Social determinants of health (SdoH) are swamping hospitals like rising rivers following a storm. A reported $1.7 trillion in healthcare costs are now attributed to 5 percent of the nation’s population, with a majority of that sum related to the SdoH. 

And while the focus has been largely on the most vulnerable and disenfranchised members of populations, the new face of SDoH is evolving as a consequence of an increase of natural and manmade disasters, as well as new attention being given to longstanding issues such as rural health, human trafficking, business closures, and loss of pensions for an increasing number of older adults.

Returning to Talk Ten Tuesdays to report on this developing story is nationally recognized SDoH authority, author, and educator Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP, the founder of EFS Supervision Strategies, LLC.

Other segments to be featured on the broadcast include:

• Coding Report: Coders will be dealing with new payment models in 2019, including one for skilled nursing facilities (SNFs) expected to be released on Oct. 1. Nationally recognized coding authority Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, reports this developing story.
  
  
• News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
  
  
• RegWatch: Leading healthcare technology consultant Stanley Nachimson returns with his popular segment, RegWatch, through which he reports on the latest regulatory changes coming out of Washington, D.C.
  
  
• DocTalk: Talk Ten Tuesdays guest co-host Juliet Ugarte Hopkins, MD, CHCQM, physician advisor of case management, utilization, and clinical documentation at ProHealth Care, reports on the collaboration between coding, clinical documentation integrity, and physician advisors when facing clinical validation denials.

The mystery continues. 

At the time of this report there were a reported 116 confirmed cases of acute flaccid myelitis (AFM) across 31 states, with the most cases reported in Colorado (15) and Texas (14). Plus, there are another 170 possible cases that haven’t been confirmed. 

AFM is similar to polio and leads to a sudden onset of paralysis. This condition mostly affects children younger than 4. These patients experienced a viral illness with fever and cough 3-10 days prior to the paralysis onset. 

Returning to Talk Ten Tuesdays to report on this developing story will be Jennifer P. Rubin, MD, attending physician in the neurology division of Northwestern University’s Feinberg School of Medicine. 

Other segments to be featured on the broadcast include:

• Tuesday Focus: There’s a reported fine line between coding for moderate sedation and monitored general sedation. Exploring this seemingly unchartered territory is Terry Fletcher, a nationally recognized professional physician coding consultant, educator, and auditor.
  
  
• News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
  
  
• Dateline Washington: Talk Ten Tuesdays legislative analyst Rhonda Taller has the latest news coming out of Washington, D.C. Rhonda is a member of the HIMSS professional development committee.
  
  
• TalkBack: Talk Ten Tuesdays co-host Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., reports on an issue that recently caught her attention during her popular TalkBack segment.

Never before has the responsibility of an organization to provide clear, facility-specific guidelines and in-depth training for coders been more apparent than it is today – especially now with the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) poised to conduct diagnosis-related group (DRG) validation audits. Reporting our lead story during this edition of Talk Ten Tuesdays will be Cari Greenwood who will discuss how your team should intensify training –- particularly when it comes to assigning correct codes for high-frequency, problem-prone, and high-cost diagnoses.

Other segments to be featured on the broadcast include:

• News Desk: Mary A. Inman, partner at Constantine Cannon’s London office, reports on the expected dismissal of the $188.1 million False Claims Act lawsuit filed by Med Analytics, LLC against Providence Health, now Providence St. Joseph, for allegedly upcoding various diagnoses.
  
  
• RegWatch: Leading healthcare technology consultant Stanley Nachimson returns with his popular segment, RegWatch, through which he reports on the latest regulatory changes coming out of Washington, D.C.
  
  
• Tuesday Focus: The Office of Disease Prevention and Health Promotion (ODPHP), on behalf of the Federal Interagency Steering Committee for Adverse Drug Events, recently released its final version of the National Action Plan for Adverse Drug Event Prevention (ADE Action Plan). Reporting on this developing story will be Ronald Hirsch, MD, vice president of R1 Physician Advisory Services.
  
  
• CDI Report: ICD10monitor contributor Glenn Krauss continues his reporting on clinical documentation integrity, but this time, he will focus on the recent decision by HHS OIG to conduct DRG validation audits.
  
  
• TalkBack: Talk Ten Tuesdays co-host Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., reports on an issue that recently caught her attention during her popular TalkBack segment.

Are you experiencing this dilemma at your facility? You ask your physicians to add linking verbiage to their documentation for accuracy, which in turn has a negative impact on their publicly reported scores regarding complications and other metrics. Should physicians exclude the linking verbiage? Should they enter “as expected,” or should they simply avoid addressing these issues? Reporting on this complex issue during the next edition of Talk Ten Tuesdays will be Sharon Savinsky, clinical documentation improvement specialist (CDIS) team manager at Winchester Medical Center in Winchester, Va.

