Solution Advisor for 3M/Solventum, will report on the particulars from Chapter 12 of this report, including the ...
Jun 25, 2024•29 min•Season 13Ep. 603
With summertime fast approaching, also on the horizon are the inevitable stressors leading to increased psychiatric diagnoses and possible surges in psychopathologies. As temperatures increase, so do incidents of mental health unrest – tempers flaring, mood disorders, and possible cognitive impairment. That is why, with summer officially entering our lives on June 20, we have invited world-renowned psychiatrist Dr. H. Steven Moffic to appear on the next edition of Talk Ten Tuesdays – to provide ...
Jun 18, 2024•30 min•Season 13Ep. 602
He once explained to us the value of sleep, and gave tips on how to get more of the once-devalued therapy. That was then. This is now. And during the next live edition of Talk Ten Tuesdays, Dr. Nick van Terheyden will turn his attention to another vital healthcare issue: nutrition. This buzzworthy topic is becoming increasingly relevant as the White House and federal agencies continue their interest in the pivotal role of food as medicine, particularly in the context of the social determinants o...
Jun 11, 2024•27 min•Season 13Ep. 601
Welcome to the 600th live edition of the long-running Talk Ten Tuesdays broadcast, produced by ICD10monitor. In commemorating this special edition, the producers are pleased to welcome the legendary Rose T. Dunn, chief operating officer at First Class Solutions, Inc. in St. Louis, a healthcare information management leader since 1988. Rose is the author of “The Revenue Integrity Manager’s Guidebook,” available from the National Association of Healthcare Revenue Integrity. She will headline a dis...
Jun 04, 2024•29 min•Season 13Ep. 600
In recognition of May’s National Mental Health Awareness Month, ICD10monitor and Talk Ten Tuesdays have invited world-renowned psychiatrist and award-winning author H. Steven Moffic, MD to update his theory of social psychopathologies for the next live edition of the weekly Internet radio broadcast. According to Dr. Moffic, those are harmful individuals and group “isms,” “antis,” and social phobias. The live broadcast will also feature these other recognizable segments: RegWatch: Former Centers ...
May 21, 2024•28 min•Season 13Ep. 599
As if buried in shifting sands like a booby trap, Modifier 25 is poised to wreak havoc on claims when it’s appended incorrectly to an evaluation and management (E&M) charge – typically to indicate a separate service on the same date of service. So, what’s a provider to do? When is it actually appropriate to append Modifier 25? How do providers indicate that there was a significant yet separately identifiable E&M service that went above and beyond the typical pre- and post-work associated...
May 14, 2024•31 min•Season 13Ep. 598
The ongoing consolidation of independent physician practices, in many cases resulting in ownership by private equity groups and large health systems, is causing a shift from traditional medicine to the corporate practice of medicine. The result often is not in the best interest of patients, given that the focus tends to be on maximizing profits rather than patient care. What are the solutions to this ongoing crisis? During the next live edition of Talk Ten Tuesday, Nathaniel Arana, founder and C...
May 07, 2024•29 min•Season 13Ep. 597
There’s a renewed sense of urgency. Today’s healthcare providers must modernize their approach to patient access and financial clearance operations, according to Matt Bridge, senior vice president of AGS Health and the special guest during the next live edition of Talk Ten Tuesdays. Bridge is expected to report on the pitfalls of using outdated patient access systems. He will reveal how inefficiencies and delays contribute to revenue loss. He will also offer actionable solutions to this ever-gro...
Apr 30, 2024•31 min•Season 13Ep. 596
Tired of tossing and turning? You’re not alone. A Gallup poll released last Monday revealed that 57 percent of Americans said they would feel better if they could get more sleep. And that is why ICD10monitor and Talk Ten Tuesdays invited Dr. Nick van Terheyden – to investigate our national sleep crisis. During the next live edition of the long-running Internet broadcast, you’ll discover why we seem to be clocking in fewer Z’s. Dr. Nick is also expected to reveal some sneaky culprits behind your ...
Apr 23, 2024•32 min•Season 13Ep. 595
Properly managed patient identity queues are the foundation of an effective master person index that minimizes issues and facilitates streamlined care coordination. Conversely, unresolved identity queue backlogs can have costly implications for patient care, safety, and revenue integrity. It’s a growing problem with a time-consuming, resource-intensive resolution that few HIM departments have the capacity to handle. During the next live broadcast of the popular and long-running Talk Ten Tuesday,...
Apr 16, 2024•30 min•Season 13Ep. 594
World Health Day will be observed on Sunday, April 7 but on Tuesday, April 9, 10 a.m. Eastern Time, Talk Ten Tuesday will recognize World Health Day with the special guest appearance of Lorraine Fernandes, immediate past president (2019-2022) of the International Federation of Health Information Management Association (IFHIMA). Today, Fernandes serves as the Communications Chair for IFHIMA. During the next live broadcast of the popular and long-running Talk Ten Tuesday, the Internet broadcast pr...
Apr 09, 2024•28 min•Season 13Ep. 593
The continued onslaught of cybersecurity attacks is only getting worse. These attacks have impacted the healthcare system in dramatic fashion, starting with the Change Healthcare payment network being brought down. Hopefully, everyone – including coders – will be more vigilant and wary of potential attacks and attempts to breach security. The constant development of new approaches and innovative tools means that if you or your facility have not yet been subject to an attack, it is likely only a ...
Apr 02, 2024•33 min•Season 13Ep. 592
In a move towards greater specificity, the nation’s healthcare providers have a new ICD-10-CM code category: Code W44. Having gone into effect October 2023, the new code category (foreign body entering into or through a natural orifice) is seen as enhancing specificity, although Code W45 had already existed for foreign bodies entering through the skin. During the next live edition of Talk Ten Tuesdays, Gina Yacovelli, DHSc, associated with Coding & Billing Solutions, will report on how and w...
Mar 26, 2024•29 min•Season 13Ep. 591
