Talk Ten Tuesdays

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 Nuclear Medicine & PET Coder .  Listen in to find out why this textbook could be a great addition to add to your essential library.

Long awaited and highly anticipated is the new the Industry Practice Brief Guidelines to Achieving a Compliant Query Practice©, scheduled to released Monday, Oct. 10. The American Health Information Management Association (AHIMA) and the Association of Clinical Documentation Integrity Specialists (ACDIS) have co-authored an update to the Industry Practice Brief Guidelines to Achieving a Compliant...

Important healthcare news is happening at a furious rate and that is why the editorial team at ICD10monitor and Talk Ten Tuesdays is producing a national healthcare news roundup to deliver the news you need to know. During this special 60-minute broadcast you learn the latest coding news, as well as news about updates to the 2023 E&M coding and guideline changes, plus discover how one major he...

The American Medical Association (AMA) has announced significant revisions to Evaluation and Management (E&M) services for 2023.  Consultations, inpatient and outpatient consultations, are two of the E&M categories being revised for Jan. 1, 2023.  The revisions made to consultations include code deletions, revision to the criteria for E&M level selection and additions to the guidelines...

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 CT/MR Coder .  Listen in to find out why this textbook could be a great addition to add to your essential library.

Hospital inpatient denials continue at a furious pace. And there is strong evidence of a pattern of denied claims with a principal or secondary diagnosis of sepsis, a principal or secondary diagnosis of acute respiratory failure and denied hospital inpatient claims with the secondary diagnosis of malnutrition. When it comes to denials for a diagnosis of malnutrition, there appears to an additional...

Extensive changes are coming your way for hospital observation and inpatient services. And the time to prepare is now and this upcoming live edition of the long-running Talk Ten Tuesday broadcast is the place to begin to grasp the breadth and depth of these revisions from the American Medical Association. Colleen Deighan, senior consultant with 3M, will continue the second in her multi-series of r...

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 Peripheral & Cardiology Coder .  Listen in to find out why this textbook could be a great addition to add to your essential library.

The American Medical Association (AMA) revised the criteria for evaluation and management (E&M) services for the Office Visit categories of New and Established patients.  For 2023, similar revisions have been approved for the remainder of the E&M section. Revisions were also made to services for emergency, observation, inpatient, consultations, nursing, home and residence and prolonged car...

Are you a healthcare telecommuter? Is your workspace HIPAA compliant? While there are advantages of working remotely, there’s a monstrous risk for those who are obligated to comply with HIPAA: keeping patients’ protected health information (PHI) protected. Not convinced it’s a big deal? The U.S. Department of Health and Human Services (HHS) has the authority to levy hefty financial penalties when...

The Centers for Medicare & Medicaid Services will continue using PSI-04, Death Rate among Surgical Inpatients with Serious Treatable Complications, in its Hospital Inpatient Quality Reporting program. Be advised. This affects your facility’s reputation and reimbursement through fiscal year (FY)2028.  Unlike other PSIs, PSI-04 does not exclude cases based on the Present on Admission indicator o...

The U.S. Department of Health and Human Services (HHS) of the Office of Civil Rights (OCR) is warning healthcare providers about the mandatory compliance with the HIPAA Right of Access promulgated in the 21st Century CURES Act. So far, enforcement actions bring to 38 the number of financial penalties against HIPAA-covered entities for failing to provide patients with timely access to their medical...

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 Essentials of Interventional Radiology Coding .  Listen in to find out why this textbook could be a great addition to add to your essential library.

Coders, clinical documentation integrity specialist and revenue cycle professionals will be the beneficiaries next Tuesday during the live edition of Talk Ten Tuesdays when healthcare attorney and litigator Brianna J. Santolli returns to the broadcast and cuts through the legal jargon to warn of tactics deployed by some Medicare Advantage Organizations (MAO) to preserve profits by inappropriately...

Controversy, confusion and contradiction are obfuscating the reporting of telehealth services, especially now during the recently extended public health emergency. There is so much inconsistency with how to report telehealth right now, between what Medicare determines you can do, and what the mix of commercial payers declare is appropriate. And then there are individual state executive orders. Wha...

With the recent announcement of the 2023 Physician Fee Schedule, the Centers for Medicare & Medicaid Services (CMS) remains committed to encouraging and incentivizing cost efficiency by providers. Physicians electing to participate in the CMS Merit-Based Incentive Payment System (MIPS) will experience +/-9 percent impact in their traditional Medicare reimbursement based on their performance, 3...

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 Cardiac Rhythm Management Coder .  Listen in to find out why this textbook could be a great edition to add to your essential library.

As expected, the American Medical Association (AMA) has updated the guidelines for E&M services, starting in 2023. These relate to hospital services, emergency department visits, nursing facility services, home visits, and prolonged care services. Just as important, the AMA has deleted some observation care codes, the annual nursing facility assessment code, along with the domiciliary and rest...

 2022 ICD-10-CM/PCS Coding Clinic Update, Spinal Fusion ICD-10-PCS Coding, 2022 Telehealth Tune-up are discussed by Dr. John Zelem and Chuck Buck who analyze these two essential webcasts produced by ICD10monitor. 

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 Laboratories .  Listen in to find out why this textbook could be a great edition to add to your essential library.

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 expected lowering of the 2023 conversion factor, the...

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 performed on the same date as an E&M offi...

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 services reported are provided under the public heal...

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 edition of the famed Internet broadcast that will air T...