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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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Gas prices are heading straight to the stratosphere. Inflation is the elephant in the room. And there’s a growing concern in Medicare when it comes to physician payments. Here’s why: Medicare cuts are pending, including the PAYGO 4 percent, starting in 2023. What’s more, deductions from reinstated sequestrations are on the rise. There’s also an exp…
 
The Current Procedural Terminology ® (CPT) definition of Modifier 25 is that it is used to report an evaluation and management (E&M) service on a day when another service was provided to the patient by the same physician or other qualified healthcare professional. Think of Modifier 25 as a “protective” modifier when minor procedures or services are…
 
Listen to Mary's Bookclub, where Mary summarizes the books you can find at the MedLearn online bookstore! In today's episode, Mary explains the importance of Coding Essentials for Infusion & Injection Therapy Services. Listen in to find out why this textbook could be a great edition to add to your essential library.…
 
Has the U.S. Department of Health and Human Services (HHS) clarified which telehealth services are valid for data submissions for the HHS-operated risk adjustment (RA) program? Moreover, can Hierarchical Condition Category (HCC) ICD-10-codes – the risk-adjustment model designed to estimate future healthcare costs for patients – be used when the ser…
 
Revenues are trending down. Audits are on the upswing. Experienced revenue cycle professionals are in short supply. And complex coding and documenting issues seem to be an everyday occurrence. With all the evident Sturm und Drang confronting healthcare professionals of late, ICD10monitor and Talk Ten Tuesdays are producing a special 60-minute editi…
 
Listen to Mary's Bookclub, where Mary summarizes the books you can find at the MedLearn online bookstore! In today's episode, Mary explains the importance of Coding Essentials for Respiratory Therapy/ Pulmonary Function. Listen in to find out why this textbook could be a great edition to add to your essential library.…
 
Behavioral health can be confusing. To screen or not to screen, what are the questions? Joining us this Tuesday for the lead story is a new panelist, Christine Hall. Christine Hall is the CEO and Senior Consultant for Stirling Global Solutions, LLC. She has 30+ years of healthcare administration and information management experience. Christine is a…
 
With telehealth usage during the pandemic—up from 2.1 million services in 2019, to 32.5 million services from March 2020-February 2021—the GAO (US Government Accountability Office) realized that Medicaid hasn’t collected or assessed any data on the quality-of-care beneficiaries received from telehealth services. The GAO now recommends that they do …
 
Billing and collecting patient visits continue to challenge most healthcare providers and a frequent question often heard is “Can we bill a preventative medicine and new patient visit on the same day?” As a point of reference, there are circumstances when a preventative visit and a problem-oriented visit could be billed on the same date. The proble…
 
The Centers for Medicare & Medicaid Services (CMS) has released the hospital Inpatient Prospective Payment System (IPPS) Proposed Rule for short- and long-term acute-care hospitals. The Proposed Rule not only updates the Medicare approach to Medicare-Severity DRGs (MS-DRGs) reimbursement, but also advocates for the President’s executive orders addr…
 
A tragic milestone is about to be reached, bringing with it the potential to wreak havoc on America’s crumbling mental health infrastructure: the United States is poised to record one million deaths caused by the deadly coronavirus pandemic. Collateral damage created by these deaths could likely be compounded by hundreds of thousands grieving the l…
 
The Public Health Emergency (PHE) was extended, as expected, April 16. But here’s the caveat when it comes to PHE waivers: not all waivers were created equal. For example, does a PHE declaration waive or preempt state licensing requirements for healthcare providers? Are HIPAA protections for virtual care removed? Reporting this developing story dur…
 
The World Health Organization (WHO) has released the official version of ICD-11, and the National Committee on Vital Health Statistics (NCVHS), is calling for research to evaluate its use in the U.S. Reporting the lead story during the next live edition of Talk Ten Tuesdays will be the ICD-11 national correspondent for ICD10monitor, Mary Stanfill, …
 
Thursday, April 7, 2022, is designated as World Health Day by the World Health Organization (WHO). And in a fitting preamble to this annual event, ICD10monitor and Talk Ten Tuesdays will feature a special guest: International Health Information Association (IFMA) President Lorraine Fernandes, who will release an official statement by her organizati…
 
“Clinical Validation Denials: Queries and Strategies for Defending Claims,” and “Critical Care Services: 2022 Coding Update and Major Policy Changes” are discussed by Dr. John Zelem and Chuck Buck who analyze these two essential webcasts produced by ICD10monitor. Use code FRONTANDCENTER for 15% off your ICD10monitor webcast purchase.…
 
Artificial intelligence (AI) is omnipresent — in self-driving cars, manufacturing, and healthcare management. Now, AI is even being deployed in the physician query process. Yet engineering AI to be programmed for physician queries requires understanding the physician’s thought process. And that’s always a challenge, on any level — especially for AI…
 
