Talk Ten Tuesdays

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: Clinical Audits: Nationally recognized health info...

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 broa...

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 o...

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 dur...

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,...

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 & Medic...

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 audi...

There are rules to follow when you are using "time" as your element of support for any evaluation and management (E&M) encounter. If a physician elects to report the level of care based on counseling and/or coordination of care, then a number of factors must be in the patient's medical record. During this edition of Talk Ten Tuesdays, nationally recognized professional physician...

Gender dysphoria is quickly moving into America’s healthcare lexicon as LGBTQ+ families are rising in number at historic rates, prompting the emergence of alternative medical clinics that are providing services for the transgender patient community. As a result, coders have questions – specifically, about ICD-10-CM diagnosis codes.  During this edition of Talk Ten Tuesdays, nationally recognized p...

So how do you as a coding professional ensure your physician queries are effective and compliant? First, it’s important to understand when to query a physician, how to submit a query and the best way to get a reply from your provider.  During the next edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher will provide insight into this important...

As reported by ICD10monitor, the World Health Organization (WHO) has classified physician burnout as an occupational phenomenon, while noting that it is not a medical diagnosis.  There are some estimates that more than half of physicians have experienced burnout. But what do coders and clinical documentation integrity specialists (CDISs) need to know about burnout among their physicians?  Reportin...

Has the art of telling the patient’s story through coding been lost?  So ponders Kristi Pollard, a senior coding consultant for the Haugen Group, who reports this intriguing story in this edition of Talk Ten Tuesdays. Pollard is expected to explain that, first and foremost, coders are storytellers who convey each patient’s medical story through codes.  The podcast also features these other segment...

What may seem relatively straightforward to some coders has been a headache, presenting confusion and ambiguity, for others, when it comes to charging for critical care services. During this edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher will focus not only on coding but also documentation compliance when reporting such services. The bro...

The ICD-10-CM/PCS update to the American Hospital Association’s (AHA’s) Coding Clinic for the second quarter of 2019 has been published, and there is plenty of news to report.  Each quarter, new advice and guidance are published by the AHA to address questions and challenges associated with clinical coding. The AHA Coding Clinic on ICD-10-CM/PCS is an “official” coding resource, and as such, it is...

During the sultry summer of 2018, a Talk Ten Tuesday listener asked if whether seasoned coding professionals were sufficiently trained and competent to interpret clinical terms and concepts from medical records. So the editorial team here at ICD10monitor published a story on the topic on July 17, 2018. Debra Beisel Benton, who at the time was working at Maricopa Integrated Health System as the HIM...

The dangers of cloned documentation can damage the perceived trustworthiness and integrity of the medical record for patient care. The current use of copy-and-paste functions in electronic medical record/health record (EMR/EHR) systems is a growing area of focus for government auditors. In fact, the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) has weighed in o...

There are a plethora of ICD-10 codes for sleep disorders – as many codes for these diagnoses as sheep jumping over a fence. And with the approach of summer, there is the concordant expectation of summer insomnia. “Sleep is not just a pillar of health, it is the foundation to health,” writes Nick van Terheyden, aka “Dr. Nick the Incrementalist,” founder of Incremental Healthcare, who reports our le...

The grades for America’s healthcare system are out, and the results are dismal, according to The Commonwealth Fund’s 2019 Scorecard on State Health System Performance, released Wednesday.  The Scorecard, according to The Commonwealth Fund, reveals that most states are losing ground on key measures related to life expectancy as premature deaths from suicide, alcohol, and drug overdose continue to i...

Along with one of the most common blood-thinning medications in the world, taken daily to prevent blood clots, comes frequent checks called “pro-times” or international normalized ratio (INR) monitoring.  This has been taken for granted in the past, as the work involved for the physician to monitor such patients at least monthly (and sometimes more often) can be costly for a medical practice. Howe...

The cascading implications of inaccurate ICD-10 coding are explored during this edition of Talk Ten Tuesdays. We are revisiting this timely and important subject, featured during the May 21 edition of the broadcast. Guest co-host Holly Louie returns to continue her reporting on how coding inaccuracies impact compliance and payment issues. The live broadcast will also feature these other segments:...

Central Learning is a web-based coding assessment and education application. Since 2016, the company has conducted an annual national coding review to measure ICD-10 coding accuracy and production.   The initial intent was to evaluate how coding accuracy and production fared using ICD-10, as compared to ICD-9. The common industry accuracy benchmark under ICD-9 was 95 percent.   The findings in 201...

Physicians and mid-level providers are having some serious conversations with patients regarding advanced care planning (ACP) – meaning the discussion of a serious illness and the next steps they need to take regarding advanced directives, hospice, skilled nursing, pre, and post-death arrangements, and more.  These discussions are now payable under most health insurance plans, including Medicare,...

If there’s an industry buzzword that is heard most often in today’s healthcare discourse, it might be “artificial intelligence” (AI). And just as the advent of the computer presaged concerns about job loss, the same could be said today about AI, especially when it comes to coding. But before AI came into vogue, computer-assisted coding (CAC) and the use of natural language processing (NLP) appeare...

Proposed changes to the Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System were posted late Tuesday by the Centers for Medicare & Medicaid Services (CMS).  And while the dust has yet to settle, the proposals are sending shockwaves through the coding and clinical documentation integrity (CDI) communities. Context, perspective, and analysis...

The patient’s physician requests the treatment advice of another physician consultant, but without a face-to-face encounter with the patient and that consultant. Is this a billable situation? Traditionally No. But since 2018 and even now, more specifically, CPT® codes in 2019, "virtual" peer reviews are a covered benefit for most payers. This is new territory when it comes to insurance c...