Analyze This: Healthcare Data and Solastalgia on Mental Health

Dr. Nichols, who is authoring an exclusive four-part series on healthcare data for ICD10monitor, reports on the crucial search for reliable health information, noting that without it, all stakeholders are at significant financial and/or personal health risks. Dr. Moffic, one of America’s foremost psychiatrists, reports on the intriguing subject of solastalgia – the rising world temperature, and its impact on mental health. Dr. Moffic is writing an exclusive series on the topic for...


Million-Dollar Coding Mistakes – and How to Avoid Costly Errors

While facilities and practices are concentrating on making critical changes in 2020 and 2021, it is important not to lose focus on the basics of correct coding. CPT® and ICD-10-CM coding errors can cost healthcare providers millions of dollars in lost revenue, but also, those errors can trigger compliance issues that could lead to audits. Reporting our lead story during this edition of Talk Ten Tuesdays is a nationally recognized professional physician coder and auditor Terry Fletcher. The...


The Coding Dilemma: Reporting Deep-Tissue Pressure Injuries

The release of the fiscal year (FY) 2020 Official Guidelines for Coding and Reporting (OCG) has resulted in confusion and apprehension surrounding the intent of the new guideline related to the new ICD-10-CM codes for pressure-induced deep-tissue damage or deep-tissue pressure injury (L89.-6). The ambiguity stems from what appears to be conflicting advice found within the coding guidelines (I.C.12.a) regarding pressure ulcer stage codes, as you’ll learn when Lisa Baris, Director of Health...


Prior Authorization Headaches: A Pain Point for Providers and Practices

With prior authorization (PA) posing a significant pain point for healthcare providers and a major headache for most practices, Talk Ten Tuesdays asked Terry Fletcher to report on this troubling issue, especially in light of the WEDI survey results posted this week, revealing that 84 percent of providers reported that the number of medical services requiring PA has increased. The PA process, heavily dependent on manual tasks, has grown to become one of the biggest frustrations for...


The Coding World in 2020: Part II

Talk Ten Tuesdays is continuing its reporting on the unprecedented changes occurring this decade in the world of healthcare coding. Coders and health information management (HIM) professionals need to retool in order to meet new challenges brought about by artificial intelligence, as well as by social and political changes already underway. With profound healthcare upheaval taking place here and globally, we asked Ginna Evans, the new president and board chair of the American Health...


The Coding World in 2020: Look Ahead to ICD-10-CM Clinical Coding Challenges

The coding world in 2020 will be a new landscape of challenges for coders as well as health information management (HIM) professionals. And to help you and your team prepare for what lies ahead in the New Year, Gloryanne Bryant, a well-known, national coding and HIM leader, returns to the Talk Ten Tuesdays broadcast with her report on six major issues confronting coders this year and beyond. The podcast will also feature these other segments: Tuesday Focus: The Coding Report: Mental...


In the Holiday Spirit of Giving: Free Advice to Avoid Claim Denials

In the true holiday spirit of giving, during this edition of Talk Ten Tuesdays weekly broadcast will provide you and your team with some free advice on how to avoid claim denials – especially if you don’t have a robust claim denials management process. Unfortunately, the majority of healthcare organizations encounter claim denials on a regular basis, often habitually. Though some claim denials may be unavoidable, ineffective claim denials management can result in even more lost revenue, as...


Beyond CCs and MCCs: Say Hello to HCCs and APR-DRGs

There was a time when the coin of the realm in the world of coding was knowledge of complications or comorbidities (CCs) and major complications or comorbidities (MCCs). But 10 years later, the industry has changed rapidly, and to avoid going the way of the dinosaur, coders today need to embrace all patients’ refined diagnosis-related groups (APR-DRGs) and hierarchical condition categories (HCCs). A coder’s staying power lies beyond MS-DRGs, according to Kristi Pollard, who reports our lead...


Ten Going on Eleven: Help is Here

As we conclude our month-long Talk Ten Tuesdays series, “Ten Going on Eleven,” we do so with a special appearance by Valerie Watzlaf, board president and chair of the American Health Information Management Association (AHIMA). Valerie, vice chair of education and associate professor within the Department of Health Information Management in the School of Health and Rehabilitation Sciences at the University of Pittsburgh, will discuss how AHIMA is helping the health information management...


Ten Going on Eleven: The Role of HCC Coding

Exclusive reporting on ICD-11 and the need for early preparation for the new code set continues at ICD10monitor and Talk Ten Tuesdays. Among those skills that will need to be honed is hierarchical classification category (HCC) coding. HCCs thrive on specificity. Although it was thought that ICD-10 delivered the ultimate level of specificity, ICD-11 is expected to surpass ICD-10 in that area. But HCCs require documentation, and the key looming question remains, at this time, unanswered: will...


Ten Going on Eleven: Data Mining: A Must-Have Skill for Coders

Data mining is the next frontier in healthcare – and it’s here. The creation of revenue management and data management educational tracks in health information technology (HIT) associate degree programs, plus the use of artificial intelligence (AI) to assign ICD-11 codes, means that data mining skills are a must-have for coding specialists, requiring extensive education. To help assist this major educational initiative, ICD10monitor and Talk Ten Tuesdays are producing a series of articles...


Ten Going on Eleven: The Train Has Left the Station

ICD-11 is on track to arrive here in the U.S. sooner than most expected – 2022. In fact, global experts convened in Switzerland to create a roadmap to advance the digital health ecosystem. For the very latest update on ICD-11, the World Health Organization’s (WHO’s) Robert Jakob, MD, team leader of classifications and terminologies (ICD, ICF, ICHI), is today's Talk Ten Tuesdays special guest. Also joining the broadcast is Margaret Skurka, who has just returned from the WHO Family of...


Reasons Not to Believe DRG Denials

“In the hospital setting, we see multiple insurance denials on a weekly basis,” Lamon Willis recently wrote in an article for ICD10monitor. “Teams of people route them to various departments for analysis and review. I have staff members who review the APC and/or DRG, along with coding criteria, to determine if we have properly fulfilled our duties as coders and to support the appeals process for the organization,” he continued. “My staff and I agree on one thing at the very beginning, and...


Five Looking at Ten: Lessons Learned

Five Looking at Ten, the month-long series on ICD10monitor and Talk Ten Tuesdays that examines lessons learned since the nation’s healthcare system adopted ICD-10, will continue with a special guest appearance of Robert Tennant of the Medical Group Management Association (MGMA). The broadcast also feature these other segments: Five Looking at Ten: Five Looking at Ten: Revenue Cycle Report: News Desk: TalkBack:


Do EHRs Contribute to Patient Deaths?

There is ongoing concern that electronic health record (EHR) systems are one of the top contributing causes to patient deaths, complications, and erroneous care plans. During this edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher, a member of the ICD10monitor editorial board, reports on the growing issue of EHR-related errors. The live broadcast will also feature these other segments: The Coding Report: Tuesday Focus: Five Looking...


Searching for Codes on Facebook

There’s growing concern in the healthcare industry regarding offshore and untrained staff getting their CPT® and ICD-10 codes from non-verified Internet sites such as Facebook, Twitter, and other social media platforms. This practice aligns with another troubling trend: the use of Google by folks leveraging the Internet for self-diagnosis, doing so with a misdirected sense of trust in all things online while hoping to reach their own conclusions about their illness. During this edition of...


Five Looking at Ten: Lessons Learned

Five Looking at Ten is an upcoming month-long series on ICD10monitor and Talk Ten Tuesdays, through which we will examine what lessons have been learned since the nation’s healthcare system adopted ICD-10, which became effective Oct. 1, 2014. Each week, we will report on lessons learned as we approach year five – while at the same time, looking ahead to the implementation of ICD-11. Joining us during this broadcast is our special guest is Denise Buenning, who, during the run-up to ICD-10,...


Late Signatures for Medical Services: Can You Still Bill and Get Paid?

The Centers for Medicare & Medicaid Services (CMS) has published rules and guidance on the topic of a "completed medical record." But what if the provider didn't sign off on the note or authenticate it in the electronic health record (EHR) until after the fact? Is the record still considered complete, for billing and reporting purposes? During this edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher reports on the need for complete...


New ICD-10 Codes Coming Your Way

What new codes are coming your way? The ICD-10 Coordination and Maintenance Committee (C&M) met for two days this past week to discuss requests for ICD-10 code changes. Laurie Johnson, an ICD10monitor editorial member and senior healthcare consultant for Revenue Cycle Solutions, LLC, reports on the public forum held Monday and Tuesday at the headquarters of the Centers for Medicare & Medicaid Services (CMS). This episode also features these other segments: Tuesday Focus: The Coding...


Smoking Cessation Programs: Coding for Reimbursement

Is your facility currently providing smoking cessation counseling and treatment? Did you know you can bill and get reimbursed for your services? It isn't just part of your standard evaluation and management (E&M) encounter. But who is covered? What are the CPT® and ICD-10-CM codes? What is the reimbursement and rules for payment? Nationally recognized professional physician coder and auditor Terry Fletcher reports on the latest information about revenue opportunities for all specialty...