Talk Ten Tuesdays

Talk Ten Tuesdays

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Get the most up-to-minute news and information on ICD-10. Join Chuck Buck and Erica Remer, MD, FACEP, CCDS, every Tuesday as they welcome ICD10monitor contributing editors and special guests to monitor and report on the progress that all healthcare sta…


ICD-10-CM Coding for Transgender Patients
Aug 20 • 30 min
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…
The Art of the Physician Query
Aug 13 • 29 min
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.
Burnout: Information for Coders and CDI Specialists
Aug 6 • 27 min
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?
Patient-Focused Coding: Using Codes to Tell the Patient’s Story
Jul 30 • 29 min
Has the art of telling the patient’s story through coding been lost?
Avoiding Confusion over Critical Care Services
Jul 23 • 29 min
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.
2019 ICD-10-CM/PCS Coding Clinic Update
Jul 16 • 28 min
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.
Are HIM Coding Professionals Qualified to Query for Clinical Validity? Part III
Jul 9 • 29 min
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.
Serious Issues with Cloning Around
Jul 2 • 31 min
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…
A Physician’s Prescription for Avoiding ICD-10 Codes for Sleep Disorders
Jun 25 • 30 min
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.
States Receive Low Scores in the 2019 Scorecard on State Health System Performance
Jun 18 • 28 min
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.
Coding and Documenting Anticoagulation Management
Jun 11 • 28 min
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.
Coding Accuracy Assessment: Part II
Jun 4 • 28 min
Exploring the cascading implications of inaccurate ICD-10 coding .
Coding Accuracy Assessment: The News not Good
May 21 • 31 min
web-based coding assessment and education application
Advanced Care Planning: Now is Always a Good Time to Plan
May 14 • 29 min
Physicians and mid-level providers are having some serious conversations with patients regarding advanced care planning.
Computer-Assisted Coding and Artificial Intelligence: The Same, or Different?
May 7 • 30 min
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.
2020 IPPS Proposed Rule: Context, Perspective, and Analysis
Apr 30 • 29 min
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).
Peer-to-Peer Reviews: Virtually Speaking
Apr 23 • 30 min
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?
Removing the Speed Bumps from ICD-11 Adoption: Part II
Apr 16 • 30 min
ICD-11 – the new code set that is expected to be released next month by the WHO.
2020 Changes in Risk-Adjusted Reimbursement
Apr 9 • 30 min
What’s next, when it comes to risk-adjusted reimbursement?
CDI in the UAE: AHIMA World Congress
Apr 2 • 29 min
Clinical documentation integrity (CDI) is seen through an international lens as the contributions of the American Health Information Management Association’s (AHIMA’s) World Congress
Surprise Balance Billing Issues: Part II
Mar 26 • 30 min
Surprise balance billing is an issue that is not only generating national interest but also legislative engagement on the state level.
Removing the Speed Bumps from ICD-11 Adoption
Mar 19 • 28 min
Imagine an almost seamless transition from ICD-10 to ICD-11, unlike the sturm and drang that characterized the transition from ICD-9 to ICD-10 – which, finally, after the dust settled, became effective in 2015.
Welcome, Madam President
Mar 12 • 28 min
We are honored to welcome the President and Chair of the 2019 American Health Information Management Association (AHIMA) Board of Directors, Valerie Watzlaf, Ph.D. to this edition of Talk Ten Tuesdays.
Advocating for CDI
Mar 5 • 30 min
Clinical documentation integrity (CDI) industry continues to grow beyond the traditional inpatient setting, the American Health Information Management Association (AHIMA) is working to provide best-practice resources to provider stakeholders.
Reporting and Coding Separate Procedures: What Coders Need to Know
Feb 26 • 30 min
Many procedures in the CPT® codebook are designated “separate procedures,” but that doesn’t mean you can report those procedures “separately” in every case, according to nationally recognized professional coding expert Terry Fletcher, who returns to Talk…
New Patient versus Established Patient: The Coder’s Dilemma
Feb 12 • 28 min
Knowing how to distinguish new patients from established patients, apart from ensuring that coding guidelines are being followed, enables you to be reimbursed for the additional work that new patient visits warrant.
ICD-11: It’s Coming – So Start Planning Now
Feb 5 • 29 min
ICD-11 is fast approaching – which is why the new code set is on the radar screen at the American Health Information Management Association (AHIMA)
Sepsis-3 versus Sepsis-2: In Search of an Offramp
Jan 29 • 28 min
Dr. Remer will share insights from a targeted sepsis project that should help clarify how your facility should approach sepsis.
Code or Not to Code: Revisiting ICD-10-CM Guidelines
Jan 22 • 28 min
This guideline is frequently cited as the reason coders list diagnoses because the doctor said so. But is the doctor’s say-so enough?
Social Determinants of Health: Healthcare Issues Outside Your Hospital Are Affecting What Happens Inside
Jan 15 • 28 min
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.
Mystery Disease: Latest Update on AFM
Dec 12, 2018 • 30 min
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.
Perilous Compliance Challenges Facing Today’s New Coders
Dec 4, 2018 • 29 min
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…
To Link, or not to Link: That is the Question for Physician Documentation
Nov 27, 2018 • 29 min
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?
The Enigma of Sepsis: Providers vs. Payers
Nov 13, 2018 • 28 min
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…
Physician Burnout and PTSD: How Traumatic Events Impact Care
Nov 6, 2018 • 29 min
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?
ICD-10 Official Guidelines versus Coding Clinic for ICD-10-CM-PCS
Oct 30, 2018 • 31 min
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.
Understanding the Definition of Sepsis-3: The Sepsis Saga Continues
Oct 23, 2018 • 31 min
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…
Third-Quarter AHA Coding Clinic: A Developing Story
Oct 16, 2018 • 29 min
The third-quarter 2018 issue of AHA’s (the American Hospital Association’s) Coding Clinic for ICD-10-CM/PCS has been released.
ICD-10 Coding of Medicinal Marijuana: Developing Story
Oct 9, 2018 • 28 min
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…
New ICD-10 Codes Address Human Trafficking
Oct 2, 2018 • 27 min
Twenty-nine new ICD-10 codes that are expected to leverage the ability of providers to document clients who might be at risk of sex and labor exploitation went into effect Oct. 1.
Fourth Universal Definition of Myocardial Infarction: The Coder and the Cardiologist
Sep 25, 2018 • 30 min
During this of Talk Ten Tuesdays, the fourth universal definition of myocardial infarction (MI) is reported on from two perspectives: the cardiologist and the coder.
2019 IPPS Updates: Reviewing Major Disease Category 18
Sep 18, 2018 • 29 min
Many important and timley topics were covered in this weeks edition of Talk Ten Tuesdays.
ICD-10 Coordination and Maintenance Committee Meeting: Live Reporting
Sep 11, 2018 • 29 min
The next big milestone for ICD-10 is the 2018 Coordination and Maintenance Committee meeting in Baltimore. The two-day meeting covered the latest requests for diagnosis and procedure codes.
Proposed E&M Changes: The Good, the Bad, and the Ugly (Part II)
Aug 28, 2018 • 31 min
Questions are overflowing about the Centers for Medicare & Medicaid Services’ (CMS’s) proposed changes to evaluation and management (E&M) coding and reimbursement found inside the proposed 2019 Medicare Physician Fee Schedule.
Proposed E&M Changes: The Good, the Bad, and the Ugly
Aug 21, 2018 • 28 min
Backlash continues over the Centers for Medicare & Medicaid Services (CMS) proposed changes to evaluation and management (E&M) coding and reimbursement found inside the proposed 2019 Medicare Physician Fee Schedule.
Are HIM Coding Professionals Qualified to Query for Clinical Validity? Part II
Aug 14, 2018 • 27 min
Are HIM Coding Professionals Qualified to Query for Clinical Validity?
ICD-11: Hear the Latest Industry Buzz
Aug 7, 2018 • 29 min
There is a lot of buzz out in the industry about ICD-11, especially since the World Health Organization (WHO) released the new code set in June as first reported by ICD10monitor and Talk Ten Tuesday.
Stressing Out About the Z Codes: Healthcare’s New Imperative
Jul 31, 2018 • 28 min
American Hospital Association (AHA) changed coding rules, allowing case managers and social workers to assign Z codes—one of 88 assignable ICD-10 codes to report on claims for homelessness, low income, stressful work environment, low literacy, divorce,…
Reporting Bronchoalveolar Lavage Documentation Nightmare for Docs, Quandary for Coders
Jul 24, 2018 • 28 min
Coding guidelines and advice are taking bronchoalveolar lavage (BAL) to a surgical DRG. Should the body part be the bronchus or the lung?
Are HIM Coding Professionals Qualified to Query for Clinical Validity?
Jul 17, 2018 • 30 min
Are seasoned coding professionals competent or trained well enough to interpret clinical terms and concepts from the medical record? Although they have been doing so for decades, the question continues to remain contentious.
A Cautionary Tale: Text Messaging Medical Orders
Jul 10, 2018 • 31 min
Fast, convenient, and cutting-edge, the new trend of text-messaging medical orders is being met with mixed results.
The New Reality: ICD-11 Codes
Jun 26, 2018 • 29 min
ICD-11 codes are becoming healthcare’s new reality since the new code set was released this week by the World Health Organization (WHO) and reported on by ICD10monitor.
Coding and Documenting Sexual Harassment
Jun 19, 2018 • 7 min
“Sexual Harassment of Physicians Report 2018” – was published this week by Medscape, reporting that more than 10 percent of female physicians have experienced workplace sexual harassment.
Introducing the Hybrid CDI
Jun 12, 2018 • 32 min
The latest reiteration of its CDI program, called Hybrid CDI, constitutes a system that combines off-site as well as on-site clinical documentation integrity specialists.
2019 ICD-10-PCS Codes: New Details Revealed in Recently Released Files
Jun 5, 2018 • 29 min
There are 78,881 ICD-10-PCS codes for fiscal year 2019. Of these there will be 392 new codes; eight revision titles; and 216 deleted codes, according to nationally recognized coding authority Gloryanne Bryant, who reports our lead story during this…
Send in the Scribes: Medical Scribes to the Rescue
May 22, 2018 • 28 min
Smoldering below the surface is burnout, and it’s taking a toll on physicians. With increasingly high rates of reported physician suicides and an alarming decline in the volume of medical school applications, this situation could be the nation’s next…
New ICD-10 Codes for Women
May 15, 2018 • 29 min
Whether it’s discussing equal pay for women healthcare professionals, uncovering #MeToo narratives in the medical profession, or examining studies comparing women physicians’ and surgeons’ outcomes favorably to men’s, there has never been a more important…
Chief Complaint and the Medical Necessity Imperative
May 8, 2018 • 29 min
If there is no chief complaint, or no acute or chronic condition, auditors may not even continue with the record and negate its value altogether.
New ICD-10 Codes, New Challenges: Reporting on the IPPS Proposed Rule
May 1, 2018 • 30 min
Not wishing to disappoint, the 2019 Medicare Inpatient Prospective Payment System (IPPS) proposed rule, released on Tuesday, has something for everyone.
Auditing Issues Uncovered in Physician Documentation
Apr 24, 2018 • 31 min
It’s auditing season, and nationally recognized coding and documentation authority Terry Fletcher will be reporting on errors she is uncovering in a review of more than 1,000 records. During this episode, she shares her findings in the first of a…
How Risk Adjustment and HCCs Are Impacting Coding and CDI
Apr 19, 2018 • 29 min
During this episode Marie A. Morin, director at Alvarez and Marsal Healthcare Industry Group LLC, reports on her experiences in assisting clients with risk assessment, coding and documentation practices.
Wage Disparity and the Gender Gap: Probable Causes for Burnout?
Apr 10, 2018 • 29 min
Discussing the gender gap and wage disparities in medicine during this episode is Dr. Juliet Ugarte Hopkins, a physician advisor for case management, utilization, and clinical documentation at ProHealth Care, Inc. in Wisconsin.
MIPS: Maligned and Misunderstood
Apr 3, 2018 • 29 min
Maligned and misunderstood, the Merit-Based Incentive Payment System (MIPS) is under assault, as industry experts are urging officials at the U.S. Department of Health and Human Services (HHS) to consider repealing the program.
Medicare Beneficiaries to be Carded
Mar 27, 2018 • 28 min
Medicare beneficiaries will soon be receiving from the Centers for Medicare & Medicaid Services (CMS) new identification cards—cards that will use a unique and what CMS describes as a “randomly-assigned number” called a Medicare Beneficiary Identifier…
Myocardial Infarctions: The Impact on Mortality Rates
Mar 20, 2018 • 30 min
Given that February was American Heart Month, we will continue to focus on cardiology during this episode, as Jeffrey E. Epstein, MD, FACPA appears as a special guest along with Glenn Krauss.
The Continuous Challenge to Code and Document COPD Compliantly
Mar 13, 2018 • 29 min
COPD continues to be a challenge to code and document – its coding in particular, and its sequencing, can be difficult. Shedding light on this subject during this episode is Nelly Leon-Chisen, the director of coding and classification for the AHA.
Live Reporting on the ICD-10 Coordination and Maintenance Committee
Mar 6, 2018 • 30 min
The federal ICD-10 Coordination and Maintenance Committee (C&M) is scheduled to meet Tuesday and Wednesday, March 6 and 7, to discuss proposals for diagnosis code topics, with the conversation to be led by the Centers for Disease Control and Prevention…
Baltimore’s Best and Brightest Breaks Down Barriers in Health
Feb 27, 2018 • 29 min
February is Black History Month, and Talk Ten Tuesdays is recognizing it with an appearance by Dr. Crystal Watkins, who shares thoughts about her ascension from an African-American student in the Baltimore City Public Schools to becoming an MD, PhD,…
Changes to the NCD for Chronic Heart Failure Patients Receiving ICDs
Feb 20, 2018 • 29 min
CMS released a final decision memo for changes to the national coverage determination (NCD) for ICDs last Friday during American Heart Month. Reporting on this breaking news is Ronald Hirsch, MD.
How Cardiology Diagnosis Coding Will be Impacted in 2018
Feb 13, 2018 • 28 min
February is American Heart Month, and in recognition of this national focus, Talk Ten Tuesdays will center on how cardiology diagnosis coding for myocardial infarction (MI) is being impacted in 2018.
Medical Necessity vs. Medical Decision-Making
Feb 6, 2018 • 28 min
Are medical decision-making and medical necessity one in the same? Often, bad advice tends to circulate regarding how to select the correct E&M codes.
Unraveling the Mystery of OB Coding
Jan 30, 2018 • 29 min
Renal disease has been complicating obstetrics coding. For the first time on Talk Ten Tuesdays, two subject matter experts delve into this subject, which is rife with confusion and contradiction.
Coding and Documenting Chronic Conditions
Jan 23, 2018 • 29 min
Coding chronic conditions and co-morbidities is becoming increasingly critical as the healthcare landscape shifts toward value-based care, which attempts to advance the triple aim of providing better care for individuals, improving population health…
Six New Perspectives for Coding and CDI Programs
Jan 16, 2018 • 29 min
Senior healthcare consultant Michelle Wieczorek returns to discuss six ideas she says will improve performance indicators for coding and CDI departments.