Other segments to be featured on the broadcast include:

• News Desk: Laurie Johnson will anchor the Talk Ten-Tuesdays News Desk. Johnson is a senior healthcare consultant with Revenue Cycle Solutions, LLC and an ICD10monitor contributor.   
  
  
• Coding Report: Although the Centers for Medicare & Medicaid Services (CMS) has released the final rule on the 2019 Medicare Physician Fee Schedule (MPFS), Dr. Jeffrey Lehrman will report on one issue that CMS did not include in its extensive update.
  
  
• Tuesday Focus: Alarms are being sounded because of the clinical and privacy issues being raised as a result of offshore coding. Terry Fletcher, a nationally recognized professional physician coding consultant, educator and auditor, will report this developing story.
  
  
• TalkBack: Talk Ten Tuesdays co-host Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., will report on the recent decision by U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) to conduct DRG validation audits.

When it comes to defining sepsis, who wins? Is it providers, who rely on the current definition of sepsis as “life-threatening organ dysfunction caused by a dysregulated host response to infection?” Or do payers prevail – the ones who control the reimbursement? And under what circumstances would you ever side with a carrier that has denied a claim of sepsis?

Reporting our lead story during this edition of Talk Ten Tuesdays will be Roland Dale, responsible for denials prevention, for Hardin Medical Center, who shares his experience in these situations while offering important and timely advice.

Other segments to be featured on the broadcast include:

• News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
  
  
• Dateline Washington: Talk Ten Tuesdays legislative analyst Rhonda Taller has the latest news coming out of Washington, D.C. Rhonda is a member of the HIMSS professional development committee.
  
  
• Tuesday Focus: The Centers for Medicaid & Medicare Services (CMS) last week released the final rule on the 2019 Medicare Physician Fee Schedule (MPFS) and the Quality Payment Program (QPP). Reporting this developing story is Dheeraj Mahajan, MD, president and CEO of Chicago Internal Medicine Practice and Research (CIMPAR, SC), who leads its affiliated group of companies.
  
  
• TalkBack: Talk Ten Tuesdays co-host Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., will report on the Global Leadership Initiative on Malnutrition (GLIM) during her popular TalkBack segment.

The tragic events that shocked the nation’s collective conscience on an otherwise peaceful recent Saturday morning call to mind the intersection of physician burnout and post-traumatic stress syndrome.

With physician burnout reported to be widespread and suicides among physicians escalating at an alarming rate, do disasters – both natural and manmade – disproportionately impact the profession? Or are there other conflicts endemic to healthcare that tear at the emotional and mental health of physicians, thus creating a sense of helplessness?

Reporting on our lead story during this edition of Talk Ten Tuesdays will be Dr. Tracy Sanson, a practicing emergency physician, consultant, and educator on leadership development and medical education. A national and international speaker, Dr. Sanson also serves as a core faculty member for the American College of Emergency Physicians.

Other segments to be featured on the broadcast include:

• CDI Report: What does the future of clinical documentation integrity (CDI) look like? Mel Tully, vice president of clinical services and education for the healthcare division of Nuance Communication, reports on the evolution of CDI as an integrated, interdisciplinary function impacting patient care.
  
  
• News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesday News Desk.
  
  
• Tuesday Focus: Julie Dooling, a director at the American Health Information Management Association (AHIMA), reports on health information management challenges and tips for hospitals and other healthcare organizations in the aftermath of a hurricane, specifically in light of the devastation recently brought by Hurricane Michael.
  
  
• RegWatch: Leading healthcare technology consultant Stanley Nachimson returns to the broadcast to report on the final rules for the Medicare Physician Fee Schedule and the Quality Payment Program (QPP) that were released by the Centers for Medicare & Medicaid Services (CMS) on Thursday. 
  
  
• TalkBack: Talk Ten Tuesdays co-host Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., reports on an issue that recently caught her attention during her popular TalkBack segment.

The FY 2019 Official Guidelines for Coding and Reporting versus the American Hospital Association (AHA) third-quarter Coding Clinic: when it comes to coding body mass index (BMI), there’s a contradiction.

The Guidelines say BMI codes should only be assigned when the associated diagnosis meets the definition of a reportable diagnosis. AHA guidance states that obesity is always coded, even without supporting clinical significance. What’s a coder to do?

During this edition of Talk Ten Tuesdays, James Kennedy, MD offers timely and practical advice on how to handle and resolve this issue.

Other segments to be featured on the broadcast include:

• Coding Report: ICD-11 is being touted for its complexity and granularity, as you’ll learn when national health information management (HIM) expert and past American Health Information Management Association (AHIMA) President Rose Dunn returns to the broadcast.
  
  
• CDC Report: It’s flu season, and the Centers for Disease Control and Prevention (CDC) is recommending an annual influenza vaccination for patients six years and older. But is there more to be done? Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC and an ICD10monitor contributor,  reports the latest news from the CDC.
  
  
• News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesday News Desk.
  
