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.

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 increase. Among other findings, the Scorecard found that healthcare costs are placing an increasing financial burden on families across the nation. 

Reporting our lead story during the next edition of Talk Ten Tuesdays will be David C. Radley, a senior scientist for The Commonwealth Fund's Tracking Health System Performance program. Dr. Radley and his team develop the national, state, and sub-state regional analyses on healthcare system performance and related insurance and care system market structure. He is also a senior study director at Westat, a research firm that supports the Scorecard project. 

The broadcast will also feature 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 skilled nursing facility (SNF) revenue cycle for FY 2020.
  
  
• 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: John K. Hall joins the broadcast to discuss the latest news on TPE audits.
  
  
• 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.

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. However, in 2018, as Medicare continues to reinforce support for primary care and certain medical specialties like cardiology, anticoagulation management is now a payable service, which may be available for work that is already being done in your practice.

During this edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher reports on the importance of documentation to capture the new CPT® codes for home and outpatient INR monitoring services. 

This broadcast will also feature:

• The Coding Report: The Centers for Medicare & Medicaid Services (CMS) Inpatient Prospective Payment System (IPPS) proposed changes for acute-care hospitals in the 2020 fiscal year include discussions of complication or comorbidity (CC) and major complication or comorbidity (MCC) adjustments. Nationally recognized health information management (HIM) leader and past president of the California Health Information Management Association, Gloryanne Bryant, reports this developing story. 
  
  
• The Dunn Report: National HIM expert and past American Health Information Management Association (AHIMA) President Rose Dunn returns to the broadcast with her fifth installment in her series on how HIM can play a role in other areas of the revenue cycle.
  
  
• 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, offers her unique blend of analysis and commentary on a current healthcare issue. 

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:

• Tuesday Focus: The trend of mobile monitoring and moving the intensive care monitoring unit out into the community to improve care, thus allowing people to age safely and gracefully in their homes, will be reported on when Nick van Terheyden, MD, AKA, “The Incrementalist,” returns to the broadcast.
  
  
• 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 at 11: Rhonda Buckholtz, chief compliance officer for Century Vision Global, reports on the new codes for corneal dystrophy in ICD-11.
  
  
• Mental Health Report: A recent Journal of the American Medical Association (JAMA) study shows that the suicide rate among girls 10 to 14 has been increasing faster than it has for boys in the same age bracket. Providing context and insight into this disturbing trend will be a nationally renowned psychiatrist and author H. Steven Moffic, MD.
  
  
• The Coding Report: Laurie Johnson will report on burnout, since the topic is now an official diagnosis in ICD-11, according to the World Health Organization (WHO). Johnson is a senior healthcare consultant at Revenue Cycle Solutions, LLC.
  
  
• News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.

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 2018 indicated that the industry at large still lags far behind past expectations. In addition, as production under ICD-10 increases, accuracy decreases. Reporting our lead story during the next edition of Talk Ten Tuesdays will be Holly Louie, past president of the Healthcare Business and Management Association (HBMA) and guest co-host. 

The live broadcast will also feature these other segments:

• Tuesday Focus: Justin Hammerling, president of Kapios Health and vice president of ProMedica, reports on the disconnect between doctors and coders when scheduling inpatient surgeries.
  
  
• The CDI Report: Dr. James Kennedy, physician, certified coder, and clinical documentation improvement (CDI) specialist, reports on strategies you can use to appropriately upgrade your action plan for coding additional inpatient diagnoses.
  
  
• Coding Life in Transition: Nationally recognized professional physician coder and auditor Terry Fletcher reports on coding for transitional care management (TCM) for patients with medical and/or psychosocial problems requiring moderate or high-complexity medical decision-making.
  
  
• Revenue Cycle Report: Bonnie S. Cassidy, nationally renowned health information management (HIM) authority, reports on why the mid-revenue cycle has traditionally been under-resourced.
  
  
• News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent anchors the Talk Ten Tuesdays News Desk.

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, but you need to be walked through the steps of these important conversations first, then consider the options, for coding, billing, and reimbursement. Most practices have been providing this important service for years, but have never charged for it. 

Nationally recognized professional physician coder and auditor Terry Fletcher will be reporting our lead story during this edition of Talk Ten Tuesdays, she will discuss ACP directives and regulatory insight you need to get started. 

The live broadcast will also feature these other segments:

• Tuesday Focus: The American Hospital Association’s (AHA’s) quarterly ICD-10-CM/PCS Coding Clinic addresses questions and challenges associated with clinical coding and helps ensure that compliant coding is practiced. The ICD10monitor webcast series on this topic updates coders with the latest information. Reporting on the most recent update is Gloryanne Bryant.
  
  
• The Coding Report: Laurie Johnson, a senior healthcare consultant at Revenue Cycle Solutions, LLC, reports on the latest coding news.
  
  
• 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, will offer her unique blend of analysis and commentary on a current healthcare issue.