2023 E&M Updates and PSI Series Announced for ICD10monitor and Talk Ten Tuesdays

The series of articles and broadcast segments is being produced by ICD10monitor.

What is the commonality between evaluation and management (E&M) codes and patient safety indicators (PSI)? Both involve the patient and the interaction of caregivers but beyond the obvious is that both subjects are being featured on both ICD10monitor and the Talk Ten Tuesdays, the long-running Internet broadcast, as series of articles and segments.

Colleen Deighan, a senior healthcare consultant for 3M Health, is writing a multi-phase series on the 2023 E&M code and guideline updates. The updates, generated by the American Medical Association, are reported to be the most significant changes in more than 25 years and the changes are expected to have a major impact on clinical documentation as well as reimbursement.

Deighan launched her series in late August with a prelude to the 2023 CPT® E&M changes. Her segments and corroborative articles continue weekly on both Talk Ten Tuesdays and ICD10monitor.

“When the Centers for Medicare & Medicaid Services publishes the final rule for the physician fee schedule, I will address the final rule related to E&M changes,” Deighan told ICD10monitor. “In addition to the category revisions, there are quite a few revisions to the E&M guidelines.”

According to Deighan, the E&M Guidelines overview at the beginning of the E&M section has extensive revisions and more clarification needed from the 2021 revisions to selecting the level of service based on medical decision making. Several of the E&M categories with code revisions also have guidelines revisions. 

Patient Safety Indicators

ICD10monitor and Talk Ten Tuesdays will also be producing a series on Patient Safety Indicators (PSI) in association with ChristianaCare. The series will launch Oct. 18 with articles and segment continuing through November.

The purpose of this series is to assist hospitals and health systems understand and manage their PSIs. PSIs address potentially avoidable safety events related to in-hospital occurrences. Many are related to procedures, including childbirth. 

Participating in this series will be representatives from ChristianaCare including the following:

• Kimberly Seery, associated director of coding and data quality
• Jennifer Brettler, MD
• Varadarajan “Raj” Subbiah, MD

The purpose of the series is to report on how to create a multidisciplinary approach – how clinicians, coding, and CDIs can partner together to improve patient safety data.  

The genesis of series came about from a listener question of Talk Ten Tuesdays. The listener asked Erica Remer, MD, program cohost, if she had advice on PSI 04, the death rate among surgical inpatients with serious treatable complications. Remer said she then reached out Dr. Varadarajan Subbiah, vice president of utilization management and quality at ChristianaCare, and from that initial conversation, plus a number of email exchanges, the idea of a series emerged.

The schedule of segments

• October 18: Program 1:

How to build a multidisciplinary PSI review team 

• November 1: Program 2

Navigating through the inclusion and exclusion criteria for PSIs plus a look at PSI 4

• November 15: Program 3

PSI 90:  an overview of the composite PSI and areas of focus plus a look at PSI 3 

• November 22: Program 4 

Taking a deeper dive into PSI 11, 13, & 12 

E&M Program Schedule

8/30/33	Prelude to 2023 CPT E&M changes series
9/13/22	Revisions/deletion to Hospital Inpatient and Observation Services E&M codes
9/20/22	Revisions to Emergency Department Services E&M codes
9/27/22	Revisions/deletions to Consultation Services E&M codes (office and inpatient)
10/4/22	Revisions/deletions to Nursing Facility Services E&M codes
10/11/22	Revisions/deletions to Home or Resident Services E&M codes
10/18/22	Revisions/deletions to Prolonged Services E&M codes