POPULARITY
Categories
196 episodes with icd
117 episodes with icd
32 episodes with icd
41 episodes with icd
19 episodes with icd
20 episodes with icd
13 episodes with icd
16 episodes with icd
10 episodes with icd
12 episodes with icd
6 episodes with icd
23 episodes with icd
7 episodes with icd
8 episodes with icd
19 episodes with icd
11 episodes with icd
4 episodes with icd
8 episodes with icd
6 episodes with icd
4 episodes with icd
4 episodes with icd
3 episodes with icd
4 episodes with icd
6 episodes with icd
8 episodes with icd
3 episodes with icd
4 episodes with icd
3 episodes with icd
7 episodes with icd
8 episodes with icd
5 episodes with icd
4 episodes with icd
3 episodes with icd
8 episodes with icd
6 episodes with icd
2 episodes with icd
Welcome to the Back to Business Podcast, where we spotlight Calgary's industry leaders and delve into the heart of entrepreneurialism in our vibrant city!Bruce Edgelow has extensive experience as a life time banker (RBC-31 years & ATB-14 years) and has run his mid-market private company consulting practice since 2017. He has been an active community board member following the attainment of his ICD designation in 2011. He is very active in the faith community and his greatest passion is co-leading his Leader Impact group.Get Connected With Bruce:https://www.edgemarkcas.com/https://www.linkedin.com/in/bruce-edgelow-97726615/Visit www.calpeteclub.com for information on our next networking and membership opportunities.https://calpeteclub.com/https://twitter.com/calpeteclubhttps://www.linkedin.com/in/calgary-petroleum-club-3a5868117/https://www.facebook.com/calpeteclubhttps://www.youtube.com/user/calpeteclub
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, BA, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 years on Feedspot.Sonal's 16th Season starts up and Episode 17 features Newsworthy updates on the month's fraud, waste, and abuse cases. Sonal's Trusty Tip and compliance recommendations focus on podiatry practices' evaluation and management services with modifier 25.Spark inspires us all to reflect on resilience based on the inspirational words of Winston Churchill.Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
Arguably, the trans movement really took hold when organizations like The World Professional Association for Transgender Health (WPATH) began a de-psychopathologization campaign back in 2010. This campaign was not based on “science,” but was politically motivated, and resulted in the removal of mental health protections and enabled the medical scandal we see today, wherein minors are being sterilized and mutilated on the basis they are “trans. Genspect argues that this campaign “systematically dismantled psychiatric safeguards by declaring transgender identity innate and healthy, demoting mental health professionals to facilitators in Standards of Care 7, replacing Gender Identity Disorder with Gender Dysphoria in the DSM-5 and with Gender Incongruence in the ICD-11, redefining medical transition as medically necessary, and removing age barriers in Standards of Care 8.”In response, Genspect launched a “re-psychopathologization” campaign a few months ago, calling for “recognition of transgender identification and the drive for medical transition as a pathological condition characterized by an Extreme Overvalued Belief [a rigid, non-delusional conviction, shared and reinforced within a culture or subculture, defended with passion, and experienced by the individual as entirely rational.]”Mia Hughes announced the campaign at this year's Genspect conference in Albuquerque. I spoke with her about why “re-psychopathologization” is key to ending the scandal that is the modern trans movement, the backlash she received in response to the campaign, and why suing organizations like WPATH could help stop this medical malpractice. Mia Hughes is a writer and researcher on paediatric gender medicine, social contagion, and the intersection of trans and women's rights. She authored The WPATH Files and co-hosts Beyond Gender with Stella O'Malley and Dr Bret Alderman.The Same Drugs is on X @thesamedrugs_. Meghan Murphy is on X @meghanemurphy and on Instagram @meghanemilymurphy. Find The Same Drugs merch at Fourthwall. Support this podcast with a donation! Don't forget to click that "follow" button to ensure you don't miss a single episode!
Hospital discharge is a critical and often overlooked moment for antibiotic stewardship. In this episode of The ASHE Podcast, hosts Dr. Gonzalo Bearman and Dr. Priya Nori are joined by Dr. David Ha (Stanford University) and Dr. Ritika Prasad (University of California, San Francisco), authors of the recent ASHE article “Unraveling indications for discharge antibiotics: the Devil’s in the details.” The conversation explores why discharge prescribing is so challenging, the limitations of ICD-10 codes, and how using indication-based fields like the Last Inpatient Indication can more accurately capture clinician intent and improve stewardship at transitions of care. https://www.cambridge.org/core/journals/antimicrobial-stewardship-and-healthcare-epidemiology/article/unraveling-indications-for-discharge-antibiotics-the-devils-in-the-details/00D66BAC14D6C6B878572EB7069C7014
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 Years on Feedspot. Sonal's 16th Season starts up and Episode 16 features a Newsworthy update on the PEPPER program. It's back.Sonal's Trusty Tip and compliance recommendations focus on skin substitutes and the upcoming LCDs.Spark inspires us all to reflect on resilience based on the inspirational words of Thomas Edison.Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
Cancer screening in older adults (1:30), an app for obstructive sleep apnea (5:10), nonsteroidal anti-inflammatory–induced ulcers and dyspepsia (7:20), hemorrhoids (10:00), late pregnancy bleeding (11:30), intensive glucose control in older patients (16:00), and all new holiday ICD-10 codes (19:30).
In this episode, we talk about ICD codes for Gulf War Illness in greater detail and discuss the research behind them. We break down what these codes mean, why they matter for veterans, and how research is shaping recognition, diagnosis, and care.Gulf War Illness Study : https://ucsd.co1.qualtrics.com/jfe/form/SV_8kroz7Jamr365hQGet access to past and bonus content with exclusive guest. Please help support the podcast and veterans so we can keep making the show - patreon.com/GulfWarSideEffects▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬Life Wave Patches: https://lifewave.com/kevinsimon/store/products*Here is my recommendations on what patches to get and what has helped me.Ice Wave - this helps with my neuropathy.x39 - this helps me with brain fog and my shakesx49 - helps with bone strengthGludifion - helps get rid of toxinsMerch: https://gulfwar-side-effects.myspreadshop.com/Contact me with your questions, comments, or concerns at kevinsimon@gulfwarsideeffects.com
In this episode, we talk about ICD codes for Gulf War Illness in greater detail and discuss the research behind them. We break down what these codes mean, why they matter for veterans, and how research is shaping recognition, diagnosis, and care.Gulf War Illness Study : https://ucsd.co1.qualtrics.com/jfe/form/SV_8kroz7Jamr365hQGet access to past and bonus content with exclusive guest. Please help support the podcast and veterans so we can keep making the show - patreon.com/GulfWarSideEffects▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬Life Wave Patches: https://lifewave.com/kevinsimon/store/products*Here is my recommendations on what patches to get and what has helped me.Ice Wave - this helps with my neuropathy.x39 - this helps me with brain fog and my shakesx49 - helps with bone strengthGludifion - helps get rid of toxinsMerch: https://gulfwar-side-effects.myspreadshop.com/Contact me with your questions, comments, or concerns at kevinsimon@gulfwarsideeffects.com
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 Years on Feedspot. Sonal's 16th Season starts up and Episode 15 features a Newsworthy update on the OIG Work Plan for November 2025.Sonal's Trusty Tip and compliance recommendations focus on chronic care management documentation.Spark inspires us all to reflect on resilience based on the inspirational words of Edmund Hillary.Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
This episode of The Dish on Health IT features Denny Brennan, Executive Director of the Massachusetts Health Data Consortium (MHDC), in conversation with host Tony Schueth, CEO of Point-of-Care Partners (POCP), and co-host Ross Martin, MD, Senior Consultant with POCP. Together, they examine how MHDC is translating national interoperability policy into practical, statewide action, specifically around the CMS-0057 rule.After brief introductions, the conversation quickly turns to MHDC's long history and why it matters. Founded in 1978, before the internet, MHDC guided Massachusetts through nearly every major health IT transition: HIPAA, Meaningful Use, ICD-10, and now interoperability and automation. Denny explains that this continuity has created something rare in healthcare: sustained trust across payers, providers, vendors, regulators, and associations. That trust, he notes, is what allows competitors to work through shared infrastructure problems that no single organization could solve on its own.From there, the discussion turns to why the MHDC community chose to coordinate and support members in their CMS-0057 compliance journey, versus just letting each member organization go it alone. Denny emphasizes that while healthcare is regulated federally, it functions locally. Each state has its own mix of insurers, hospital systems, rules, and market pressures. In Massachusetts, where long-standing relationships already exist, MHDC saw an opportunity to move faster, test real workflows, and generate lessons that could inform efforts far beyond the state.The discussion then moved to how work to improve prior authorization became such a high-priority focus. Denny describes how the process has grown into one of the most disruptive administrative burdens for clinicians. Rules vary by plan, criteria change frequently, and the information providers need is often hard to access in real time. The result is defensive behavior. Offices routinely submit prior authorizations “just in case,” often by fax or phone, simply to avoid denials and treatment delays. That inefficiency, he