icd-11

From starkly arid lands to lush, cosmopolitan foreign capitals, a wide-ranging mix of peoples – some old, some new – were the focus of attention as the World Health Organization (WHO), with characteristic dignity, celebrated 75 years of improving the health of mankind.

ICD10monitor (so named for the WHO’s International Classification of Diseases, Version 10) and Talk Ten Tuesdays will mark the occasion with the conclusion of a two-part series recognizing the accomplishments of the WHO, which has been working overtime to alleviate deadly diseases, protect people from pandemics, and promote world peace.

During the next live edition of Talk Ten Tuesdays, Lorraine Fernandes, immediate past president and communications chair of the International Health Information Management Association (IHIMA), will be the special guest and will report on activities that took place during World Health Day.

The live broadcast will also feature these other segments:

• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the latest coding news.
  
  
• RegWatch: Stanley Nachimson, founder of Nachimson Advisors, LLC, will report on the latest news regulatory news coming out of Washington, DC.
  
  
• SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
  
  
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
  
  
• TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

Although World Health Day isn’t until April 7, ICD10monitor and Talk Ten Tuesdays will usher in an early recognition of the worldwide event beginning this coming Tuesday, with the start of a two-part series of broadcasts.

During the next live edition of Talk Ten Tuesdays, Mary H. Stanfill, ICD10monitor and broadcast ICD-11 correspondent, will have an update on the new coding system, which has been, according to the World Health Organization (WHO), adopted by 35 countries, including the U.S.

However, the implementation of the code set here remains, at this time, uncertain. During the subsequent Tuesday broadcast, on April 11, Lorraine Fernandes, immediate past president and communications chair of the International Health Information Management Association (IHIMA), will be the special guest and will report on activities that took place during World Health Day.

The live broadcast will also feature these other segments:

• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the latest coding news.
  
  
• SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
  
  
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
  
  
• TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

The end is near: the federal COVID-19 public health emergency (PHE) and national emergency declarations will come to a screeching halt on May 11.

And with that, there will be significant effects on healthcare and healthcare providers in the United States. The ends of these declarations could signal a major shift in the response to the pandemic, and may have far-reaching consequences for the industry.

One immediate effect could be a decrease in funding for COVID-19-related activities. And that is why, for the next upcoming edition of Talk Ten Tuesdays, we asked Lidiya Ter-Markarova to report on some of the more causative effects this post-PHE era will have on the healthcare system and providers.

The live broadcast will also feature these other segments:

• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the latest coding news.
  
  
• SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
  
  
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
  
  
• TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

Are there significant risks of potential fraud and abuse with Medicare Advantage (MA) by plans, vendors, and providers, with an emphasis on ICD-10-CM’s impact on Centers for Medicare & Medicaid Services Hierarchical Condition Category (CMS-HCC) risk adjustment?

Evidently, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) believes there are. Recently, Christi A. Grimm, Inspector General, issued a statement in which she addressed the concerns of the federal watchdog agency.

In response to her speech, we invited Dr. James Kennedy, a 20-year veteran in clinical documentation integrity (CDI) consulting and a popular panelist, to share succinct advice on how a compliance plan can best prepare for OIG audits that are sure to come.   

Programming note: Invite your compliance teams to hear what promises to be the best four minutes applicable to this challenge, during the next live edition of Talk Ten Tuesdays.

The live broadcast will also feature these other segments:

• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on coding colorectal cancer.
  
  
• SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
  
  
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
  
  
• TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

It’s all about the money. It’s not only getting paid, but also getting paid the right amount. Little wonder that this is first and foremost on every provider’s mind. Often, though, success or failure lies in the completion and details of medical notes taken.

So, what’s the deal with medical notes? Why are notes so important, and why are they difficult for providers to complete? We’ve invited Kevin Lasser, Co-founder and CEO of TiaTech, to be our special guest and to answer those questions during the next live edition of Talk Ten Tuesdays.

The live broadcast will also feature these other segments:

• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the outcome of the recent Coordination and Maintenance Committee (C&M) meeting.
  
  
• SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
  
  
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
  
  
• TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

ICD10monitor correspondent Linda Holtzman, founder of Clarity Coding, will return to the Talk Ten Tuesdays (TTT) broadcast this coming Tuesday, March 7 to report on the activities at the Coordination & Maintenance Committee (C&M) meeting taking place from the headquarters of the Centers for Medicare & Medicaid Services (CMS).

Holtzman, a longtime C&M observer, will bring her knowledge and expertise to her reporting of this important event – an essential meeting for coders and clinical documentation integrity specialists (CDISs). 

The two-day meeting will be held on March 7 and 8, virtually. The usual program will begin at 9 a.m. EST until 5 p.m. EST, until the business is finished. The tentative agendas are light this spring, with 18 topics on the diagnosis side and nine proposals for procedure codes. The procedure code information, however, will not be presented during the meeting. 

Remember, TTT will be covering this event live!

The live broadcast will also feature these other segments:

• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will also report on the C&M meeting.
  
  
• The Dunn Report: Legendary HIM professional Rose Dunn, COO at First Class Solutions, and past president of the American Health Information Management Association (AHIMA), will report on the latest news about hierarchical categories of classification (HCCs).
• SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
  
  
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
  
  
• TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

We will conclude our month-long observance of American Heart Month on the Talk Ten Tuesdays weekly Internet radio broadcast with an upcoming guest appearance of Cardiologist Harry B. Peled, MD with St. Jude Medical Center in Fullerton, Calif.

Last Tuesday, Dr. Mahesh Amin reported on the use of new protocols centered on high-sensitivity troponins for the diagnosis of type 2 myocardial infarction (MI). The response to his appearance was overwhelming; hence the continuation of this timely and critically important topic during the next broadcast.

Our series on the plight of rural hospitals will also continue with Dr. James Kennedy, who will report on an unfolding tragedy facing America’s rural populations as they seek care from facilities faced with drastically dwindling resources.

The live broadcast will also feature these other segments:

• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
  
  
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
  
  
• TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

Last year, the Food and Drug Administration (FDA) issued its approval of using new protocols centered on high-sensitivity troponins for the diagnosis of type 2 myocardial infarction (MI).

Reporting our lead story during the next edition of Talk Ten Tuesdays will be Dr. Mahesh Amin, CV Service Line Medical Director for BayCare Health Systems in Clearwater, Fla., a board-certified cardiologist.

This story, along with a Feb. 28 report by Henry Peled, MD at St. Jude Medical Center in Fullerton, Calif., will conclude the monthlong observance of American Heart Month by ICD10monitor and Talk Ten Tuesdays. In previous February broadcasts, the focus has been on the topics of coding and clinical documentation integrity (CDI).

This live broadcast will also feature these other segments:

• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
  
  
• SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
  
  
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
  
  
• TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

In continuing our observance of American Heart Month, during the next live edition of the Talk Ten Tuesdays live Internet radio broadcast we will zero in on the topic of coding and clinical documentation integrity (CDI) issues related to cardiovascular procedures – and, specifically, the importance of obtaining pre-authorizations for cardiology procedures.

Obtaining cardiology procedure pre-authorizations tends to be a time-consuming process, depending on the complexity of the patient’s insurance coverage and staff experience. And that is why we invited Susie Vestevech, the COO for TiaTech USA, to walk you through the process, which can range from several days to several weeks, often requiring multiple phone calls and documentation submissions.

Every year, some 805,000 people in the United States have a heart attack. Basically, someone has a heart attack every 40 seconds. Making certain that your facility is prepared to obtain cardio procedure pre-authorizations is of vital importance every month, not just in February.

The live broadcast will also feature these other segments:

• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
  
  
• SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
  
  
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
  
  
• TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

February is American Heart Month, a time to raise awareness of cardiovascular health and to shine the light on cardiac issues, especially myocardial infarction.

Unfortunately, every year about 805,000 people in the United States have a heart attack. Basically, someone has a heart attack every 40 seconds. 

And that is why we invited the Chief Executive Officer for the Innova Revenue Group, Lidiya Ter-Markorova, a clinical documentation integrity expert, to discuss documentation and coding pain points for myocardial infarction during the next live edition of Talk Ten Tuesdays.

The live broadcast will also feature these other segments:

• Coding Report: Patricia Chua will report on the latest coding news.
• SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
• TalkBack: Erica Remer,MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment. 

As rural hospital closures continue to increase (136 have occurred between 2010 and 2021), health information management (HIM) and clinical documentation improvement (CDI) professionals have key roles in ensuring revenue integrity and optimization essential to sound operations and access. 

Even so, small facilities, especially those operating independently, simply do not have the resources that larger chains have to negotiate favorable payer contracts and to implement processes, technologies, and training essential to withstanding payer denials.

In addressing these crucially important issues, Talk Ten Tuesdays, the live Internet radio program produced by ICD10monitor, will begin a new series that will address rigorous revenue integrity solutions that can be developed in a rural environment, while offering tips in creating win-win scenarios with medical/provider staffs. 

Join expert coder James S. Kennedy, MD – a native of East Tennessee, which has its own share of rural hospitals – as he offers experience, guidance, and hope essential to success.

The live broadcast will also feature these other segments:

• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
• Talk Law: Healthcare attorney Karen N. George with the Los Angeles-based law firm of Buchalter will resume her popular segment, reporting on healthcare law.
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
• TalkBack: Erica Remer,MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.  

Who knew that when the venerable American Medical Association’s (AMA’s) combining two hospital encounter service types into one code set of inpatient/observation services – initial and subsequent – consternation would be the outcome. The confusion: what entity can actually bill an inpatient initial code, 99221-99223, and who must default to subsequent codes or report office and other outpatient codes when seeing patients in the observation setting?

The good news: during the next live edition of the long-running and popular Talk Ten Tuesdays Internet broadcast, Terry Fletcher will return to the broadcast and offer her interpretation of the rules, and how multi-specialty practices will handle these changes. Moreover, Fletcher, a nationally recognized professional coder, educator, and auditor, will report on the contrast between CPT® and Medicare when reporting these services.

The live broadcast will also feature these other segments:

• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
• Journaling John: John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, will continue with his journal entries.
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
• TalkBack: Erica Remer,MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

The term “DRG mismatches” is most often used to describe situations wherein the working diagnosis-related group (DRG) selected by the clinical documentation improvement specialist (CDIS) differs from the final coded DRG, signaling that the CDIS and the coder have arrived at different principal diagnoses. In other situations, a procedure may have been coded incorrectly by the CDI professional, causing the DRG mismatch.

But here’s good news: there’s a new workflow for resolving inpatient DRG mismatches. With this new workflow, the CDIS and coder no longer have to spend countless hours reconciling DRG mismatches.

During the next live edition of Talk Ten Tuesdays, Patty Chua, president of Innova Revenue Group, will report on the positive coding implications this new workflow has created.

The live broadcast will also feature these other segments:

• Revenue Cycle Report: Susan A. Vestevich, JD, chief operations officer for Tia Tech USA, will report on the need for physician credentialing to ensure proper billing and reimbursement.
• SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will make her debut appearance on Talk Ten Tuesdays, having been a regular panelist on the long-running Monitor Mondays. Ferguson will report on the news that’s happening at the intersection of coding and the SDoH.
• Journaling John, MD: John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, will continue with his journal entries.
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
• Point of View: James S. Kennedy, MD, president of CDIMD, will serve as co-host, and will report on a subject that has caught his attention.

Within the hospital setting, the term “mismatch” is most often used to describe a situation wherein the final working diagnosis-related group (DRG) selected by the clinical documentation improvement (CDISs) specialists from the final coded DRG.

This can be due to many reasons. One of the most frequent reasons is that the CDI professional and coder have arrived at a different principal diagnosis. In other situations, a CC (complication or comorbidity) or MCC (Major CC) may not have been coded by either the CDI professional or the coder. In still other situations, a procedure may have been coded incorrectly by the CDI professional, causing the DRG mismatch.

There are also other reasons for mismatches, as you’ll discover during upcoming editions of the long-running and popular live Internet broadcast Talk Ten Tuesdays. ICD10monitor and Talk Ten Tuesdays are joining forces with Innova Revenue Group to produce a two-part series, debuting next week: “DRG Mismatches.” Reporting our lead story will be Lidiya Ter-Markarova, a principal at Innova Revenue Group.

The live broadcast will also feature these other segments:

• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• RegWatch: Stanley Nachimson, founder of Nachimson Advisors, LLC, will report on the latest regulatory news coming out of Washington, D.C.
• Journaling John: John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, will continue with his journal entries.
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
• TalkBack: Erica Remer,MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

Telehealth is considered to be rendered at the physical location of the patient, and therefore a provider typically needs to be licensed in the patient’s state. When the public health emergency (PHE) was declared in March of 2020, most states, followed the federal exceptions under the 1135 CARES Act waivers, allowing, an out-of-state provider to render services via telemedicine in a state where they are not located, or allow a clinician to provide services via telehealth in a state if certain conditions are met. However, as of summer 2021, 80 percent of the states implemented telehealth pandemic workarounds. Because these laws were issued under state emergency declarations, they were never meant to be permanent. During the next live edition of Ten Tuesday, healthcare consultant, Terry Fletcher will report on some updates to state  rules and what physicians need to do to make sure they are compliant. 

The live broadcast will also feature these other segments:

• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• RegWatch: Stanley Nachimson, founder of Nachimson Advisors, LLC, will report on the latest news regarding ICD-11. 
• Journaling John: John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, will continue with his journal entries.
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
• TalkBack: Erica Remer,MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.  

Be sure to join us for the next live edition of Talk Ten Tuesdays, when Karen Bartrom, director of clinical integration and documentation at Cameron Memorial Hospital in Indiana, will report on how Z codes – the social determinants of health (SDoH) and ICD-10-CM codes – can reveal insights related to the health of a community.

With the mapping of patient SDoH responses to Z-codes, valuable aggregate data on a community’s health disparities can be validated and measurable. And the capturing of Z-codes then moves from anecdotal patient stories to strategic analysis, which opens opportunities to identify and develop community programs – as you will learn during the next upcoming edition of the popular weekly Internet broadcast.

The live broadcast will also feature these other segments:

• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• Journaling John: John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, will continue with his journal entries.
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
• TalkBack: Erica Remer,MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.  

Will the United States experience another federal public health emergency (PHE) beyond Jan. 11, 2023? The U.S. Department of Health and Human Services (HHS) on Oct. 13 renewed the PHE for an additional 90 days. Meanwhile, states continue to wait for a 60-day termination warning, as HHS had promised earlier.

Joining the broadcast during the next live edition of the popular Internet radio program Talk Ten Tuesdays will be nationally recognized professional coder, auditor, and consultant Terry Fletcher, who will weigh the pros and cons of continuing the PHE. Also appearing on the program will be Dr. Jennifer Brettler and Kimberly Seery, both from ChristianaCare, a Delaware-based health system; they will give you on a close-up look at Patient Safety Indicators (PSIs).

The live broadcast will also feature these other segments:

• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• The Mental Health Report: Internationally renowned psychiatrist and author H. Steven Moffic, MD, will return to the broadcast with a special Thanksgiving report.
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
• TalkBack: Erica Remer,MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.  

Our exclusive series on patient safety indicators (PSIs), being produced by ICD10monitor and Talk Ten Tuesdays in association with ChristianaCare, will continue next week.

During the next live edition of Talk Ten Tuesdays, Dr. Jennifer Brettler and Kimberly Seery, both from the Delaware-based health system, will give you on a close-up look at AHRQ Patient Safety Indicator 90 – Patient Safety and Adverse Events Composite. Diving deep into the subject, you will also gain critically important information on PSI 03 – Pressure Ulcer and PSI 09 –  Postoperative Hemorrhage or Hematoma Rate. 

Both will share with you areas of opportunity and how a multidisciplinary chart review can help reduce your PSI composite score. 

The live broadcast will also feature these other segments:

• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• The Dunn Report: Rose Dunn, a nationally recognized professional in health information and former CEO, president, and board member of the American Health Information Management Association (AHIMA), will file her popular Dunn Report. She currently serves as COO of First Class Solutions, Inc. 
• Journaling John: John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, will continue with his journal entries.
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
• TalkBack: Erica Remer,MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.  

Long-awaited and highly anticipated, the Centers for Medicare & Medicaid Services (CMS) Medicare Physician Fee Schedule Final Rule for 2023 released this past week supports the expansion of access to behavioral health and cancer screening, while promoting health equity.

The timing of this Final Rule brings to mind the loss of actor Chadwick Boseman of Black Panther fame. Boseman died in 2020, following his battle with colon cancer – an issue addressed in the Final Rule with a focus on cancer screening, as colon and rectal cancers continue to be a leading cause of death in the U.S., with even higher numbers of new cases and death rates for Black Americans, Native Americans, and Alaskan Natives. 

Reporting our lead story during the next live edition of Talk Ten Tuesdays will be senior healthcare consultant Sharon Easterling, who is writing a series of articles for ICD10monitor on the experience of Black Americans dealing with the country’s healthcare system.

Other segments during the live broadcast will include the following:

• RegWatch: Stanley Nachimson, former CMS career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington, D.C.
• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.
• Journaling John: John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, will continue with his journal entries.
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
• TalkBack: Erica Remer,MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.  

Much like urban legends, the recurring tales of Medicare Advantage (MA) plans being accused of manipulating diagnoses and denying care that otherwise would have been covered under traditional Medicare are gaining traction.

They are now even being referred to as Medicare “Dis-Advantage” plans because of all the manipulation, much related to the fact that a MA patient is more expensive to the Medicare program than a traditional Medicare patient. The government pays MA insurers a set amount for each person who enrolls, with higher rates for sicker patients.

But the Department of Justice (DOJ) recently uncovered irregularities in reporting accurate patient diagnoses, even accusing some insurers of developing elaborate systems to make their patients appear as sick as possible, often without providing additional treatment.

During the next live edition of Talk Ten Tuesdays, nationally recognized healthcare consultant Terry Fletcher will report on the details.

Other segments during the live broadcast will include the following:

• PSI Series:  The series on patient safety indicators (PSIs) continues with Dr. Jennifer Brettler and Kimberly Seery reporting on the PSI Inclusion and Exclusion criteria for PSI 04.
• Talk Law: Karen George, an attorney at Buchalter in Los Angeles, and a member of the firm’s health care practice group, will file a report on the latest healthcare laws.
• News Desk: Timothy Powell, CPA will anchor the Talk Ten Tuesdays News Desk.
• TalkBack: Erica Remer,MD, founder and president of Erica Remer, MD, Inc., and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.