  
• Tuesday Focus: Telemedicine is at a tipping point, expanding far beyond interactions between physicians and patients into entirely new ways to deliver healthcare and practice medicine. Where do ICD-10 and CPT® fit into this virtual delivery of medicine? That’s the question, and nationally recognized professional physician coding authority Terry Fletcher has the answers. 
  
  

UnitedHealthcare (UHC) has thrust Sepsis-3 into the national healthcare conversation with its recent announcement that come Jan. 1, 2019 it use the SEP-3 definition to determine if a diagnosis of sepsis is clinically validated, advising that the Sequential (sepsis-related) Organ Failure Assessment (SOFA) score is to be used to determine if sepsis is present.  Although the definition of Sepsis-3 was announced in February 2016, its acceptance has become more widespread as you learn when Dr. Edward Hu addresses this timely subject during this edition of Talk Ten Tuesdays. Dr. Hu is the executive director of Inpatient Physician Advisor Services for the University of North Carolina Health Care System and president of the American College of Physician Advisors.

Other segments to be featured on the broadcast include:

• Coding Report: The fourth-quarter 2018 issue of AHA’s (the American Hospital Association’s) Coding Clinic for ICD-10-CM/PCS has been released. Gloryanne Bryant reports on its significance.
  
  
• News Desk: Canada is now the second country following Uruguay to legalize the sale and recreational use of marijuana, although medical marijuana has been legal since 2001. Following up on an ICD10monitor exclusive story on medical marijuana on Oct. 9, is Timothy Powell, compliance expert and ICD10monitor national correspondent.
  
  
• Tuesday Focus: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC and an ICD10monitor contributor, reports on acute flaccid myelitis (AFM), a polio-like condition that mostly affects children. Joining the discussion is also Jennifer P. Rubin, MD, attending physician, Division of Neurology, Assistant professor of Pediatrics, Northwestern University Feinberg School of Medicine
  
  
• TalkBack: Talk Ten Tuesday co-host Erica Remer, MD reports on the first of her two-part series on diabetic foot ulcers versus pressure ulcers.

The third-quarter 2018 issue of AHA’s (the American Hospital Association’s) Coding Clinic for ICD-10-CM/PCS has been released, and during this edition of Talk Ten Tuesdays, Gloryanne Bryant will report on its significance.

Other segments to be featured on the broadcast include:

• News Desk: Daniel Zirkman, MD, anchors the Talk Ten Tuesdays News Desk with the very latest news on hospitals in the disaster zone, coping with the aftermath of Hurricane Michael. Zirkman rode out Hurricane Florence from his hospital, CarolinaEast Health System, in New Bern, North Carolina, where he is chief physician advisor.
  
  
• Tuesday Focus: Rhonda Buckholtz, chief compliance officer for Century Vision Global, reports on a recent study her organization undertook involving certified coders and clinical documentation integrity specialists (CDISs).
  
  
• Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC and an ICD10monitor contributor, reports on the very public health issue being faced by radio personality Marty Griffin of KDKA. Griffin recently announced to his listening audience that he has cancer related to human papilloma virus (HPV), which infects 80 million people, according to the Centers for Disease Control and Prevention (CDC).
  
  
• CDI Report: ICD10monitor contributor Glenn Krauss continues his reporting on clinical documentation integrity, but this time, Krauss will focus on what he describes as the “query quagmire,” in which too much emphasis is placed upon the query process without changing physician patterns of documentation.
  
  
• Parting Shot: Guest co-host Deborah Grider, consultant, educator and AMA author, reports on the recurring issue of cloned documentation.

Medical marijuana allows chronically ill patients to relieve painful, often debilitating symptoms legally instead of taking pills that many claim are mostly unhelpful. So why are there are no valid codes for submission for payment in the Current Procedural Terminology® (CPT), Healthcare Common Procedural Coding System (HCPCS), or National Drug Code (NDC) for medical marijuana?

The current state of claims payments for medical marijuana clearly has yet to be defined. So, what is the answer? Reporting this timely story during this edition of Talk Ten Tuesdays will be Terry Fletcher, a nationally recognized professional physician coding expert.

Other segments to be featured on the broadcast include:

• News Desk: Larry Field, DO, anchors the Talk Ten Tuesdays News Desk with the very latest healthcare news. Field is the treasurer of the American College of Physician Advisors.
  
  
• Tuesday Focus: Two new studies point to the alarming issue of physician burnout. The Journal of the American Medical Association (JAMA) reported that resident physicians’ symptoms of burnout and career choice regret have become increasingly prevalent. And the Physician’s Foundation’s 2018 Survey of America’s Physicians reported that physicians feeling burned out increased from 74 percent in 2016 to 77.8 percent in 2018. We report on this topic with two perspectives: Physician Michael Salvatore with Beebe Healthcare, and H. Steven Moffic, nationally renowned psychiatrist, will both share their reactions to this epidemic.
  
  
• TalkBack: Talk Ten Tuesdays co-host Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., reports on an issue that recently caught her attention during her popular TalkBack segment.