explains, ripples outward by slowing patient care, driving up providers' overhead, and requiring health plans to spend more time and resources processing and reviewing the required PA alongside the unneeded submissions.The financial impact quickly becomes apparent. Denny points to evidence showing that administrative costs consume a massive share of U.S. healthcare spending, with prior authorization playing a meaningful role. If automation is implemented through a neutral, nonprofit infrastructure, MHDC believes there is a much greater chance that savings will flow back into premiums and public program costs rather than being swallowed by inefficiency.Ross adds an important dose of realism. Prior authorization friction, he notes, is not always accidental. In some cases, operational complexity functions as a utilization control mechanism. That creates a built-in tension between access, cost containment, and patient experience, and helps explain why national reform has moved slowly despite widespread frustration.At that point, the conversation shifts from why this is broken to how MHDC is trying to fix it. Denny walks through MHDC's operating model: convene the full ecosystem early and often. In a recent deep-dive session, roughly 60 representatives from health plans, providers, and the state participated in a working session focused on what an automated prior authorization workflow could realistically look like. MHDC brought a draft framework to the table. The community pressure tested it and surfaced workflow conflicts, operational blind spots, and policy misalignments that no single organization could see on its own.That collaborative process, Denny explains, is the real engine behind adoption. When stakeholders help build the solution themselves, implementation becomes a shared commitment rather than a compliance exercise. It also reduces resistance later because decisions are not delivered top-down. They are constructed collectively.The discussion then turns to FHIR adoption and why, while real, progress has taken time. Denny traces the turning point back to the 21st Century Cures Act, which reframed patient access to health data as a legal right and categorized data blocking as a regulatory violation. That policy shift, combined with the growing maturity of API-based interoperability, created the conditions for real-time data exchange to finally move from theory to practice.Ross provides a historical perspective from the standards side. Earlier generations of health data standards were conceptually elegant but extremely difficult to implement consistently. FHIR changed that equation by aligning healthcare data exchange with the same API-driven architecture that supports the modern web. He points to accelerating real-world adoption, particularly from large EHR platforms, as evidence that FHIR has entered a phase of broad, practical deployment.Although pharmacy prior authorization falls outside the formal scope of CMS 0057, Denny makes clear that MHDC could not ignore it. For many physicians, especially in oncology, dermatology, and primary care, PA for prescriptions is far more frequent and far more disruptive than PAs for medical services. If MHDC solved only one side of the problem, much of the daily burden for clinicians would remain unchanged.Pharmacy prior authorization, however, introduces a new level of complexity. PBMs, pharmacists, prescribing systems, payers, and patients are all involved, often across fragmented workflows. Denny explains that the challenge looks less like a pure technology gap and more like an orchestration problem. It is about getting the right information to the right party at the right moment across multiple handoffs.Ross shares insights from the pharmacy PA research work conducted with MHDC and POCP. One of the most striking findings was the massive year-end renewal surge that hits providers every benefit cycle as authorizations tied to prior coverage suddenly expire. He also reflects on a recent national electronic prior authorization roundtable, where deep stakeholder discussion ultimately led most participants to conclude that today's technology alone still is not sufficient to fully solve pharmacy PA. The tools are improving, but the problem remains deeply multi-layered.As the episode winds down, the tone shifts toward practical calls to action.Denny challenges the industry to separate where competition belongs from where collaboration is essential. Contract negotiations may be adversarial by nature, he notes, but interoperability initiatives cannot succeed under the same mindset. Real progress depends on bringing collaboratively minded people into the room. These are people willing to solve shared infrastructure problems even when their organizations compete elsewhere.Ross builds on that message with a longer-term challenge: sustained participation in standards development. Organizations cannot sit back and hope others shape the future on their behalf. Active involvement in national standards organizations is critical. This is not for immediate quarterly returns, but to influence the systems everyone will be required to use in the years ahead.The episode closes with a clear takeaway. MHDC did not wait for perfect conditions. It moved when the pieces were good enough, tested real workflows with real stakeholders, adjusted in the open, and began sharing lessons nationally. In an industry often slowed by fragmentation and risk aversion, this conversation offers a grounded look at what forward motion actually looks like when collaboration, policy, and technology finally align.You can find this and other episodes of The Dish on Health IT wherever you get your podcasts, including Spotify and Healthcare Now Radio. If you found this conversation valuable, share it with a colleague and be sure to subscribe so you never miss an episode. Have an idea for a topic you would like us to cover in future episodes? Fill out the form and tell us about it. Until next time, Health IT is a dish best served hot.
In dieser Episode spreche ich mit Dr. Antje Kallweit über die neuesten Erkenntnisse in der Therapie von chron. Schmerzen, was noziplastische Symptome sind und was sich Betroffene von anderen chron. Erkrankungen von der chron. Schmerztherapie eventuell abschauen und mitnehmen können. **Zur Studie von Dr. Antje Kallweit: ++ Stand: 10. Dezember 2025 ++ Wen suchen wir? Menschen mit chronischen primären Schmerzen, z. B.: Fibromyalgie chronischer Rücken-/Nackenschmerz Spannungskopfschmerz CRPS chronic pelvic pain andere noziplastische Schmerzsyndrome Schmerz bei ME/CFS ICD-10 Diagnosen: F45.41 oder M79.7 Aktuell brauchen wir eher F45.41 und gerne auch ein paar Männer Die Teilnehmer:innen sollten offen sein, neue Wege zu gehen, und das Durchhaltevermögen für eine 3-monatige Studie mitbringen. Als Gegenleistung können sie HELP sechs Monate komplett kostenlos nutzen – drei Monate im Studienrahmen plus drei Monate Bonus – und erhalten zusätzlich einen 40 € Gutschein. Die größte Hürde ist meist: In den 3 Monaten vor Studieneinschluss sollte eine stabile Therapie vorliegen (keine neu begonnenen Medikamente, keine neue Psychotherapie). Und im Studienzeitraum darf keine stationäre Therapie oder Reha geplant sein. Wir müssen gegenüber dem BfArM sauber nachweisen, dass die Effekte tatsächlich von HELP stammen – nicht von parallelen Veränderungen. Ambulante Schmerztherapie ist absolut kein Problem. Auch wenn die MMST erst später geplant ist – die Wartelisten sind ja lang. Ein weiteres Einschlusskriterium ist ein Durchschnittsschmerz von mindestens 4 (0–10 Skala). Das sollte man wissen, bevor man die Eingangsfragen beantwortet. Hilfreich ist es, gleich einen Arztbrief oder eine andere Bescheinigung mit ICD-10 Code bereitzuhalten, um den Diagnosenachweis hochladen zu können. Die Registrierungsseite ist leider etwas unlogisch aufgebaut – wenn es Schwierigkeiten gibt, gerne einfach an studie@mediacc.org schreiben. **Studien-Landingpage: https://help-app.climedo.de/de/68deb76bfbbd6deee2c1ff0f/6911f8010fa3b52c436435b7/68e52959c22e9b0012ea78b6/68e53408c22e9b0012ea7cc2/Ihre%2520Teilnahme%2520an%2520der%2520klinischen%2520Studie?app=patient&displayLabel=Ihre%20Teilnahme%20an%20der%20klinischen%20Studie&isSurvey=true **Help-Website zur Studienteilnahme: https://www.help-app.de/studie/ **Studienbeschreibung beim BfArm: https://www.drks.de/search/de/trial/DRKS00038377/details Du magst meine Arbeit und möchtest mir einen (virtuellen/koffeinfreien/energiebringenden) Kaffee spendieren? Ne Maledivenreise nehm ich natürlich auch :) Dann kannst du das hier tun: https://www.buymeacoffee.com/superheldenohnecape Oder auf PayPal an: superheldenohnecape Ich dank dir für deine Wertschätzung! Kontakt Dr. Antje Kallweit: IG: @drantje Website: www.help-app.de Superheld/-innen Ohne Cape IG: @superheldenohnecape E-Mail: superheldenohnecape@yahoo.com This podcast is hosted by ZenCast.fm
Dr. Eithan Haim first became nationally known as the whistleblower on Texas Children's Hospital's secret pediatric gender program. After facing prosecution by the Biden Department of Justice and the prospect of ten years in prison, the surgeon was ultimately successful in his case and is now practicing medicine while continuing to expose ethical violations in pediatric sex trait modification.Today, we dive deep into the insurance fraud that enables gender clinics to operate—a layer of scandal beneath the already discredited evidence base for these interventions. Dr. Haim explains how medical billing codes work and reveals that clinics are routinely using false diagnosis codes to get insurance companies to cover hormones, blockers, and surgeries. We discuss the 95% rate of fraudulent "endocrine disorder unspecified" diagnoses found at one university gender clinic, how patients' sex is being falsified in medical records, and how the American Medical Association—with its government-mandated monopoly on medical coding—may be facilitating this fraud.What are the consequences of this scheme? Why would the AMA recommend coding mastectomies as "breast reductions"? How is this affecting insurance premiums for ordinary Americans? And where does Dr. Haim see all of this heading? This conversation will change how you understand the machinery behind gender medicine.Dr. Eithan Haim is a general and trauma surgeon in Greenville, Texas. In 2023, he served as the anonymous whistleblower who exposed Texas Children's Hospital for secretly continuing its pediatric gender program after publicly claiming it had shut down. Within 24 hours of the story's publication, the Texas Senate passed bipartisan legislation banning these interventions on minors.The Biden Department of Justice responded by charging Dr. Haim with four federal felonies, sending armed U.S. Marshals to his home on the morning of his surgical residency graduation. Facing up to 10 years in prison, he and his wife—an attorney—drained their savings to fight the charges. He was ultimately successful, with the case resolved in his favor.Dr. Haim now continues his work as a surgeon while raising awareness about fraud and ethical violations in pediatric gender medicine. He and his wife Andrea live outside Dallas with their young child.Follow him on X @EithanHaimDonate to his GiveSendGo[00:00:00] Start[00:01:29] Introduction to Dr. Eithan Haim[00:05:30] How medical billing codes work: CPT and ICD codes[00:09:30] 95% of gender clinic patients had fraudulent "endocrine disorder" diagnosis[00:14:45] Iatrogenic harm: treatment creates the condition listed in the diagnosis[00:19:45] The AMA's government-mandated monopoly on medical coding[00:24:15] AMA recommends coding mastectomies as breast reductions[00:34:00] The "alternative diagnosis codes" guide removed after exposure[00:39:00] Falsifying patient sex in medical records[00:49:00] Wildest case: male diagnosed with "agenesis of the cervix"[00:58:00] How this fraud affects healthcare costs for everyone[01:04:15] The disturbing romanticization of surgery among trans-identified youth[01:10:30] Why "adults can do what they want" doesn't apply to doctors[01:16:00] Where this is heading: criminal prosecutions[01:25:15] Dr. Haim's family and current work[01:28:15] Where to find Dr. Eithan HaimROGD REPAIR Course + Community gives concerned parents instant access to over 120 lessons providing the psychological insights and communication tools you need to get through to your kid. Now featuring 24/7 personalized AI support implementing the tools with RepairBot! Use code SOMETHERAPIST2025 to take 50% off your first month.PODCOURSES: use code SOMETHERAPIST at LisaMustard.com/PodCoursesTALK TO ME: book a meeting.PRODUCTION: Looking for your own podcast producer? Visit PodsByNick.com and mention my podcast for 20% off your initial services.SUPPORT THE SHOW: subscribe, like, comment, & share or donate.Watch NO WAY BACK: The Reality of Gender-Affirming Care. Use code SOMETHERAPIST to take 20% off your order.MUSIC: Thanks to Joey Pecoraro for our song, “Half Awake,” used with gratitude & permission.ALL OTHER LINKS HERE. To support this show, please leave a rating & review on Apple, Spotify, or wherever you get your podcasts. Subscribe, like, comment & share via my YouTube channel. Or recommend this to a friend!Learn more about Do No Harm.Take $200 off your EightSleep Pod Pro Cover with code SOMETHERAPIST at EightSleep.com.Take 20% off all superfood beverages with code SOMETHERAPIST at Organifi.Check out my shop for book recommendations + wellness products.Show notes & transcript provided with the help of SwellAI.Special thanks to Joey Pecoraro for our theme song, “Half Awake,” used with gratitude and permission.Watch NO WAY BACK: The Reality of Gender-Affirming Care (our medical ethics documentary, formerly known as Affirmation Generation). Stream the film or purchase a DVD. Use code SOMETHERAPIST to take 20% off your order. Follow us on X @2022affirmation or Instagram at @affirmationgeneration.Have a question for me? Looking to go deeper and discuss these ideas with other listeners? Join my Locals community! Members get to ask questions I will respond to in exclusive, members-only livestreams, post questions for upcoming guests to answer, plus other perks TBD. ★ Support this podcast on Patreon ★
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, BA, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 years on Feedspot.Sonal's 16th Season starts up and Episode 14 features a Newsworthy update on World AIDS Day.Sonal's Trusty Tip and compliance recommendations focus on a new Medicare hospice outpatient services edit.Spark inspires us all to reflect on resilience based on the inspirational words of Marcus Aurelius.Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
55 - Autismus wird von vielen noch immer stark missverstanden. Zwischen Klischees vom „Genie“ auf der einen Seite und dem „beziehungsunfähigen Aussenseiter“ auf der anderen gehen oft die eigentlichen Merkmale und Stärken unter. In dieser Episode sprechen wir über die Autismus Spektrum Störung (ASS), die nach ICD-11 als Spektrum verstanden wird, und darüber, was Autismus tatsächlich ist – und was nicht. Wir erklären die zentralen Kriterien, zum Beispiel Schwierigkeiten in der sozialen Interaktion und rigide Routinen, aber auch das besondere Wahrnehmungsprofil, aus dem sich häufig Nischeninteressen und beeindruckende Talente in bestimmten Bereichen entwickeln. Wir gehen darauf ein, warum Menschen mit ASS sehr wohl Emotionen wahrnehmen und emotionale Empathie besitzen, gleichzeitig aber kognitive Empathie und unausgesprochene soziale Regeln anspruchsvoll sein können. Im Beziehungskontext schauen wir uns an, warum Smalltalk, Gruppensituationen und soziale Veranstaltungen anstrengend sind, weshalb Online-Dating für manche Menschen im Spektrum eine hilfreiche Alternative ist und welche typischen Missverständnisse in Partnerschaften entstehen. Gleichzeitig sprechen wir über Stärken, die in Beziehungen besonders wertvoll sind: Direktheit statt Spielchen, Ehrlichkeit, Verlässlichkeit und Loyalität, wenn man sich einmal auf eine Person eingelassen hat – und was sich neurotypische Paare davon vielleicht abschauen können. Wir geben einen Einblick in die Autismus Spektrum Störung aus Beziehungs- und Alltagsperspektive: Welche Herausforderungen begegnen Betroffenen und Angehörigen, was entlastet im Miteinander und wo liegen die Chancen in Beziehungen mit Menschen im Spektrum. Eine Episode über Mythen, Realität und darüber, warum Autismus in Beziehungen oft ganz anders aussieht, als viele glauben.
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, BA, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 years on Feedspot.Sonal's 16th Season starts up and Episode 13 features Newsworthy updates on the month's fraud, waste, and abuse cases. Sonal's Trusty Tip and compliance recommendations focus on a Medicare telehealth update.Spark inspires us all to reflect on resilience based on the inspirational words of Dalai Lama.Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
This Thanksgiving episode is a full-tilt ride through holiday chaos, Florida strangeness, and medical absurdities. Tim and May kick things off with memories of disastrous holiday meals — including wild turkeys marinated in whiskey and a Bengal cat that ate itself into a literal tryptophan coma. The conversation quickly detours into “Florida Man” headlines featuring drunken alligators, foot-mobile arrests, and fast-food robberies fueled by late-night hunger.From there, they dive into the medical side: ICD-10 codes for turkey comas, overstuffed stomachs, and what happens when people put things where things are not meant to go. That leads to a brutally funny takedown of the bizarre mailers they've received since moving to Florida — including products promising to fix “vaginal odor,” boost intimacy, and balance microbiomes using bark extract and rose hips.They wrap with a preview of upcoming podcast episodes, reflections on gratitude, and warnings about deep-fried turkey disasters, Black Friday injuries, and the perils of blood thinners during holiday shopping. It's irreverent, warm, and all the way BS Free MD. GET SOCIAL WITH US!
About Nikhil Buduma:Nikhil Buduma is a San Francisco–based entrepreneur, scientist, and engineer working at the cutting edge of AI and healthcare. He is the co-founder and CEO of Ambience Healthcare, an AI platform built to supercharge every healthcare worker with intelligent automation. Under his leadership, Ambience has grown into one of the most well-funded AI healthcare startups in the world, raising over $343 million from top investors, including a16z, OpenAI, Kleiner Perkins, Oak HC/FT, Optum Ventures, and industry pioneers such as Jeff Dean and Pieter Abbeel. Before becoming CEO, Nikhil served as Ambience's Chief Scientist, leading the development of its core AI systems that streamline documentation, coding, and clinical workflows for healthcare systems, including the Cleveland Clinic and St. Luke's.Prior to Ambience, Nikhil co-founded Remedy Health, where he applied machine learning to advance value-based care models, backed by Khosla Ventures and Greylock. He also co-founded Lean On Me, a nonprofit organization that supports mental health and wellness across U.S. college campuses through anonymous peer-to-peer text support networks at institutions such as MIT, Duke, and UC Berkeley.A graduate and valedictorian of Bellarmine College Preparatory, Nikhil earned both his bachelor's and master's degrees in computer science and engineering from MIT. His career reflects a rare blend of technical mastery, compassion, and vision—using AI not to replace clinicians, but to restore the human joy in the practice of medicine.Things You'll Learn:Health systems often see low real-world usage of ambient tools; when daily adoption crosses most clinicians and visits, the ROI conversation becomes meaningful. This requires solving fundamentals across specialties, not just shipping features.If AI generates notes that don't align with payer rules and codes, organizations incur rework and risk. Integrating HCC, ICD-10, and CPT selection, along with supporting language, at the point of care helps prevent denials.Revenue integrity upside: Bringing CDI intelligence forward can reclaim large sums from work already done but not credited. This strengthens both financial sustainability and compliance posture.Continuous third-party auditing and domain-specific modeling are essential because general reasoning models often struggle with the nuances of revenue cycles. Independent validation builds organizational trust.Patient Summary anticipates questions and data needs before the visit, while Chart Chat answers complex, EHR-aware queries in seconds, helping to democratize top-tier standards of care in rural settings.Resources:Connect with and follow Nikhil Buduma on LinkedIn.Follow Ambience Healthcare on LinkedIn and visit their website.
