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. But it’s not all bad news. On this edition of Talk Ten Tuesdays, when Sally Streiber, president of Practical Coding Solutions, LLC, returns to the broadcast and launch part one of her two-part series reviewing the proposed changes. Sally will begin the first ...
It’s often said that “words matter.” And hospital patient status assignment is no exception. What do your teams say when a patient is in inpatient status which isn’t supported? How about the reverse: when a patient is in outpatient status with observation services. Can your team change to inpatient? Words matter, and Dr. Juliet Ugarte Hopkins, chief medical officer for Phoenix Medical Management, Inc., will explain precisely how impactful your choices can be. During the next...
A new version of the Sequential Organ Failure Assessment (SOFA) score, has been introduced. The new revision aligns the organ dysfunction measurement in critically ill adults with current clinical practices, especially those diagnosed with sepsis. Published Oct. 29 in Journal of the American Medical Association (JAMA) and is available here https://jamanetwork.com/journals/jama/fullarticle/2840822. During the next live edition of Talk Ten Tuesday, Dr. James S. Kennedy will discuss this new SOF...
Welcome to “Is Ambient Listening Right for You?” Or, in the alternative, “Free AI Tools and Other Expensive Mistakes.” Nick van Terheyden, MD, the special guest during the next live edition of Talk Ten Tuesdays, says he has seen enough of artificial intelligence (AI) “helpers” turn doctors into unpaid editors and part-time exorcists for hallucinating software. “Clinicians signed up to heal humans, not debug bots,” Dr. Nick said. “Yet here we are, creating ‘AI slop’ so thick it needs its own b...
H.R. 1, known as the One Big Beautiful Bill Act (OBBBA), is set to reshape hospital finances by cutting an estimated $840 billion from Medicaid and Patient Protection and Affordable Care Act (PPACA) funding. As hospitals absorb these losses, many are tightening budgets, reducing staff, and facing renewed labor tensions. For the first time, clinical documentation integrity (CDI) teams are part of this unionized landscape, connecting frontline workforce issues directly to reimbursement and data...
Have you been told that Medicare and Medicare Advantage (MA) patients who have difficulties with activities of daily living (ADLs) are appropriate for inpatient status if their hospital stay crosses a second midnight? What direction have you received about “discharge effectuation?” Are your physicians keen on placing the majority of their patients into inpatient status because they want to prevent delivery of an expensive hospital bill? During the next live edition of Talk T...
Join us this coming Tuesday, Oct. 14, when Talk Ten Tuesday will bring you an exclusive interview with two nationally recognized healthcare leaders: Thea Campbell and Mackenzie Higgins. Thea Campbell is the 2026 AHIMA President-Elect and Mackenzie Higgins is the 2025 AHIMA Emerging Star award recipient. The popular broadcast will also feature these instantly recognizable panelists, who will report more news during their segments: CDI Report: Cheryl Ericson, Senior Director of Clinical Policy ...
The revenue cycle helps keep hospital revenue flowing. But sometimes, it seems to sputter out, as if not all the cylinders are firing. And that is why the producers of Talk Ten Tuesdays have invited longtime ICD10monitor editorial consultant Dennis Jones, senior director of revenue cycle at the famed Jefferson Health, to be the special guest during the next live edition of the weekly Internet radio broadcast. The popular broadcast will also feature these instantly recognizable panelists, who ...
When the final rule take effect Oct. 1, 2025, coders, providers, and administration leaders will need to adjust to several key changes, including the new MS-DRGs and broad policy changes. And that is why the producers of Talk Ten Tuesday have invited Leigh Poland, vice president of the AGS Health coding service product line to return to the popular Internet broadcast, Talk Ten Tuesday, to report on these significant changes. The popular Internet broadcast will also feature these additional in...
Prolonged hospitalizations can result from many different barriers and delays within the hospital setting. However, a new challenge is emerging. And this new hurdle appears to be identified more and more commonly. So, what’s happening? During the next live edition of Talk Ten Tuesdays, Dr. Juliet B. Ugarte Hopkins, Chief Medical Officer at Phoenix Medical Management, Inc., will reveal this new culprit that appears to be standing between many a patient and a safe discharge. The popular Interne...
Could sepsis be healthcare’s new frontier? During the next live edition of the popular Internet broadcast, Talk Ten Tuesday, James S. Kennedy, MD, will report on his recent attendance at The Unite for Sepsis symposium, sponsored by the San Diego-based Sepsis Alliance (https://www.sepsis.org). The event was held in Chicago and attracted clinicians, researchers, technologists, and government officials who collaborated to address and solve sepsis’ prevalent and high morbidity and mortality. Dr. ...
You waited and waited. Finally, the big day came, and just as quickly, day turned into evening – and there you were with cloudy vision, halos, and difficulty reading. Not to mention the occasional glare. You and about 25 percent of patients experience a common complication following cataract surgery (or, more precisely, “posterior capsule opacity,” or PCO). The good news: the standard treatment is YAG laser capsulotomy (CPT® 66821). The legendary Rose T. Dunn, past president and interim CEO f...
Artificial intelligence (AI) has quickly transitioned from something to expect in the future to the here and now today. The potential for AI in health information is both exciting and daunting. Reporting the lead story during the next live edition of Talk Ten Tuesday will be longtime RACmonitor and ICD10monitor contributing author Sharon Easterling. Sharon Easterling will continue her editorial series on artificial intelligence and medical record coding. The popular Internet broadcast will al...
At one time, a physician advisor in a hospital was a rarity. That was then, but this is now, with many healthcare systems having not just one physician advisor, but often many on staff. Does this emerging need signal the deployment of a new position within the physician advisory service team? To learn more, ICD10monitor producers have invited Dr. Juliet B. Ugarte Hopkins to explain when and how this might be accomplished. Dr. Ugarte Hopkins, the chief medical officer for Phoenix Medical Manag...
Although the proposed rule for the 2026 Inpatient Prospective Payment System (IPPS) has been released by the Centers for Medicare & Medicaid Services (CMS), mastering the complexities will continue to challenge most coders and coding team members. That is why ICD10monitor producers have asked Dr. James S. Kennedy to join the upcoming edition of Talk Ten Tuesdays: to highlight potentially significant roadblocks that are likely to confront coders as they prepare to implement the new rule th...
During the next live edition of the popular Talk Ten Tuesday Internet broadcast, you’ll learn how artificial intelligence (AI) and autonomous coding are quickly reshaping the day-to-day work of coders. From inpatient DRG suggestions to outpatient evaluation and management (E&M) automation, these tools speed up workflows, reduce errors, and help prevent costly denials, according to Penny Jefferson, the special guest for the Internet program, produced by ICD10monitor. You’ll also learn the ...
According to the Centers for Disease Control and Prevention (CDC), accidental falls are the leading cause of injury for adults 65 and older, with more than 1 in 4 older adults reporting falls every year. During the next live edition of Talk Ten Tuesday, Dr. James S. Kennedy will discuss the clinical concept of the “fragility fracture,” and how the under-documentation of fragility fractures results in inaccurate ICD-10-CM coding, adversely affecting Centers for Medicare & Medicaid Services...
Substance abuse is a pervasive issue with profound implications for hospitals. It has been estimated that up to 25 percent of hospitalized patients have a substance abuse disorder. And up to 44 percent of these patients abuse some substance during hospitalization. The annual estimated hospital cost for treating substance abuse disorders is as high as $13 billion. But it’s not limited to patients, according to physician and attorney Dr. John K. Hall, who will be the special guest during the ne...
Attention, calling all coders! Is your hospital compliantly following all the the steps in the Condition Code W2 process? It’s imperative to understand all the details that must be followed, no matter how complex and daunting. Implementation is mandated by the Centers for Medicare & Medicaid Services (CMS). Participation is not optional. So take a moment and ask yourself: are your attending physicians re-billing for Medicare Part B patients? During the next live edition of the popular liv...
Artificial intelligence (AI) has quickly transitioned from something to expect in the future to the here and now today. The potential for AI in health information is both exciting and daunting. Reporting the lead story during the next live edition of Talk Ten Tuesday will be longtime RACmonitor and ICD10monitor contributing author Sharon Easterling. Sharon Easterling is slated to create an editorial series on artificial intelligence. Her report on this topic will be a preview of what readers ...