Welcome to the 500th live broadcast of Talk Ten Tuesdays. Ten nationally recognized thought leaders are scheduled to appear during the landmark production. As part of the full 60-minute broadcast, you will hear updates on topics ranging from the deadly coronavirus to the latest healthcare regulatory news, along with updates on ICD-10 coding, clinic…
 
Two years ago this week, the World Health Organization (WHO) described COVID-19 as a pandemic — about the same time a cruise ship was held at sea off the California coast, with 3,500 people on board ultimately testing positive for the coronavirus. Today, masks are required. Social distancing is practiced. Countries close and open their borders, sch…
 
Only here on Talk Ten Tuesdays will you learn the whole story behind the latest request from the Centers for Medicare & Medicaid Services (CMS). The agency is asking for feedback on four cost-efficiency models as part of the Merit-Based Incentive Payment System (MIPS) program. The deadline is fast approaching: March 25, 2022. The proposed cost-effi…
 
“Clinical Validation Denials: Queries and Strategies for Defending Claims,” and “Critical Care Services: 2022 Coding Update and Major Policy Changes” are discussed by Dr. John Zelem and Chuck Buck who analyze these two essential webcasts produced by ICD10monitor. Use the code FRONTANDCENTER at checkout for 15% off your ICD10monitor webcasts! https:…
 
With Medicare audits looming and U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) Work Plan items now relating to telehealth services performed during the COVID-19 public health emergency (PHE), it is time to make certain that your organization is accurately reporting services and claims within the requirements o…
 
The recent announcement from the Pan American Health Organization (PAHO) that the World Health Organization’s (WHO’s) ICD-11 coding system went online as of Feb. 11 might have been met with measured enthusiasm globally, but not here in the United States. The much-vaunted coding set isn’t expected to reach America’s shores for perhaps as much as a d…
 
Brain disorders and the accurate selection of the principal diagnosis are two crucially important ICD10monitor webcast topics analyzed by Dr. John Zelem during his conversation with Chuck Buck. Great topics. Great analysis. More great educational opportunities now await you. So now get everyone on your team Front and Center.…
 
The billing rules for shared/split evaluation and management (E&M) visits are changing, as they will again in 2023. But although the Centers for Medicare & Medicaid Services (CMS) considers 2022 a transition year, controversy surrounding the 2022 Medicare Physician Fee Schedule (MPFS) is creating contagious confusion. If you and your team are suffe…
 
To improve care and create transparency, Medicare mandated a pay-for-quality reporting program for hospital outpatient services in 2009. The measures can impact hospital payment if not met, thus creating financial incentives for hospitals to achieve them. The measures are intended to evaluate the regularity of outpatient treatments known to provide…
 
Principal care management is a service that focuses on the medical and/or psychological needs manifested by a single, complex chronic condition that is expected to last at least three months in duration. During the next live edition of Talk Ten Tuesdays, Colleen Deighan, senior healthcare consultant for 3M HIS Consulting Services, will return to th…
 
In today’s supercharged general lexicon, words have enhanced meaning. So as more and more hospitals admit patients, the words “for” and “with” are garnering great significance. With hospitals filling up with patients who have a COVID-19 diagnosis linked to their stay, what is the actual admission for? During next week's Talk Ten Tuesdays broadcast,…
 
ICD10monitor and Talk Ten Tuesdays continue reporting on the social determinants of health (SDoH), as they relate to health equity. On Tuesday, Jan. 18, the day after the national observance of the life of slain civil rights leader Rev. Martin Luther King, Jr., Sharon Easterling, an African-American senior healthcare consultant, will return to the …
 
The health of all Americans is on the line – particularly among the nation’s communities of color, where maternal health issues, behavioral health issues, diabetes, and cardiovascular conditions have a disproportionate impact. Recognizing this national concern, the Blue Cross Blue Shield Association has devised a national health equity strategy to …
 
There’s never enough time to keep up with the myriad of changes confronting clinical documentation integrity specialists (CDISs). And that is why Talk Ten Tuesdays will reveal important content about a new white paper developed by the American Health Information Management Association (AHIMA) and the Association of Clinical Documentation Integrity …
 
Clinical documentation integrity (CDI) programs can have a broad impact in outpatient settings. One key area for outpatient CDI to consider is denials reduction, which begins with understanding what’s contributing to denial risk. Denial reduction is really about denial prevention. It’s about analyzing denials by category, by payer, and by reason to…
 
Are you facing a problem with your physcians? They find themselves with patients who have not just one but two or more chronic conditions that need managing? Not just for in-person encounters, but from an ongoing, non-face-to-face perspective? Many practices have this patient population, but are not capturing care management services correctly, or …
 
Like the inevitable approach of a slow-moving freight train, ICD-11 is on the horizon, heading this way. It’s coming. That’s why we asked Margaret Skurka to join us for the next upcoming edition of Talk-Ten-Tuesdays: to give you an exclusive update on the new code set for America’s health system. Skurka, a member of the National Committee of Vital …
 
The Omnibus COVID-19 Health Care Staff Vaccination Mandates are out! What entities are included under the regulations, and which are excluded? Facilities and physician practices have been doing everything they can to get staff and providers vaccinated, in fear of losing their provider status with Medicare and their funds being interrupted. But what…
 
Is the emergency department (ED) an outpatient CDI priority for your organization? The emergency department is the main source of admissions to a hospital – and the first location patients typically receive care. What should you consider when determining how an outpatient CDI program could support quality patient care, proper payment, and complete …
 
What can a medical assistant do – and not do? Medical assistants have a narrow list of tasks they can perform for patients or for a doctor in a doctor's office. It's often difficult to know what's allowed, because there are not strong laws or regulations in place regarding medical assistants. Since no one really “regulates” them, and they are frigh…
 
Outpatient CDI expert Colleen Deighan will return to the next edition of Talk Ten Tuesdays to continue her popular series on a subject that continues to generate listener interest and questions. Deighan will also conduct a listener’s survey during the weekly Internet radio broadcast. When healthcare organizations are considering, planning, or begin…
 
We’re taking AIM at reducing maternal morbidity and mortality during an exclusive four-part series on ICD10monitor and Talk Ten Tuesdays. The series will be led by senior healthcare consultant Kristi Pollard, Director of Coding Quality and Education for the Haugen Consulting Group. During her series, Kristi will discuss how coded data is being used…
 
Outpatient CDI programs can have real impact with risk adjustment and Hierarchical Condition Categories (HCCs). An important component of the HCC risk adjustment model is accurate and appropriate HCC capture, representing a patient’s disease burden year over year. HCCs reflect hierarchies within related disease categories. A patient can have multip…
 
The COVID-19 pandemic rages on, exposing huge gaps in America’s vulnerable healthcare system, posing life-or-death questions that tear at our collective subconsciousness. There’s also the constant drumbeat of headline news: vaccination mandates versus personal freedom, for example. Are two shots sufficient, or are three better? Should young childre…
 
Physician engagement, query productivity, and revenue integrity are some but not all of the activities that encompass today’s outpatient clinical documentation integrity (OP CDI) arena, which continues to gain traction among America’s hospitals and health systems. During an exclusive broadcast report, CDI expert Colleen Deighan will unveil a Talk T…
 
The National Institutes of Health (NIH) is awarding $470 million to New York University to perform a national study on “tens of thousands of people, to research the long-term effects of COVID-19.” One such individual who might be included in the study will be the special guest during the next live edition of Talk-Ten-Tuesdays: Deborah Grider, longt…
 
The COVID-19 pandemic continues to rage throughout the U.S., fueled by the Delta variant that is driving a new surge of infections of the deadly coronavirus – all this amid growing antagonism about mask mandates and vaccine hesitancy. The U.S. death toll now stands at more than 650,000, with projections indicating more than 750,000 deaths being lik…
 
Questions and concerns about the recent and significant updates to Patient Safety Indicators (PSI) by the Agency for Healthcare Research and Quality (AHRQ) has prompted the return of Dr. James Kennedy, a subject matter expert on PSIs, to the next live edition of Talk Ten Tuesdays. The live broadcast will also feature these other segments: Coding Re…
 
The Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs) – which factor greatly into provider success with the Medicare Inpatient Quality Reporting, Leapfrog, and Maryland quality initiatives – were recently significantly updated for the 2021 fiscal year (FY). During the next live edition of Talk Ten Tuesdays, you’ll l…
 
The rapidly expanding surge of COVID-19 infections is triggering a renewed look at the impact the virus is having on long-haulers. The pressing challenge is to understand the findings on the sequelae after recovery from COVID-19 – and what variations are expected to evolve. Meanwhile, research reveals that about 14 percent of adults who had been in…
 
Let’s start with a basic question: are you affiliated with a Health Insurance Portability and Accountability Act (HIPAA) covered entity? If so, remember, such entities must comply with standards for electronic transactions, not just privacy. When you’re asked about your vaccine status, do you claim a HIPAA violation? Is your vaccine status only you…
 
Surgery doesn't have to be complicated; it shouldn't automatically translate into a misadventure. Recent American Hospital Association (AHA) advice has the potential to result in artificially elevated complication rates for surgery, however, jeopardizing your safety and performance profiles. Clinical accuracy of diagnoses is king, even in the opera…
 
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