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Get the most up-to-minute news and information on ICD-10. Join Chuck Buck and Erica Remer, MD, FACEP, CCDS, every Tuesday as they welcome ICD10monitor contributing editors and special guests to monitor and report on the progress that all healthcare stakeholders are experiencing in their respective implementations of ICD-10. Register to attend live here: https://event.webcasts.com/starthere.jsp?ei=1236510&tp_key=da0e4c0f76
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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-inten…
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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 ser…
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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 const…
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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 s…
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On the horizon, looming like an ominous thunderhead, is ICD-11. But wait! There’s more: the expanding role of coding in big data, for example. The evolving healthcare IT, and how it will redefine the coding profession. All this and more is coming your way. That’s why ICD10monitor and Talk Ten Tuesdays invited senior healthcare consultant Angela Com…
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Code G2211 continues to be a gift disguised as something else. As many nuances surrounding the code continue to linger, there are still some areas that are not as clear-cut as many healthcare professionals would prefer. As a refresher, G2211 allows providers (primary care, as well as specialists) to bill for additional cognitive work effort that is…
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How many hospital star ratings does your facility have? Do you know? If you don’t, you’re not alone. Apparently, many coders and clinical documentation integrity specialists (CDISs) don’t know. But you should know. That’s why ICD10monitor and Talk Ten Tuesdays have invited Michelle Wieczorek, a registered nurse (RN) and a CDI authority, to explain …
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During the next live edition of Talk Ten Tuesdays, award-winning author H. Steven Moffic, MD, considered to rank among the world’s most renowned psychiatrists, will report on what he calls “social psychoexemplaries” – the other side of what he reported two weeks ago on social psychopathologies. Moffic, in his popular daily column in Psychiatric Tim…
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What are the “do’s” and “don’ts” for the safe handling of HCPCS code G2211, used to report payment to physicians and other qualified healthcare providers for the additional work required to adequately care for patients with serious or complex conditions? The code is now payable for the 2024 calendar year (CY). Not only has the code quickly become e…
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Achieving high-performing revenue cycle management (RCM) begins with understanding where your healthcare organization falls on the RCM Maturity Framework, according to Matt Bridge, senior vice president for AGS Health. Bridge, who will be the special guest during the next upcoming edition of Talk Ten Tuesdays, says this four-stage framework informs…
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We are all familiar with DSM-5 and ICD-10 for the classification of various mental disorders. Both, but especially ICD, also cover some of the social conditions needing medical attention that may or may not be connected to the primary disorder or illness. ICD does that in the Z codes. However, Z codes are used infrequently. Moreover, many social pr…
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New Condition Code 92 is here, and it’s effective now. The code outlines the billing requirement for intensive outpatient program services for hospital outpatient departments, critical access hospitals (CAHs), and community mental health centers (CMHCs). To explain what you need to know about correctly billing the new Condition Code 92 during the n…
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Shrouded in controversy, the HCPCS code G2211 was released in 2021, proposed by the Centers for Medicare & Medicaid Services (CMS) to pay physicians and other qualified healthcare providers for the additional work required to adequately care for patients with serious or complex conditions. The code is now payable for calendar year (CY) 2024. The jo…
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Last year, healthcare professionals saw many of the rules for evaluation and management (E&M) services that were implemented in 2021 now applied to 2023 E&M codes. This included codes representing services for hospital inpatient care (99221-99223 and 99231-99233), emergency department visits (99281-99285), nursing facility visits (99307-99210), and…
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Codes for split (or shared) evaluation and management (E&M) services for 2024 have been revised, simplified, and aligned by the American Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS). During the next live edition of the long-running Talk Ten Tuesdays broadcast, 3M Senior Consultant Colleen Deighan-Ejak will repo…
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There’s a new code in town. It’s an add-on code, HCPCS Code G2211. And its effective date is Jan. 1, 2024. The new code is associated with the continuing focal point for all needed medical services that are part of ongoing care related to a patient’s single, serious condition, or complex condition. The Centers for Medicare & Medicaid Services (CMS)…
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There are substantial new changes to the minimum data set (MDS) assessment, including how functional abilities and goals are scored, the introduction of tracking of indications for medication use, and the addition of new measures for tracking communication of transfer-of-health information. The recent changes became effective Oct. 1, the start of t…
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MINOCA (myocardial infarction with non-obstructive coronary arteries) and INOCA (ischemia with non-obstructive coronary arteries) pertain generally to coronary artery disease. During the next live edition of the long-running and popular Internet broadcast Talk Ten Tuesdays, Pam Scott will take you on a coding journey into these conditions and the m…
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With thousands of followers on social media, Dr. Robert Oubre, aka “The Doctor of Documentation,” will make his Talk Ten Tuesdays debut on Tuesday, Nov. 7, when he will be the broadcast’s special guest. Dr. Oubre will be reporting on what documentation considerations should be given when patients are reading physician notes appearing on the monitor…
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Like autumn leaves, new codes and guidelines are raining down on hospitals and physician practices, impacting coders, clinical documentation integrity specialists (CDISs), and professionals managing the revenue cycle. And while there appears to be no respite, the weary can take comfort during the next live edition of the long-running and popular Ta…
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As the demand for telehealth services has surged, the nuances of coding and documentation for virtual visits present unique challenges and opportunities. During the next live edition of Talk Ten Tuesdays, Angela Comfort will delve into the specifics of coding for telehealth, including the evolving Centers for Medicare & Medicaid Services (CMS) guid…
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A must-have resource for any coding or clinical documentation integrity specialist (CDIS) is the American Hospital Association (AHA) Coding Clinic. Each quarterly issue provides official guidance for ICD-10-CM and ICD-10-PCS coding for all healthcare settings. The third-quarter issue covers a variety of topics, from prescribed marijuana use for chr…
