Talk Ten Tuesdays

A major focus for many hospitals is understanding the changes that impact Hierarchical Condition Category (HCC) reimbursement methodology – changes made as a result of the Inpatient Prospective Payment System (IPPS) rule that will become effective in 2024. Because it’s important for you to know about these changes, we invited John Pitsikoulis principal at Premier Health, to be the special guest during the next live edition of Talk Ten Tuesdays. Pitsikoulis is expected to report on these recent regulatory and payment model changes, noting that for the first time, the Centers for Medicare & Medicaid Services (CMS) used ICD-10 codes in their analytics for policy changes. These changes are expected to impact your Medicare Shared Savings Plan (MSSP), Medicare Advantage, and other payment models. Talk Ten Tuesdays will also feature these outstanding segments and thought leaders: Coding Report: SDoH Report: News Desk: TalkBack:

May is Mental Health Awareness Month, and ICD10monitor and Talk Ten Tuesdays are recognizing the major national milestone with a special appearance of world-renowned psychiatrist and author H. Steven Moffic, MD. Every year since 1949, Mental Health Awareness Month has been observed in the U.S. According to Moffic, this year could feature the worst state of America’s mental health since that year. Add to that another level of anxiety among healthcare providers, who are currently grappling with the unforeseen consequences of coming to grips with the end of the nation’s COVID-19 public health emergency (PHE) May 11, and it’s a troubling scenario. Talk Ten Tuesdays will also feature these outstanding segments and thought leaders: Coding Report: SDoH Report: News Desk: TalkBack:

Nearly 80 percent of medical practice administrators struggle to keep track of and reconcile patient encounters, as you will learn during the next live edition of Talk Ten Tuesdays, when Susie Vestevich will serve as the special guest. Without adequate tracking, insurance claims aren’t submitted, copays aren’t collected, and patient financial responsibility balances aren’t received. Talk Ten Tuesdays will also feature these outstanding segments and thought leaders:

The 2024 Inpatient Prospective Payment System (IPPS) proposed rule by the Centers for Medicare & Medicaid Services (CMS), plus half a dozen other proposed payment rules, will all require new codes and fresh new thinking. And that is why ICD10monitor is producing an exclusive national coding update broadcast on Talk Ten Tuesdays. All this and more will be covered during the next live edition of the weekly Internet radio broadcast, which will feature these outstanding segments and thought leaders: Coding Report: SDoH Report: News Desk: TalkBack:

Continuing previous discussions of cancer screening covered under preventive benefits, the subject will get a second look on the next edition of Talk Ten Tuesdays – when Robin Miller Zweifel joins the broadcast to focus on non-invasive versus invasive procedure options for colorectal cancer screening. Robin is also expected to report on the recent National Correct Coding Initiative (NCCI) procedure-to-procedure edits released in October 2022, noting the sequencing of performance for screening procedures. She will also report on the more recent changes to the age requirements for patients to qualify for coverage under the preventive benefits for colorectal cancer screening. And no report on cancer screening would be complete without mention of related procedures, including the gold standard of occult blood testing, Cologuard, and other molecular-based testing, as well as colonoscopy. All this and more will be covered during the ICD10monitor and Talk Ten Tuesdays recognition of Medical Laboratory Professionals Week. The live broadcast will also feature these other segments: Coding Report: SDoH Report: News Desk: Point of View:

Is your facility suffering from revenue loss? If so, you’re not alone. A study by the Journal of the American Medical Informatics Association (JAMIA) found that clinics can experience a 10 to 30 percent decrease in revenue due to coding errors alone, losing up to $125,000 per year. Moreover, the American Medical Association (AMA) estimates that coding errors cost the healthcare industry approximately $36 billion annually in lost revenue, denied claims, and potential fines. During the next live edition of Talk Ten Tuesdays, Susie Vestevich, COO for TiaTech, will report on how errors are costing facilities and practices significant revenue losses. But she will also report on how five, ironclad strategies can be implemented to help prevent such losses. Her revenue cycle report is part of an ongoing services presented by TiaTech, USA and ICD10monitor. The live broadcast will also feature these other segments: Coding Report: SDoH Report: News Desk: Point of View:

From starkly arid lands to lush, cosmopolitan foreign capitals, a wide-ranging mix of peoples – some old, some new – were the focus of attention as the World Health Organization (WHO), with characteristic dignity, celebrated 75 years of improving the health of mankind. ICD10monitor (so named for the WHO’s International Classification of Diseases, Version 10) and Talk Ten Tuesdays will mark the occasion with the conclusion of a two-part series recognizing the accomplishments of the WHO, which has been working overtime to alleviate deadly diseases, protect people from pandemics, and promote world peace. During the next live edition of Talk Ten Tuesdays, Lorraine Fernandes, immediate past president and communications chair of the International Health Information Management Association (IHIMA), will be the special guest and will report on activities that took place during World Health Day. The live broadcast will also feature these other segments: Coding Report: RegWatch: SDoH Report: News Desk: TalkBack:

Although World Health Day isn’t until April 7, ICD10monitor and Talk Ten Tuesdays will usher in an early recognition of the worldwide event beginning this coming Tuesday, with the start of a two-part series of broadcasts. During the next live edition of Talk Ten Tuesdays, Mary H. Stanfill, ICD10monitor and broadcast ICD-11 correspondent, will have an update on the new coding system, which has been, according to the World Health Organization (WHO), adopted by 35 countries, including the U.S. However, the implementation of the code set here remains, at this time, uncertain. During the subsequent Tuesday broadcast, on April 11, Lorraine Fernandes, immediate past president and communications chair of the International Health Information Management Association (IHIMA), will be the special guest and will report on activities that took place during World Health Day. The live broadcast will also feature these other segments: Coding Report: SDoH Report: News Desk: TalkBack:

The end is near: the federal COVID-19 public health emergency (PHE) and national emergency declarations will come to a screeching halt on May 11. And with that, there will be significant effects on healthcare and healthcare providers in the United States. The ends of these declarations could signal a major shift in the response to the pandemic, and may have far-reaching consequences for the industry. One immediate effect could be a decrease in funding for COVID-19-related activities. And that is why, for the next upcoming edition of Talk Ten Tuesdays, we asked Lidiya Ter-Markarova to report on some of the more causative effects this post-PHE era will have on the healthcare system and providers. The live broadcast will also feature these other segments: Coding Report: SDoH Report: News Desk: TalkBack:

Are there significant risks of potential fraud and abuse with Medicare Advantage (MA) by plans, vendors, and providers, with an emphasis on ICD-10-CM’s impact on Centers for Medicare & Medicaid Services Hierarchical Condition Category (CMS-HCC) risk adjustment? Evidently, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) believes there are. Recently, Christi A. Grimm, Inspector General, issued a statement in which she addressed the concerns of the federal watchdog agency. In response to her speech, we invited Dr. James Kennedy, a 20-year veteran in clinical documentation integrity (CDI) consulting and a popular panelist, to share succinct advice on how a compliance plan can best prepare for OIG audits that are sure to come. Programming note: Invite your compliance teams to hear what promises to be the best four minutes applicable to this challenge, during the next live edition of Talk Ten Tuesdays. The live broadcast will also feature these other segments: Coding Report: SDoH Report: News Desk: TalkBack:

It’s all about the money. It’s not only getting paid, but also getting paid the right amount. Little wonder that this is first and foremost on every provider’s mind. Often, though, success or failure lies in the completion and details of medical notes taken. So, what’s the deal with medical notes? Why are notes so important, and why are they difficult for providers to complete? We’ve invited Kevin Lasser, Co-founder and CEO of TiaTech, to be our special guest and to answer those questions during the next live edition of Talk Ten Tuesdays. The live broadcast will also feature these other segments: Coding Report: SDoH Report: News Desk: TalkBack:

ICD10monitor correspondent Linda Holtzman, founder of Clarity Coding, will return to the Talk Ten Tuesdays (TTT) broadcast this coming Tuesday, March 7 to report on the activities at the Coordination & Maintenance Committee (C&M) meeting taking place from the headquarters of the Centers for Medicare & Medicaid Services (CMS). Holtzman, a longtime C&M observer, will bring her knowledge and expertise to her reporting of this important event – an essential meeting for coders and clinical documentation integrity specialists (CDISs). The two-day meeting will be held on March 7 and 8, virtually. The usual program will begin at 9 a.m. EST until 5 p.m. EST, until the business is finished. The tentative agendas are light this spring, with 18 topics on the diagnosis side and nine proposals for procedure codes. The procedure code information, however, will not be presented during the meeting. Remember, TTT will be covering this event live! The live broadcast will also feature these other segments: Coding Report: The Dunn Report: SDoH Report: News Desk: TalkBack:

We will conclude our month-long observance of American Heart Month on the Talk Ten Tuesdays weekly Internet radio broadcast with an upcoming guest appearance of Cardiologist Harry B. Peled, MD with St. Jude Medical Center in Fullerton, Calif. Last Tuesday, Dr. Mahesh Amin reported on the use of new protocols centered on high-sensitivity troponins for the diagnosis of type 2 myocardial infarction (MI). The response to his appearance was overwhelming; hence the continuation of this timely and critically important topic during the next broadcast. Our series on the plight of rural hospitals will also continue with Dr. James Kennedy, who will report on an unfolding tragedy facing America’s rural populations as they seek care from facilities faced with drastically dwindling resources. The live broadcast will also feature these other segments: Coding Report: News Desk: TalkBack:

Last year, the Food and Drug Administration (FDA) issued its approval of using new protocols centered on high-sensitivity troponins for the diagnosis of type 2 myocardial infarction (MI). Reporting our lead story during the next edition of Talk Ten Tuesdays will be Dr. Mahesh Amin, CV Service Line Medical Director for BayCare Health Systems in Clearwater, Fla., a board-certified cardiologist. This story, along with a Feb. 28 report by Henry Peled, MD at St. Jude Medical Center in Fullerton, Calif., will conclude the monthlong observance of American Heart Month by ICD10monitor and Talk Ten Tuesdays. In previous February broadcasts, the focus has been on the topics of coding and clinical documentation integrity (CDI). This live broadcast will also feature these other segments: Coding Report: SDoH Report: News Desk: TalkBack:

In continuing our observance of American Heart Month, during the next live edition of the Talk Ten Tuesdays live Internet radio broadcast we will zero in on the topic of coding and clinical documentation integrity (CDI) issues related to cardiovascular procedures – and, specifically, the importance of obtaining pre-authorizations for cardiology procedures. Obtaining cardiology procedure pre-authorizations tends to be a time-consuming process, depending on the complexity of the patient’s insurance coverage and staff experience. And that is why we invited Susie Vestevech, the COO for TiaTech USA, to walk you through the process, which can range from several days to several weeks, often requiring multiple phone calls and documentation submissions. Every year, some 805,000 people in the United States have a heart attack. Basically, someone has a heart attack every 40 seconds. Making certain that your facility is prepared to obtain cardio procedure pre-authorizations is of vital importance every month, not just in February. The live broadcast will also feature these other segments: Coding Report: SDoH Report: News Desk: TalkBack:

February is American Heart Month, a time to raise awareness of cardiovascular health and to shine the light on cardiac issues, especially myocardial infarction. Unfortunately, every year about 805,000 people in the United States have a heart attack. Basically, someone has a heart attack every 40 seconds. And that is why we invited the Chief Executive Officer for the Innova Revenue Group, Lidiya Ter-Markorova, a clinical documentation integrity expert, to discuss documentation and coding pain points for myocardial infarction during the next live edition of Talk Ten Tuesdays. The live broadcast will also feature these other segments: Coding Report: SDoH Report: News Desk: TalkBack:

Listen to Mary's Bookclub, where Mary summarizes the products you can find at the MedLearn online bookstore! In this episode, Mary goes over the Respiratory Therapy All Access Pass, and why it is an important product for healthcare professionals.

As rural hospital closures continue to increase (136 have occurred between 2010 and 2021), health information management (HIM) and clinical documentation improvement (CDI) professionals have key roles in ensuring revenue integrity and optimization essential to sound operations and access. Even so, small facilities, especially those operating independently, simply do not have the resources that larger chains have to negotiate favorable payer contracts and to implement processes, technologies, and training essential to withstanding payer denials. In addressing these crucially important issues, Talk Ten Tuesdays, the live Internet radio program produced by ICD10monitor, will begin a new series that will address rigorous revenue integrity solutions that can be developed in a rural environment, while offering tips in creating win-win scenarios with medical/provider staffs. Join expert coder James S. Kennedy, MD – a native of East Tennessee, which has its own share of rural hospitals – as he offers experience, guidance, and hope essential to success. The live broadcast will also feature these other segments: Coding Report: SDoH Report: Talk Law:News Desk: TalkBack:

Who knew that when the venerable American Medical Association’s (AMA’s) combining two hospital encounter service types into one code set of inpatient/observation services – initial and subsequent – consternation would be the outcome. The confusion: what entity can actually bill an inpatient initial code, 99221-99223, and who must default to subsequent codes or report office and other outpatient codes when seeing patients in the observation setting? The good news: during the next live edition of the long-running and popular Talk Ten Tuesdays Internet broadcast, Terry Fletcher will return to the broadcast and offer her interpretation of the rules, and how multi-specialty practices will handle these changes. Moreover, Fletcher, a nationally recognized professional coder, educator, and auditor, will report on the contrast between CPT® and Medicare when reporting these services. The live broadcast will also feature these other segments: Coding Report: SDoH Report: Journaling John: News Desk: TalkBack:

The term “DRG mismatches” is most often used to describe situations wherein the working diagnosis-related group (DRG) selected by the clinical documentation improvement specialist (CDIS) differs from the final coded DRG, signaling that the CDIS and the coder have arrived at different principal diagnoses. In other situations, a procedure may have been coded incorrectly by the CDI professional, causing the DRG mismatch. But here’s good news: there’s a new workflow for resolving inpatient DRG mismatches. With this new workflow, the CDIS and coder no longer have to spend countless hours reconciling DRG mismatches. During the next live edition of Talk Ten Tuesdays, Patty Chua, president of Innova Revenue Group, will report on the positive coding implications this new workflow has created. The live broadcast will also feature these other segments: Revenue Cycle Report: SDoH Report: Journaling John, MD: News Desk: Point of View: