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 coder and auditor Terry Fletcher discusses the American Medical Association’s (AMA’s) rules, the position taken by Medicare, and how the electronic medical record (EMR) can actually assist you in your efforts.

But should time really be the new standard for supporting your patient encounters? 

The broadcast also features these other segments:

• Coding Report: Speaking of E&M coding, 2020 proposed Medicare Physician Fee Schedule (MPFS) shows a significant shift from the 2019 version. Sally Streiber, president of Practical Coding Solutions, explores the changes, including removal of 99201, how levels of service may be selected, and what “time” may mean in the future. 
  
  
• Tuesday Focus: Susan Gatehouse, CEO of Axea Solutions, returns to the broadcast to continues her reporting on the need to focus technology advancements on real transformation rather than transactional efficiency.
  
  
• News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent anchors the Talk Ten Tuesdays News Desk.
  
  
• TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, discusses the recent decision by a Texas federal judge to dismiss a False Claims Act lawsuit alleging that Dallas-based Baylor Scott & White Health overbilled Medicare by improperly upcoding claims.

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 professional physician coder and auditor Terry Fletcher explains what codes to choose, how to understand them, and how to apply them to this new population of patient encounters.

The live broadcast will also feature these other segments:

• Coding Report: Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on the latest development in the baffling condition known as acute flaccid myelitis (AFM).
  
  
• CDI Report: Gloryanne Bryant, nationally recognized health information management leader, author, and clinical coding and documentation expert, reports on the MS-DRG updates as found in the 2020 Inpatient Prospective Payment System (IPPS) Final Rule. 
  
  
• Tuesday Focus: Susan Gatehouse, CEO of Axea Solutions, reports on the need to focus technology advancements on real transformation rather than transactional efficiency. 
  
  
• News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk. 
  
  
• TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, continues her discussion of SEP-1.

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 and powerful communication tool.

The live broadcast will also feature these other segments:

• The Coding Report: Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, will have the Talk Ten Tuesdays coding report.  
  
  
• Tuesday Focus: Rhonda Buckholtz, chief compliance officer for Century Vision Global, will report on the use of evidence-based medicine to influence CDI improvements.
  
  
  
• News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent will anchor the Talk Ten Tuesdays News Desk.
  
  
  
• TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will discuss the contentious subject of SEP-1.

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? 

Reporting our lead story during this edition of Talk Ten Tuesdays will be Megan Cortazzo, MD, Medical Director for Clinical Documentation Improvement and Health Information Management at UPMC and Assistant Professor of Physical Medicine and Rehabilitation. Joining the conversation on burnout will be nationally prominent psychiatrist H. Steven Moffic, MD. 

The live broadcast will also feature these other segments:

• The Coding Report: Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, has the Talk Ten Tuesdays coding report.
  
  
• RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional turned well-known healthcare IT authority, reports on the latest regulatory news coming out of Washington, D.C. 
  
  
• News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk. 
  
  
  
• TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on the latest coding and documentation issue that has caught her attention.

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 segments:

• The Coding Report: Laurie Johnson, a senior healthcare consultant at Revenue Cycle Solutions, LLC, discusses World Hepatitis day on the Talk Ten Tuesday coding report.
  
  
• The Dunn Report: National health information management (HIM) expert and past American Health Information Management Association (AHIMA) President Rose Dunn returns to the broadcast with the sixth installment in her series on how HIM can play a role in other areas of the revenue cycle.
  
  
• Tuesday Focus: Rhonda Buckholtz, chief compliance officer for Century Vision Global, reports on a mystery code – actually, a diagnosis code – that could trigger an audit that could lead to a complete refund.
  
  
• News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent anchors the Talk Ten Tuesdays News Desk.
  
  
• TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on emergency room critical care time documentation.

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 broadcast also features these other segments:

• The Revenue Cycle Report: Bonnie S. Cassidy, nationally renowned health information management (HIM) authority, reports on the importance of ICD-10 coding in the revenue cycle.
  
  
• Dateline Washington: Leslie Krigstein, vice president of congressional affairs for the College of Health Information Management Executives (CHIME), reports on the latest healthcare news coming out of Washington, D.C. 
  
  
• News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent anchors the Talk Ten Tuesdays News Desk.
  
  
• TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, discuss' the need for physicians to take care of the whole patient, without a preoccupation with DRGs and CC/MCCs.

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 recognized by regulators and auditors alike. 

Reporting our lead story during thisTalk Ten Tuesdays is nationally recognized health information management leader, author, and clinical coding and documentation expert Gloryanne Bryant.

The broadcast also features these other segments:

• Tuesday Focus: A new national collaborative to advance interoperable social risk and protective factor documentation, titled The Gravity Project, was launched May 2, 2019. The Robert Wood Johnson Foundation has funded this partnering with the SIREN: the University of California San Francisco’s Social Interventions Research and Evaluation Network, along with EMI Advisors LLC. Reporting of the work of The Gravity Project is EMI Project Manager Evelyn Gallego. 
  
  
• Coding Report: Melinda Battaile, physician advisor for CDI at Vidan Health, report on how a provider used a 2003 Coding Clinic to decrease reimbursement when both acute kidney injury (AKI) and dehydration were present on admission and established to be a coequal diagnosis.
   
• News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
  
  
• TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on clinical validation denials for cerebral edema.

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 System Coding Educator, wrote the story. The topic solicited many comments, creating a contentious debate. 

Now, one year later Talk Ten Tuesday checks in with Anny Pang Yuen who wrote a follow-up article for ICD10monitor in August of last year. Returning to the broadcast will be Debra Beisel Benton. 

What changes have taken place since last year? How are AHIMA and AAPC responding to this debate? During the next edition of Talk Ten Tuesday, you’ll hear the very latest on this contentious issue when both Yuen and Beisel Benton report our lead story. 

The live broadcast will also feature these other segments:

• Tuesday Focus: S. Diane Iverson, a case manager at a major teaching hospital in Baltimore, reports on The Gravity Project as it relates to the social determinants of health (SdoH).
  
  
• News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent anchors the Talk Ten Tuesdays News Desk.
  
  
• TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on pitfalls of voice recognition.

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 on this topic, as well as The Joint Commission and several of the Centers for Medicare & Medicaid Services (CMS) Medicare Administrative Contractor (MAC) payers. Reporting on this, our lead story during this edition of Talk  Ten Tuesdays is a nationally recognized professional physician coder and auditor Terry Fletcher.

The live broadcast also features these other segments:
The Coding Report: Laurie Johnson reports on the latest ICD-10 coding news. Johnson is a senior healthcare consultant at Revenue Cycle Solutions, LLC.

CDI Report: Continually monitoring the clinical documentation improvement/integrity (CDI) landscape, to assess current issues the industry may be facing, is one of the roles being fulfilled by the American Health Information Management Association (AHIMA). Tammy Combs, director of HIM Practice Excellence/CDI Nurse Plan for AHIMA, reports on this story.

RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional turned well-known healthcare IT authority, reports on the latest regulatory news coming out of Washington, D.C.

News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent anchors the Talk Ten Tuesdays News Desk.

TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, reports on the latest coding and documentation issue that has caught her attention.

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 lead story.

Dr. Nick discusses the importance of sleep, which he describes as offering “the incredible benefits of this amazing new treatment that allows you to live longer, improves your memory, makes you more creative and slimmer, (and) decreases (risk of) cancer, dementia, infections, heart disease, strokes, and diabetes.”

The live broadcast will also feature these other segments:

• The Coding Report: Laurie Johnson report on ICD-10 coding for sleep disorders. Sleep disorders can be coded based on interruption in sleep patterns to substances that interrupt sleep. Johnson is a senior healthcare consultant at Revenue Cycle Solutions, LLC.  
  
  
• Tuesday Focus: Inaccurate ICD-10 coding reported by Holly Louie, past president of the Healthcare Business and Management Association. Louie, who continues her exploration of this important subject, will also report on her recent meeting with officials at the Centers for Medicare & Medicaid Services (CMS).  
  
  
• News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent anchors the Talk Ten Tuesdays News Desk.  
  
  
• TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, continues her reporting on the recent ACDIS conference.