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The nation’s healthcare spotlight will shine on the American Health Information Management Association (AHIMA) during the organization’s live AHIMA23 Conference, gaveling to order Oct. 8 through Oct. 10 at the Baltimore Convention Center. During the next live edition of Talk Ten Tuesdays, the legendary Rose Dunn, former AHIMA president and CEO, wil…
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The Centers for Disease Control and Prevention (CDC) has released the ICD-10-CM code updates for the 2024 fiscal year (FY), which will be effective starting Oct. 1. The update includes more than 433 diagnosis code changes, including 395 code additions, 25 code deletions, and 13 code revisions. It is essential for coding professionals to stay up-to-…
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There’s a new ICD-10 code presenting a new challenge for facilities, physicians, clinical documentation integrity specialists (CDISs), and coders: E88.A, muscle wasting due to underlying conditions. This new code represents an opportunity to identify, document, and report the frequent and too-often unrecognized undernutrition, sarcopenia, and cache…
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Artificial intelligence (AI) is what many in healthcare will come to remember about the closing years of this decade in healthcare – a decade of unprecedented technological changes, ranging from telehealth to algorithms. And now AI is becoming an accepted technology for evaluation and management (E&M) coding. The results appear to be dramatic in te…
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A reported 700,000 suicides worldwide annually are the impetus for the World Health Organization (WHO) to recognize what it has called a major public health problem ahead of World Suicide Prevention Day on Sept. 10. In recognition of this global issue, during its next edition, Talk Ten Tuesdays will feature world-renowned psychiatrist and award-win…
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Despite their advanced capabilities, artificial intelligence (AI) tools can occasionally misinterpret ambiguous documentation or lack the nuance necessary for complex decision-making. And that is why coders must continue to exercise their expertise and judgment when reviewing AI-assisted code assignment. This level of vigilance is crucial for ensur…
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The Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs) affect Leapfrog’s ubiquitous reputation scores and contribute approximately 15 percent to the Centers for Medicare & Medicaid Services (CMS) Hospital-Acquired Condition (HAC) penalty determinations of 1 percent of a hospital’s total inpatient reimbursement. AHRQ …
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The Centers for Medicare & Medicaid Services (CMS) has released the finalized 2024 Part C risk adjustment model, which goes into effect Jan. 1, 2024. This revised model, V28, comes with substantial changes to the current V24 model, starting with using the ICD-10-CM classification system – which aligns with the rest of the healthcare system that has…
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Start unpacking. The 2024 Inpatient Prospective Payment System (IPPS) Final Rule by the Centers for Medicare & Medicaid Services (CMS), plus half a dozen other final payment rules have arrived. To help you and your team prepare for the onslaught of new codes, Leigh Poland, vice president of coding service line for AGS Health, will offer practical t…
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The 2024 Inpatient Prospective Payment System (IPPS) Final Rule by the Centers for Medicare & Medicaid Services (CMS), plus half a dozen other 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 cover…
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Could clinical documentation improvement specialists (CDISs) be at risk as a profession, with the growing acceptance of automated query solutions? And what is driving the demand for them? Today, with the advent of “smart hospitals,” automated query solutions are being used by providers and CDISs in capturing acute and chronic diagnoses, as specifie…
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Revenue leakage presents a huge challenge for healthcare organizations. According to a study by the Healthcare Financial Management Association (HFMA), it can account for up to 5 percent of a healthcare organization’s net revenue – potentially making the difference between an entity being profitable or not profitable. Fear not, however – there are …
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At the intersection of ICD-10-CM social determinants of health (SDoH) codes and the Centers for Medicare & Medicaid Services (CMS) Star Rating Quality Measures, one will find a wide array of socio-economic factors and competing issues, all of which carry the potential to profoundly affect healthcare outcomes and ratings. During the next live editio…
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Major updates regarding progress on the imminent ICD-11 code set were made during the recent meeting of the National Committee of Vital Health Statistics (NCVHS), including a request for information on the enigmatic code set, yet to be adopted by the U.S. Stanley Nachimson, longtime editorial contributor to ICD10monitor and former career profession…
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What possible factors might trigger an audit or result in money being left on the table? During the live edition of Talk Ten Tuesdays, Gloryanne Bryant, an independent health information management (HIM) consultant, will report on highlights of the 2023 Second Quarter ICD-10-CM/PCS Coding Clinic from the American Hospital Association (AHA) for the …
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Delays in billing can cost healthcare providers billions of dollars annually. Join us during the next live edition of Talk Ten Tuesdays, when the broadcast’s special guest, Susie Vestevich, COO of TiaTech USA, will discuss potential solutions that may be implemented to combat this dire issue. Talk Ten Tuesdays will also feature these outstanding se…
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A recurring conflict continues to plague America’s patchwork system of healthcare delivery. How often, muses Mary Beth Pace, vice president of care management at Trinity Health, is the acute-care environment at odds with payers on the issue of inpatient versus outpatient care? “Is there a better way?” she asks rhetorically. “What if we partnered to…
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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 princ…
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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 …
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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 respo…
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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 w…
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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 …
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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 cod…
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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, V…
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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 …
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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…
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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 H…
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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 diffic…
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