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 Years on Feedspot. Sonal's 16th Season starts up and Episode 12 features a Newsworthy update on RAC audits for 2025.Sonal's Trusty Tip and compliance recommendations focus on specific RAC audits for 2025.Spark inspires us all to reflect on resilience based on the inspirational words of Isabel Allende.Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
Co-hosts Ryan Piansky, a graduate student and patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Sciences Advisory Council, interview Evan S. Dellon, MD, and Elizabeth T. Jensen, PhD, about a paper they published on predictors of patients receiving no medication for treatment of eosinophilic esophagitis. Disclaimer: The information provided in this podcast is designed to support, not replace, the relationship between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own. Key Takeaways: [:52] Co-host Ryan Piansky introduces the episode, brought to you thanks to the support of Education Partners GSK, Sanofi, Regeneron, and Takeda. Ryan introduces co-host Holly Knotowicz. [1:14] Holly introduces today's topic, predictors of not using medication for EoE, and today's guests, Dr. Evan Dellon and Dr. Elizabeth Jensen. [1:29] Dr. Dellon is an Adjunct Professor of Epidemiology at the University of North Carolina School of Medicine in Chapel Hill. He is also the Director of the UNC Center for Esophageal Diseases and Swallowing. [1:42] Dr. Dellon's main research interest is in the epidemiology, pathogenesis, diagnosis, treatment, and outcomes of eosinophilic esophagitis (EoE) and eosinophilic GI diseases (EGIDs). [1:55] Dr. Jensen is a Professor of Epidemiology with a specific expertise in reproductive, perinatal, and pediatric epidemiology. She has appointments at both Wake Forest University School of Medicine and the University of North Carolina at Chapel Hill. [2:07] Her research primarily focuses on etiologic factors in the development of pediatric immune-mediated chronic diseases, including understanding factors contributing to disparities in health outcomes. [2:19] Both Dr. Dellon and Dr. Jensen also serve on the Steering Committee for EGID Partners Registry. [2:24] Ryan thanks Dr. Dellon and Dr. Jensen for joining the podcast today. [2:29] Dr. Dellon was the first guest on this podcast. It is wonderful to have him back for the 50th episode! Dr. Dellon is one of Ryan's GI specialists. Ryan recently went to North Carolina to get a scope with him. [3:03] Dr. Dellon is an adult gastroenterologist at the University of North Carolina at Chapel Hill. He directs the Center for Esophageal Diseases and Swallowing. Clinically and research-wise, he is focused on EoE and other eosinophilic GI diseases. [3:19] His research interests span the entire field, from epidemiology, diagnosis, biomarkers, risk factors, outcomes, and a lot of work, more recently, on treatments. [3:33] Dr. Jensen has been on the podcast before, on Episode 27. Holly invites Dr. Jensen to tell the listeners more about herself and her work with eosinophilic diseases. [3:46] Dr. Jensen has been working on eosinophilic gastrointestinal diseases for about 15 years. She started some of the early work around understanding possible risk factors for the development of disease. [4:04] She has gone on to support lots of other research projects, including some with Dr. Dellon, where they're looking at gene-environment interactions in relation to developing EoE. [4:15] She is also looking at reproductive factors as they relate to EoE, disparities in diagnosis, and more. It's been an exciting research trajectory, starting with what we knew very little about and building to an increasing understanding of why EoE develops. [5:00] Dr. Dellon explains that EoE stands for eosinophilic esophagitis, a chronic allergic condition of the esophagus. [5:08] You can think of EoE as asthma of the esophagus or eczema of the esophagus, although in general, people don't grow out of EoE, like they might grow out of eczema or asthma. When people have EoE, it is a long-term condition. [5:24] Eosinophils are a type of white blood cell, specializing in allergy responses. Normally, they are not in the esophagus. When we see them there, we worry about an allergic process. When that happens, that's EoE. [5:40] Over time, the inflammation seen in EoE and other allergic cell activity causes swelling and irritation in the esophagus. Early on, this often leads to a range of upper GI symptoms — including poor growth or failure to thrive in young children, abdominal pain, nausea, and symptoms that can mimic reflux. [5:58] In older kids, symptoms are more about trouble swallowing. That's because the swelling that happens initially, over time, may turn into scar tissue. So the esophagus can narrow and cause swallowing symptoms like food impaction. [6:16] Ryan speaks of living with EoE for decades and trying the full range of treatment options: food elimination, PPIs, steroids, and, more recently, biologics. [6:36] Dr. Dellon says Ryan's history is a good overview of how EoE is treated. There are two general approaches to treating the underlying condition: using medicines and/or eliminating foods that we think may trigger EoE from the diet. [6:57] For a lot of people, EoE is a food-triggered allergic condition. [7:01] The other thing that has to happen in parallel is surveying for scar tissue in the esophagus. If that's present and people have trouble swallowing, sometimes stretching the esophagus is needed through esophageal dilation. [7:14] There are three categories of medicines used for treatment. Proton pump inhibitors are reflux meds, but they also have an anti-allergy effect in the esophagus. [7:29] Topical steroids are used to coat the esophagus and produce an anti-inflammatory effect. The FDA has approved a budesonide oral suspension for that. [7:39] Biologics, which are generally systemic medications, often injectable, can target different allergic factors. Dupilumab is approved now, and there are other biologics that are being researched as potential treatments. [7:51] Even though EoE is considered an allergic condition, we don't have a test to tell people what they are allergic to. If it's a food allergy, we do an empiric elimination diet because allergy tests aren't accurate enough to tell us what the EoE triggers are. [8:10] People will eliminate foods that we know are the most common triggers, like milk protein, dairy, wheat, egg, soy, and other top allergens. You can create a diet like that and then have a response to the diet elimination. [8:31] Dr. Jensen and Dr. Dellon recently published an abstract in the American Journal of Gastroenterology about people with EoE who are not taking any medicine for it. Dr. Jensen calls it a real-world data study, leveraging electronic health record patient data. [8:51] It gives you an impression of what is actually happening, in terms of treatments for patients, as opposed to a randomized control trial, which is a fairly selected patient population. This is everybody who has been diagnosed, and then what happens with them. [9:10] Because of that, it gives you a wide spectrum of patients. Some patients are going to be relatively asymptomatic. It may be that we arrived at their diagnosis while working them up for other potential diagnoses. [9:28] Other patients are going to have rather significant impacts from the disease. We wanted to get an idea of what is actually happening out there with the full breadth of the patient population that is getting diagnosed with EoE. [9:45] Dr. Jensen was not surprised to learn that there are patients who had no pharmacologic treatment. [9:58] Some patients are relatively asymptomatic, and others are not interested in pursuing medications initially or are early in their disease process and still exploring dietary treatment options. [10:28] Holly sees patients from infancy to geriatrics, and if they're not having symptoms, they wonder why bother treating it. [10:42] Dr. Jensen says it's a point of debate on the implications of somebody who has the disease and goes untreated. What does that look like long-term? Are they going to develop more of that fibrostenotic pattern in their esophagus without treatment? [11:07] This is a question we're still trying to answer. There is some suggestion that for some patients who don't manage their disease, we very well may be looking at a food impaction in the future. [11:19] Dr. Dellon says we know overall for the population of EoE patients, but it's hard to know for a specific patient. We have a bunch of studies now that look at how long people have symptoms before they're diagnosed. There's a wide range. [11:39] Some people get symptoms and get diagnosed right away. Others might have symptoms for 20 or 30 years that they ignore, or don't have access to healthcare, or the diagnosis is missed. [11:51] What we see consistently is that people who may be diagnosed within a year or two may only have a 10 or 20% chance of having that stricture and scar tissue in the esophagus, whereas people who go 20 years, it might be 80% or more. [12:06] It's not everybody who has EoE who might end up with that scar tissue, but certainly, it's suggested that it's a large majority. [12:16] That's before diagnosis. We have data that shows that after diagnosis, if people go a long time without treatment or without being seen in care, they also have an increasing rate of developing strictures. [12:29] In general, the idea is yes, you should treat EoE, because on average, people are going to develop scar tissue and more symptoms. For the patient in front of you with EoE but no symptoms, what are the chances it's going to get worse? You don't know. [13:04] There are two caveats with that. The first is what we mean by symptoms. Kids may have vomiting and growth problems. Adults can eat carefully, avoiding foods that hang up in the esophagus, like breads and overcooked meats, sticky rice, and other foods. [13:24] Adults can eat slowly, drink a lot of liquid, and not perceive they have symptoms. When someone tells Dr. Dellon they don't have symptoms, he will quiz them about that. He'll even ask about swallowing pills. [13:40] Often, you can pick up symptoms that maybe the person didn't even realize they were having. In that case, that can give you some impetus to treat. [13:48] If there really are no symptoms, Dr. Dellon thinks we're at a point where we don't really know what to do. [13:54] Dr. Dellon just saw a patient who had a lot of eosinophils in their small bowel with absolutely no GI symptoms. He said, "I can't diagnose you with eosinophilic enteritis, but you may develop symptoms." People like that, he will monitor in the clinic. [14:14] Dr. Dellon will discuss it with them each time they come back for a clinic visit. [14:19] Holly is a speech pathologist, but also sees people for feeding and swallowing. The local gastroenterologist refers patients who choose not to treat their EoE to her. Holly teaches them things they should be looking out for. [14:39] If your pills get stuck or if you're downing 18 ounces during a mealtime, maybe it's time to treat it. People don't see these coping mechanisms they use that are impacting their quality of life. They've normalized it. [15:30] Dr. Dellon says, of these people who aren't treated, there's probably a subset who appropriately are being observed and don't have a medicine treatment or are on a diet elimination. [15:43] There's also probably a subset who are inappropriately not on treatment. It especially can happen with students who were under good control with their pediatric provider, but moved away to college and didn't transfer to adult care. [16:08] They ultimately come back with a lot of symptoms that have progressed over six to eight years. [16:18] Ryan meets newly diagnosed adult patients at APFED's conferences, who say they have no symptoms, but chicken gets caught in their throat. They got diagnosed when they went to the ER with a food impaction. [16:38] Ryan says you have to wonder at what point that starts to get reflected in patient charts. Are those cases documented where someone is untreated and now has EoE? [16:49] Ryan asks in the study, "What is the target EGID Cohort and why was it selected to study EoE? What sort of patients were captured as part of that data set?" [16:58] Dr. Jensen said they identified patients with the ICD-10 code for a diagnosis of EoE. Then they looked to see if there was evidence of symptoms or complications in relation to EoE. This was hard; some of these are relatively non-specific symptoms. [17:23] These patients may have been seeking care and may have been experiencing some symptoms that may or may not have made it into the chart. That's one of the challenges with real-world data analyses. [17:38] Dr. Jensen says they are using data that was collected for documenting clinical care and for billing for clinical care, not for research, so it comes with some caveats when doing research with this data. [18:08] Research using electronic health records gives a real-world perspective on patients who are seeking care or have a diagnosis of EoE, as opposed to a study trying to enroll a patient population that potentially isn't representative of the breadth of individuals living with EoE. [18:39] Dr. Dellon says another advantage of real-world data is the number of patients. The largest randomized controlled trials in EoE might have 400 patients, and they are incredibly expensive to do. [18:52] A study of electronic health records (EHR) is reporting on the analysis of just under 1,000. The cohort, combined from three different centers, has more than 1,400 people, a more representative, larger population. [19:16] Dr. Dellon says when you read the results, understand the limitations and strengths of a study of health records, to help contextualize the information. [19:41] Dr. Dellon says it's always easier to recognize the typical presentations. Materials about EoE and studies he has done that led to medicine approvals have focused on trouble swallowing. That can be relatively easily measured. [20:01] Patients often come to receive care with a food impaction, which can be impactful on life, and somewhat public, if in a restaurant or at work. Typical symptoms are also the ones that get you diagnosed and may be easier to treat. [20:26] Dr. Dellon wonders if maybe people don't treat some of the atypical symptoms because it's not appreciated that they can be related to EoE. [20:42] Holly was diagnosed as an adult. Ryan was diagnosed as a toddler. Holly asks what are some of the challenges people face in getting an EoE diagnosis. [20:56] Dr. Jensen says symptoms can sometimes be fairly non-specific. There's some ongoing work by the CEGIR Consortium trying to understand what happens when patients come into the emergency department with a food bolus impaction. [21:28] Dr. Jensen explains that we see there's quite a bit of variation in how that gets managed, and if they get a biopsy. You have to have a biopsy of the esophagus to get a diagnosis of EoE. [21:45] If you think about the steps that need to happen to get a diagnosis of EoE, that can present barriers for some groups to ultimately get that diagnosis. [21:56] There's also been some literature around a potential assumption about which patients are more likely to be at risk. Some of that is still ongoing. We know that EoE occurs more commonly in males in roughly a two-to-one ratio. Not exclusively in males, obviously, but a little more often in males. [22:20] We don't know anything about other groups of patients that may be at higher risk. That's ongoing work that we're still trying to understand. That in itself can also be a barrier when there are assumptions about who is or isn't likely to have EoE. [23:02] Dr. Dellon says that in adolescents and adults, the typical symptoms are trouble swallowing and food sticking, which have many causes besides EoE, some of which are more common. [23:18] In that population, heartburn is common. Patients may report terrible reflux that, on questioning, sounds more like trouble swallowing than GERD. Sometimes, with EoE, you may have reflux that doesn't improve. Is it EoE, reflux, or both? [24:05] Some people will have chest discomfort. There are some reports of worsening symptoms with exercise, which brings up cardiac questions that have to be ruled out first. [24:19] Dr. Dellon mentions some more atypical symptoms. An adult having pain in the upper abdomen could have EoE. In children, the symptoms could be anything in the GI tract. Some women might have atypical symptoms with less trouble swallowing. [24:58] Some racial minorities may have those kinds of symptoms, as well. If you're not thinking of the condition, it's hard to make the diagnosis. [25:08] Dr. Jensen notes that there are different cultural norms around expressing symptoms and dietary patterns, which may make it difficult to parse out a diagnosis. [25:27] Ryan cites a past episode where access to a GI specialist played a role in diagnosing patients with EoE. Do white males have more EoE, or are their concerns just listened to more seriously? [25:57] Ryan's parents were told when he was two that he was throwing up for attention. He believes that these days, he'd have a much easier time convincing a doctor to listen to him. From speaking to physicians, Ryan believes access is a wide issue in the field. [26:23] Dr. Dellon tells of working with researchers at Mayo in Arizona and the Children's Hospital of Phoenix. They have a large population of Hispanic children with EoE, much larger than has been reported elsewhere. They're working on characterizing that. [26:49] Dr. Dellon describes an experience with a visiting trainee from Mexico City, where there was not a lot of EoE reported. The trainee went back and looked at the biopsies there, and it turned out they were not performing biopsies on patients with dysphagia in Mexico City. [27:13] When he looked at the patients who ended up getting biopsies, they found EoE in 10% of patients. That's similar to what's reported out of centers in the developed world. As people are thinking about it more, we will see more detection of it. [27:30] Dr. Dellon believes those kinds of papers will be out in the next couple of months, to a year. [27:36] Holly has had licensure in Arizona for about 11 years. She has had nine referrals recently of children with EoE from Arizona. Normally, it's been one or two that she met at a conference. [28:00] Ryan asks about the research on patients not having their EoE treated pharmacologically. Some treat it with food avoidance and dietary therapy. Ryan notes that he can't have applesauce, as it is a trigger for his EoE. [28:54] Dr. Jensen says that's one of the challenges in using the EHR data. That kind of information is only available to the researchers through free text. That's a limitation of the study, assessing the use of dietary elimination approaches. [29:11] Holly says some of her patients have things listed as allergies that are food sensitivities. Ryan says it's helpful for the patients to have their food sensitivities listed along with their food allergies, but it makes records more difficult to parse for research. [30:14] Dr. Dellon says they identify EoE by billing code, but the codes are not always used accurately. Natural Language Processing can train a computer system to find important phrases. Their collaborators working on the real-world data are using it. [30:59] Dr. Dellon hopes that this will be a future direction for this research to find anything in the text related to diet elimination. [31:32] Dr. Jensen says that older patients were less likely to seek medication therapy. She says it's probably for a couple of reasons. First, older patients may have been living with the disease for a long time and have had compensatory mechanisms in place. [32:03] The other reason may be senescence or burnout of the disease, long-term. Patients may be less symptomatic as they get older. That's a question that remains to be answered for EoE. It has been seen in some other disease processes. [32:32] Dr. Dellon says there's not much data specifically looking at EoE in the older population. Dr. Dellon did work years ago with another doctor, and they found that older patients had a better response to some treatments, particularly topical steroids. [32:54] It wasn't clear whether it was a milder aspect of the disease, easier to treat, or because they were older and more responsible, taking their medicines as prescribed, and having a better response rate. It's the flip side of work in the pediatric population. [33:16] There is an increasingly aging population with EoE. Young EoE patients will someday be over 65. Dr. Dellon hopes there will be a cure by that point, but it's an expanding population now. [33:38] Dr. Jensen says only a few sites are contributing data, so they hope to add additional sites to the study. For some of the less common outcomes, they need a pretty large patient sample to ask some of those kinds of questions. [33:55] They will continue to follow up on some of the work that this abstract touched on and try to understand some of these issues more deeply. [34:06] Dr. Dellon mentions other work within the cohort. Using Natural Language Processing, they are looking at characterizing endoscopy information and reporting it without a manual review of reports and codes. You can't get that from billing data. [34:29] Similarly, they are trying to classify patient severity by the Index of Severity with EoE, and layer that on looking at treatments and outcomes based on disease severity. Those are a couple of other directions where this cohort is going. [34:43] Holly mentions that this is one of many research projects Dr. Jensen and Dr. Dellon have collaborated on together. They also collaborate through EGID Partners. Holly asks them to share a little bit about that. [34:53] Dr. Jensen says EGID Partners is an online registry where individuals, caregivers, and parents of children affected with EGIDs can join. [35:07] EGID Partners also needs people who don't live with an EGID to join, as controls. That gives the ability to compare those who are experiencing an EGID relative to those who aren't. [35:22] When you join EGID Partners, they provide you with a set of questionnaires to complete. Periodically, they push out a few more questionnaires. [35:33] EGID Partners has provided some really great information about patient experience and answered questions that patients want to know about, like joint pain and symptoms outside the GI tract. [36:04] To date, there are close to 900 participants in the registry from all over the world. As it continues to grow, it will give the ability to look at the patient experience in different geographical areas. [36:26] Dr. Dellon says we try to have it be interactive, because it is a collaboration with patients. The Steering Committee works with APFED and other patient advocacy groups from around the world. [36:41] The EGID Partners website shows general patient locations anonymously. It shows the breakdown of adults with the condition and caregivers of children with the condition, the symptom distribution, and the treatment distribution. [37:03] As papers get published and abstracts are presented, EGID Partners puts them on the website. Once someone joins, they can suggest a research idea. Many of the studies they have done have come from patient suggestions. [37:20] If there's an interesting idea for a survey, EGID Partners can push out a survey to everybody in the group and answer questions relatively quickly. [37:57] Dr. Dellon says a paper came out recently about telehealth. EoE care, in particular, is a good model for telehealth because it can expand access for patients who don't have providers in their area. [38:22] EoE is a condition where care involves a lot of discussion but not a lot of need for physical exams and direct contact, so telehealth can make things very efficient. [38:52] EGID Partners surveyed patients about telehealth. They thought it was efficient and saved time, and they had the same kind of interactions as in person. In general, in-state insurance covered it. Patients were happy to do those kinds of visits again. [39:27] Holly says Dr. Furuta, herself, and others were published in the Gastroenterology journal in 2019 about starting to do telehealth because patients coming to the Children's Hospital of Colorado from out of state had no local access to feeding therapy. [39:50] Holly went to the board, and they allowed her to get licensure in different states. She started with some of the most impacted patients in Texas and Florida in 2011 and 2012. They collected data. They published in 2019 about telehealth's positive impact. [40:13] When 2020 rolled around, Holly had trained a bunch of people on how to do feeding therapy via telehealth. You have to do all kinds of things, like make yourself disappear, to keep the kids engaged and in their chairs! [40:25] Now it is Holly's primary practice. She has licenses in nine states. She sees people all over the country. With her diagnosis, her physicians at Mass General have telehealth licensure in Maine. She gets to do telehealth with them instead of driving two hours. [40:53] Dr. Jensen tells of two of the things they hope to do at EGID Partners. One is trying to understand more about reproductive health for patients with an EGID diagnosis. Only a few studies have looked at this question, and with very small samples. [41:15] As more people register for EGID Partners, Dr. Jensen is hoping to be able to ask some questions related to reproductive health outcomes. [41:27] The second goal is a survey suggested by the Student Advisory Committee, asking questions related to the burden of disease specific to the teen population. [41:48] This diagnosis can hit that population particularly hard, at a time when they are trying to build and sustain friendships and are transitioning to adult care and moving away from home. This patient population has a unique perspective we wanted to hear. [42:11] Dr. Jensen and Dr. Dellon work on all kinds of other projects, too. [42:22] Dr. Dellon says they have done a lot of work on the early-life factors that may predispose to EoE. They are working on a large epidemiologic study to get some insight into early-life factors, including factors that can be measured in baby teeth. [42:42] That's outside of EGID Partners. It's been ongoing, and they're getting close, maybe over the next couple of years, to having some results. [43:03] Ryan says all of those projects sound so interesting. We need to have you guys back to dive into those results when you have something finalized. [43:15] For our listeners who want to learn more about eosinophilic disorders, we encourage you to visit apfed.org and check out the links in the show notes below. [43:22] If you're looking to find specialists who treat eosinophilic disorders, we encourage you to use APFED's Specialist Finder at apfed.org/specialist. [43:31] If you'd like to connect with others impacted by eosinophilic diseases, please join APFED's online community on the Inspire Network at apfed.org/connections. [43:41] Ryan thanks Dr. Dellon and Dr. Jensen for joining us today. This was a fantastic conversation. Holly also thanks APFED's Education Partners GSK, Sanofi, Regeneron, and Takeda for supporting this episode. Mentioned in This Episode: Evan S. Dellon, MD, MPH, Academic Gastroenterologist, University of North Carolina School of Medicine Elizabeth T. Jensen, MPH, PhD, Epidemiologist, Wake Forest University School of Medicine, University of North Carolina at Chapel Hill Predictors of Patients Receiving No Medication for Treatment of Eosinophilic Esophagitis in the United States: Data from the TARGET-EGIDS Cohort Episode 15: Access to Specialty Care for Eosinophilic Esophagitis (EoE) APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast apfed.org/specialist apfed.org/connections apfed.org/research/clinical-trials Education Partners: This episode of APFED's podcast is brought to you thanks to the support of GSK, Sanofi, Regeneron, and Takeda. Tweetables: "I've been working on eosinophilic gastrointestinal diseases for about 15 years. I started some of the early work around understanding possible risk factors for the development of disease. I've gone on to support lots of other research projects." — Elizabeth T. Jensen, MPH, PhD "You can think of EoE as asthma of the esophagus or eczema of the esophagus, although in general, people don't grow out of EoE, like they might grow out of eczema or asthma. When people have it, it really is a long-term condition." — Evan S. Dellon, MD, MPH "There are two general approaches to treating the underlying condition, … using medicines and/or eliminating foods from the diet that we think may trigger EoE. I should say, for a lot of people, EoE is a food-triggered allergic condition." — Evan S. Dellon, MD, MPH "I didn't find it that surprising [that there are patients who had no treatment]. Some patients are relatively asymptomatic, and others are not interested in pursuing medications initially or are … still exploring dietary treatment options." — Elizabeth T. Jensen, MPH, PhD "We have a bunch of studies now that look at how long people have symptoms before they're diagnosed. There's a wide range. Some people get symptoms and are diagnosed right away. Other people might have symptoms for 20 or 30 years." — Evan S. Dellon, MD, MPH "EGID Partners is an online registry where individuals, caregivers, and parents of children affected with EGIDs can join. EGID Partners also needs people who don't live with an EGID to join, as controls." — Elizabeth T. Jensen, MPH, PhD
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 Years on Feedspot. Sonal's 16th Season starts up and Episode 11 features a Newsworthy update on the OIG Work Plan for October 2025.Sonal's Trusty Tip and compliance recommendations focus on another claims processing update from Medicare.Spark inspires us all to reflect on resilience based on the inspirational words of Ernest Hemingway.Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
Description Join host and HRS Digital Education Committee Chair Michael S. Lloyd, MD, FHRS and his guests Miguel A. Leal, MD, FHRS, and Jason T. Jacobson, MD, FHRS, live at HRX 2025. In this prospective series of 12 device-naïve patients (median LVEF ~30%), the authors attempted permanent implantation of a single-coil DF-4 ICD lead into the left bundle branch area (LBBA). They achieved successful implantation with adequate sensing and pacing in 75% of patients, and during short-term follow-up the lead and RV parameters remained stable; minor complications occurred in ~25% of patients (lead micro-dislodgment and septal perforations). The authors conclude that LBBA ICD lead implantation is feasible with current tools and acceptable short-term outcomes, but note the higher-than-expected minor complication rate and emphasize the need for dedicated toolkits, higher operator volume, and a procedural learning curve. Learning Objectives Describe the procedural feasibility, safety considerations, and short-term outcomes associated with left bundle branch area (LBBA) DF-4 defibrillator lead implantation. Identify key technical caveats and patient selection factors relevant to adopting this emerging pacing strategy in clinical practice. Article Information Permanent Left Budnle Branch Area DF-4 Debibrillator Lead Implantation Feasibility, Procedural Caveats, Safety, and Follow-Up Article Authors Anindya Ghosh, Chenni S. Sriram, Nibin Manu, Mullasari Ajit Sankaradas, Gaurav M. Upadhyay, Ulhas M. Pandurangi Podcast Contributors Michael S. Lloyd, MD, FHRS Jason T. Jacobson, MD, FHRS Miguel A. Leal, MD, FHRS All relevant financial relationships have been mitigated. Host Disclosure(s): M. Lloyd •Speaking/Teaching/Consulting: Medtronic, Arga Medtech, Circa Scientific •Membership on Advisory Committees: Boston Scientific Contributor Disclosure(s): J. Jacobson •Stocks, Privately Held: Atlas 5D •Honoraria/Speaking/Teaching/Consulting: Zoll Medical Corporation, Vektor Medical, Inc. •Research: Abbott Medical, CardioFocus, Inc. M. Leal •Speaking/Teaching/Consulting: Medtronic Staff Disclosure(s) (note: HRS staff are NOT in control of educational content. Disclosures are provided solely for full transparency to the learner): S. Sailor: No relevant financial relationships with ineligible companies to disclose.
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Podcast for 5 Years: https://blog.feedspot.com/medical_billing_and_coding_podcasts/Sonal's 16th Season starts up and Episode 10 features a Newsworthy spotlight on November as Lung Cancer Awareness Month.Sonal's Trusty Tip and compliance recommendations focus on telehealth updates made in the CY 2026 Medicare Physician Fee Schedule Final Rule. Spark inspires us all to reflect on resilience based on the inspirational words of Margaret Thatcher.Lung Cancer Awareness Month:American Lung Association® Website: https://www.lung.org/lung-force/about-lung-force/featured-campaigns/lung-cancer-awareness-monthPaint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
The Psychology of Self-Injury: Exploring Self-Harm & Mental Health
In this episode, Dr. Rachel Zelkowitz defines trauma and its prevalence among individuals who self-injure, delineates posttraumatic stress disorder (PTSD) from complex PTSD (C-PTSD), and discusses common treatments for addressing trauma, including Cognitive Processing Therapy (CPT), Eye Movement Desensitization and Reprocessing (EMDR), and Prolonged Exposure (PE). With interest in treating military veterans and active duty service members, Dr. Zelkowitz provides insights into nonsuicidal self-injury (NSSI), self-harm, and trauma among military members.Learn more about Dr. Zelkowitz and her work here, and learn more about common treatments for trauma at the National Center for PTSD at www.ptsd.va.gov. Below are links to some of the research referenced in today's episode:Gromatsky, M., Halverson, T. F., Dillon, K. H., Wilson, L. C., LoSavio, S. T., Walsh, S., Mellows, C., Mann, A. J., Goodman, M., & Kimbrel, N. A. (2023). The prevalence of nonsuicidal self-injury in military personnel: A systematic review and meta-analysis. Trauma Violence Abuse, 24(5), 2936-2952.Liu, R. T., Scopelliti, K. M., Pittman, S. K., & Zamora, A. S. (2018). Childhood maltreatment and non-suicidal self- injury: A systematic review and meta-analysis. Lancet Psychiatry, 5(1), 51–64.Harned, M. S., Korslund, K. E., Foa, E. B., & Linehan, M. M. (2012). Treating PTSD in suicidal and self-injuring women with borderline personality disorder: Development and preliminary evaluation of a Dialectical Behavior Therapy Prolonged Exposure Protocol. Behaviour Research and Therapy, 50(6), 381-6.Harned, M. S., Schmidt, S. C., Korslund, K. E., & Gallop, R. J.(2021). Does adding the Dialectical Behavior Therapy Prolonged Exposure (DBT PE) protocol for PTSD to DBT improve outcomes in public mental health settings? A pilot nonrandomized effectiveness trial with benchmarking. Behavior Therapy, 52(3), 639-655.Follow Dr. Westers on Instagram and Twitter/X (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter/X (@ITripleS).The Psychology of Self-Injury podcast has been rated as one of the "10 Best Self Harm Podcasts" and "20 Best Clinical Psychology Podcasts" by Feedspot and one of the Top 100 Psychology Podcasts by Goodpods. It has also been featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."
Last month, the "Billing Boys"—Chris Jones and Phil Rodgers—joined the GeriPal podcast to demystify medical billing and coding in palliative care. This month, we're back with part two, shifting the focus to geriatrics. While billing and coding may not be the most exciting topic, they're essential for ensuring fair reimbursement for the complex care we provide and for supporting the work of our interprofessional teams, many of whom can't bill directly for their services. When we underbill or leave money on the table, we not only shortchange ourselves but also devalue the critical role of geriatrics in the healthcare system. This time, we're joined by experts Peter Hollmann, Ken Koncilja, and Audrey Chun to dive into key questions: Why does billing matter, and who does it benefit? What's the difference between CPT, E&M, and ICD-10 codes (if you need a refresher, check out our chat with the Billing Boys here)? We explore how to think about billing for complexity versus time, and unpack new and impactful codes like the Cognitive Assessment and Care Plan Services code (99483), advance care planning (ACP) billing codes, and G2211, which acknowledges the added work of managing patients with chronic conditions. We also highlight the new APCM G-codes for 2025, a set of HCPCS codes that could provide substantial financial support for interdisciplinary teams in geriatrics. Finally, we discuss the advocacy behind these codes. The American Geriatrics Society (AGS) plays a vital role on the AMA's RUC committee, helping to improve reimbursement for the complex care of older adults. Tune in to this week's GeriPal podcast for expert advice, practical strategies, and insights that will help you optimize your billing practices and sustain the future of geriatrics! Here are some of the resources we also talked about: The physician fee schedule look up tool Wwere you can find out CMS expected charge based off where you practice AGS's annual coding update Geriatrics at Your Fingertips, which has a one-pager on billing Medicare Claims Processing Manual
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, BA, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Podcast for 5 Years: https://blog.feedspot.com/medical_billing_and_coding_podcasts/Sonal's 16th Season starts up and Episode 9 features Newsworthy updates on the month's fraud, waste, and abuse cases. Sonal's Trusty Tip and compliance recommendations focus on diagnosis coding for family history of breast cancer.Spark inspires us all to reflect on resilience based on the inspirational words of Maya Angelou.Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
I'm tackling a massive challenge today: burnout. While the standard advice usually involves working less, I want to show you a practical dimension of burnout you have more control over, focusing on increasing your agency and autonomy to manage chronic workplace stress more effectively. Burnout is classified by the ICD-11 as a syndrome resulting from chronic workplace stress that has not been successfully managed.This episode includes practical advice for understanding and addressing burnout by shifting focus from reducing work volume to increasing control and resources.Understand the three dimensions of burnout as classified by the ICD-11: feelings of energy depletion or exhaustion, increased mental distance/negativity toward the job, and reduced professional efficacy.Discover why the amount of time you work is not a direct input to burnout, meaning working less is often impractical and may not solve the underlying issue.Learn the core philosophy for addressing burnout: In order to control stress, provide control (meaning agency and autonomy).Explore why stress is directly correlated to the ratio of demands placed on you versus the resources (including decision-making power, training, and tooling) you have to meet those demands.I'll give you practical ways to approach your manager to secure necessary resources, training, or mentoring to improve your professional efficacy and reduce job negativity.
Some disease-modifying therapies can change the trajectory of your MS journey. But gaining access to those medications isn't always as easy or straightforward as it should be. In the United States, insurance companies are most often the gatekeepers to prescription medications. This week, Cassandra Ashby shares a story that many of you may already be too familiar with, as she takes us through her family's long, hard, and confusing struggle to get the DMT that her newly-diagnosed daughter's neurologist prescribed. I We're also talking about the game-changing results of a study that demonstrate MS-related damage to the brain occurs years before the very first symptom becomes apparent. And we're explaining why this opens the door to treatment that may stop MS symptoms from even developing. We're giving you a heads-up about changes to the way health records for MS patients are being coded, and how these changes are already creating obstacles to accessing the disease-modifying therapy that you may have been taking for months or years. And we're reminding you that you still have time to register to participate virtually in tomorrow's historic meeting between people with MS and the FDA We have a lot to talk about! Are you ready for RealTalk MS??! This Week: The sometimes overwhelming challenge of gaining access to the disease-modifying therapy that's been prescribed by your MS Specialist :22 Study results demonstrate MS-related brain damage occurs years before MS symptoms 1:22 What are ICD-10 codes, and why do the latest changes to these codes pose potential challenges for people living with MS? 5:52 You can participate virtually in tomorrow's meeting between people with MS and the FDA 9:23 Cassandra Ashby shares her family's long, hard, and confusing struggle with their insurance company 10:56 Share this episode 31:06 Next week's episode 31:26 SHARE THIS EPISODE OF REALTALK MS Just copy this link & paste it into your text or email: https://realtalkms.com/426 ADD YOUR VOICE TO THE CONVERSATION I've always thought about the RealTalk MS podcast as a conversation. And this is your opportunity to join the conversation by sharing your feedback, questions, and suggestions for topics that we can discuss in future podcast episodes. Please shoot me an email or call the RealTalk MS Listener Hotline and share your thoughts! Email: jon@realtalkms.com Phone: (310) 526-2283 And don't forget to join us in the RealTalk MS Facebook group! LINKS If your podcast app doesn't allow you to click on these links, you'll find them in the show notes in the RealTalk MS app or at www.RealTalkMS.com REGISTER: Attend the virtual Shaping Tomorrow Together meeting with the FDA https://nmss.quorum.us/event/25463 SIGN UP: Become an MS Activist https://nationalmssociety.org/advocacy STUDY: Myelin Injury Precedes Axonal Injury and Symptomatic Onset in Multiple Sclerosis https://nature.com/articles/s41591-025-04014-w WATCH: The RealTalk MS ECTRIMS Extra Conversations video playlist on YouTube https://realtalkms.com/ectrims2025 JOIN: The RealTalk MS Facebook Group https://facebook.com/groups/realtalkms REVIEW: Give RealTalk MS a rating and review http://www.realtalkms.com/review Follow RealTalk MS on Twitter, @RealTalkMS_jon, and subscribe to our newsletter at our website, RealTalkMS.com. RealTalk MS Episode 426 Guests: Cassandra Ashby Privacy Policy
The JournalFeed podcast for the week of October 20-24, 2025.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday's Spoon Feed:Prehospital tranexamic acid (TXA) administration within 3 hours may improve mortality risk in adult trauma patients with hemorrhagic shock and has minimal side effects.Tuesday's Spoon Feed:In patients with an implantable cardioverter-defibrillator (ICD) at risk for ventricular arrhythmias, keeping potassium in the high-normal range (4.5-5.0 mmol/L) reduced shocks, arrhythmia hospitalizations, and deaths, without added harm.
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Podcast for 5 Years: https://blog.feedspot.com/medical_billing_and_coding_podcasts/Sonal's 16th Season starts up and Episode 8 features a Newsworthy update on claims being held by Medicare.Sonal's Trusty Tip and compliance recommendations focus on percutaneous needle breast biopsies.Spark inspires us all to reflect on resilience based on the inspirational words of Marianne Williamson.Checkout the Workshop for Telehealth Playbook for 2025-2026 on: https://kwadvancedconsulting.com/training-education-2/on-demand-webinars/webinar-registration/Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
Before you dive in—make sure your team isn't missing a critical first step in protecting your revenue. Check out our free guide on Eligibility & Billing Verification to prevent costly claim denials before they happen.Most practices think ICD-10 codes determine how much they get paid, but the truth is, they decide if you get paid at all. In this episode, Dr. Heather Signorelli breaks down how vague or incorrect ICD-10 coding can sabotage your revenue, trigger denials, and signal “low value” to payers. You'll learn how to code with precision, prove medical necessity, and finally get paid for the work you do.If you've ever been hit with a denial for “lack of medical necessity,” this episode is a must-listen.
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Podcast for 5 Years: https://blog.feedspot.com/medical_billing_and_coding_podcasts/Sonal's 16th Season starts up and Episode 7 features a Newsworthy spotlight on October as Breast Cancer Awareness Month.Sonal's Trusty Tip and compliance recommendations focus on fine needle aspiration biopsies.Spark inspires us all to reflect on resilience based on the inspirational words of Elie Wiesel.Checkout the Workshop for Telehealth Playbook for 2025-2026 on: https://kwadvancedconsulting.com/training-education-2/on-demand-webinars/webinar-registration/Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
In this episode, Jim Stephenson (Senior Market Access Manager at Permobil) and Tamara Kittelson (Executive Director of the Clinician Task Force) unpack recent changes in Medicare's five-year wheelchair replacement policy. They explore what the new rules mean for end users, clinicians, and providers, especially the removal of the face-to-face requirement and the implications for clinical evaluations. Tamara shares her decades of experience in complex rehab technology, her personal journey as an OT and mother, and the mission behind Eleanore's Project, which helps children in Peru access wheelchairs. The conversation also highlights the importance of regular evaluations, advocacy, and the evolving role of clinicians in ensuring optimal seating and mobility outcomes. The episode wraps up with a discussion on the surprising removal of ICD-10 diagnosis codes for seating and positioning products, a change that could improve access but also demands stronger clinical documentation.
No money, no mission. Understanding coding is the key to funding care and making your practice sustainable. In this episode of BackTable OBGYN, host, Dr. Mark Hoffman, chats with Dr. Jon Hathaway, associate professor at IU School of Medicine and coding specialist. They discuss the intricacies of medical billing, the impact of coding knowledge on revenue, and the systemic gaps in residency training regarding financial literacy. ---SYNPOSISDr. Hathaway shares his journey from mastering coding to becoming a national expert, providing a crash course on CPT, RVU, and ICD codes, and emphasizing the importance of accurate billing for the sustainability of healthcare practices. The episode offers valuable insights into the challenges and opportunities in medical coding and the broader financial aspects of healthcare.---TIMESTAMPS00:00 - Introduction 02:03 - Dr. Hathaway's Journey into Coding04:11 - Understanding the Financial Side of Healthcare07:10 - The Disconnect in Healthcare Payments11:26 - The Complexity of Medical Billing18:11 - The Role of CPT, RVU, and ICD Codes24:03 - The Process of Approving New Procedures32:38 - Understanding the Value Update Process33:47 - Case Study: Cystoscopy in Hysterectomy Codes35:26 - Survey Participation and Its Impact36:12 - Roles and Responsibilities in ACOG38:12 - Challenges of RVU-Based Compensation42:08 - Specialty-Specific RVU Valuation48:42 - Comparing OB and GYN Reimbursements50:02 - Envisioning an Ideal Healthcare System55:10 - Maximizing Billing Efficiency59:46 - Final Thoughts
In today's competitive treasury landscape, technical skills alone aren't enough. If you want to grow your career, attract new opportunities, and be seen as a leader in your field, you need to become visible. This week's featured guests: Catherine Latoya Grant-Alston, CEO & Co-Founder, ART Financial SolutionsMike Richards, CEO, The Treasury Recruitment CompanyIn this high-energy episode recorded LIVE at TMANY's New York Cash Exchange, Mike Richards and Catherine Latoya Grant-Alston deliver a masterclass in networking and personal branding - tailored specifically for treasury professionals.Whether you're an introvert who dreads public speaking or someone who isn't even looking for a new job, this episode will show you why your LinkedIn profile matters, how to talk about your accomplishments without sounding boastful, and why building your personal brand is no longer a luxury - t's a necessity. You'll hear real stories, practical tips, and hard-hitting truths that will inspire you to take action, be seen, and unlock new levels of career success.What We Cover in This Episode:Why your personal brand matters more than your company brandThe role of LinkedIn in building a reputation that speaks for youOvercoming fear of self-promotion: separating confidence from cockinessHow to network authentically - even as an introvertSimple ways to optimize your LinkedIn profile and photoLeveraging speaking engagements and podcast appearances to boost visibilityWhy visibility isn't just about job searching - it's about being foundThe power of consistency and regular engagement on LinkedInTools like digital business cards and AI headshots for modern networkingReal talk on imposter syndrome and telling your professional storyCheck out the slides to the session HERE----
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Podcast for 5 Years: https://blog.feedspot.com/medical_billing_and_coding_podcasts/Sonal's 16th Season starts up and Episode 6 features a Newsworthy update on the OIG Work Plan for September 2025.Sonal's Trusty Tip and compliance recommendations focus on another update regarding E/M scrutiny by a payor.Spark inspires us all to reflect on resilience based on the inspirational words of Madeleine L'Engle.Checkout the Workshop for Telehealth Playbook for 2025-2026 on: https://kwadvancedconsulting.com/training-education-2/on-demand-webinars/webinar-registration/Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
Infants and children can experience brain injuries in many ways.What signs can parents keep an eye out for and what can you do to prevent traumatic brain injuries (TBIs)? Tune in to hear Jessica talk about childhood brain injuries with Dr. Sue Wolf, an Educational Psychologist with Empowerment Research. Learn about causes, signs, prevention, and recovery. Host:Jessica Stewart-Gonzalez is the Chief of the Office of Children's Health at the Arizona Department of Health Services. She is married, has two young children, and loves reading (anything except parenting books!) and watching movies and TV. She enjoys spending time with her kids (when they aren't driving her crazy) and celebrating all of their little, and big, accomplishments. Jessica has been in the field of family and child development for over 20 years, focused on normalizing the hard work of parenting and making it easier to ask the hard questions.Links: Strong Families AZHost: Jessica Stewart-GonzalezGuest: Dr. Sue WolfEmpowerment ResearchEncircle FamiliesBrain Injury Association of ArizonaAZ Department of Education: TBI Training
Celebrating 400 Episodes of the Treasury Career Corner!This is a major milestone - 400 episodes of The Treasury Career Corner! For seven years, we've shared the career journeys and insights of the world's top treasury professionals. To mark this special occasion, we've brought in a powerhouse guest whose story perfectly encapsulates what this show is all about: world-class leadership, growth through challenge, and relentless focus on impact.We are delighted to welcome this week's guest Tony Masone, VP, Treasurer, Treasury & Risk Management at Amazon.Tony Masone is the Vice President, Treasurer, of the Treasury & Risk Management organization at Amazon where he oversees Treasury, Global Risk Management and Claims, and Internal Audit functions. With a treasury career spanning global giants like GE, PepsiCo, and Amazon, Tony has built treasury infrastructures from scratch, led organizations through crises, and developed a personal leadership framework rooted in fortitude, passion, creativity, and grace.In this episode Tony shares how he went from working in Audit to becoming VP, Treasurer at Amazon. This episode is a masterclass in treasury career progression, leadership mindset, and building resilience in high-stakes environments.What We Cover in This Episode:Tony's early beginnings in public accounting and how it opened the door to treasuryHis transition from internal auditor to treasury specialist at PepsiCoThe critical role of mentorship in his career movesLessons learned from major treasury operations at GE, including managing through the 2008 financial crisisThe building and scaling of Amazon's treasury functionCreating a personal leadership framework to thrive in a high-growth, entrepreneurial cultureWhy treasury professionals must write their own “career book” instead of following others' pathsThe importance of resilience, risk-taking, and strategic thinking in treasury leadershipYou can connect with Tony Masone on LinkedIn. ---
In this episode, we dive deep into what the new ICD codes mean for Gulf War Veterans. We'll break down the details, explain why they matter, and share everything you need to know about how these codes affect recognition, care, and benefits.Get access to past and bonus content with exclusive guest. Please help support the podcast and veterans so we can keep making the show - patreon.com/GulfWarSideEffects▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬Life Wave Patches: https://lifewave.com/kevinsimon/store/products*Here is my recommendations on what patches to get and what has helped me.Ice Wave - this helps with my neuropathy.x39 - this helps me with brain fog and my shakesx49 - helps with bone strengthGludifion - helps get rid of toxinsMerch: https://gulfwar-side-effects.myspreadshop.com/Contact me with your questions, comments, or concerns at kevinsimon@gulfwarsideeffects.com
**Free Guide for Listeners:** Boost your practice's cash flow and reduce denials with our step-by-step **Eligibility & Billing Verification Training Guide.** Download it here → https://natrevmd.com/eligibility-billing-verification/Starting October 1st, Cigna is rolling out a controversial “R49” policy that automatically down-codes higher-level E/M visits—cutting physician reimbursement even when documentation fully supports the billed level. In this episode of the NatRevMD Podcast, Dr. Heather Signorelli, DO, breaks down what this means for your practice, how ICD-10 codes and E/M guidelines intersect, and why the California Medical Association is fighting back. You'll learn:
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Podcast for 5 Years: https://blog.feedspot.com/medical_billing_and_coding_podcasts/Sonal's 16th Season starts up and Episode 5 features a Newsworthy segment on ICD10CM codes taking effect today, October 1, 2025. *Note, when I say "I" in Section Guidelines, I am referring to roman numeral I.Sonal's Trusty Tip and compliance recommendations focus on telehealth today, October 1, 2025. Spark inspires us all to reflect on resilience based on the inspirational words of Nelson Mandela.Checkout the Workshop for Telehealth Playbook for 2025-2026 on: https://kwadvancedconsulting.com/training-education-2/on-demand-webinars/webinar-registration/Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
Wednesday, October 1st, 2025. Week 40. SYNGAP1 Related Disorders secured an ICD-10 code exactly four years ago today, through the advocacy of SRF and the hard work of volunteers like Hans Schlecht. Our code is F78.A1 Blog: https://curesyngap1.org/blog/syngap1-assigned-its-own-icd-10-code-f78-a1-srf/ Check out #S10e8 to learn more: https://www.youtube.com/watch?v=tZ5s5rQawXg Read the case study: https://everylifefoundation.org/icd-code-roadmap/#toggle-id-13 Hear from other leaders: https://effieparks.com/podcast/episode-224-the-complicated-world-of-icd10-codes-with-ceo-and-co-founder-of-slc6a1-connect-amber-freed Why does it matter and where are we now? It helps us find patients and it helps doctors and companies find YOU. We aren't where we should be. Dr. Lal's sobering post: https://www.linkedin.com/posts/dennis-lal-71a8988a_raredisease-epilepsy-precisionmedicine-activity-7373307411383857152-dQS0 Preprint: https://www.medrxiv.org/content/10.1101/2025.09.12.25335652v1.full.pdf TABLE 1. List of monogenic epilepsies with a syndrome-specific ICD-10 code, associated genes, and code implementation dates. Syndrome ICD-10 Code Gene Effective Date21 Rett syndrome F84.2 MECP2 10/01/2015 Glucose transporter protein type 1 deficiency syndrome (GLUT1-DS) E74.810 SLC2A1 10/01/2020 Cyclin-dependent kinase-like 5 deficiency disorder (CDD) G40.42 CDKL5 10/01/2020 Dravet syndrome G40.83 SCN1A 10/01/2020 SYNGAP1-related intellectual disability (SYNGAP1-ID) SYNGAP1 F78.A1 10/01/2021 MED13L syndrome Q87.85 MED13L 10/01/2023 Phelan-McDermid syndrome Q93.52 SHANK3 10/01/2023 SLC13A5 citrate transporter disorder E74.820 SLC13A5 10/01/2024 KCNQ2-related epilepsy G40.84 KCNQ2 10/01/2024 Kleefstra syndrome Q87.86 EHMT1 10/01/2024 5 Conclusion Syndrome-specific ICD-10 codes for monogenic epilepsies are markedly underutilized, even for patients with confirmed molecular diagnoses and established clinical syndromes. In our cohort, fewer than two-thirds of eligible patients were ever documented with their syndrome-specific ICD-10 code, and when used, these codes were applied inconsistently across encounters, specialties, and time. Such gaps hinder the reliable identification of patients for precision therapies, clinical trials, and research studies, limiting the intended value of these codes. Although uptake of syndrome-specific ICD-10 codes showed gradual improvement over time, additional efforts, including automated and patient-driven coding support and integration of structured genetic data, are needed to ensure accurate and consistent use. Broader, multi-institutional studies will be essential to validate these findings and to guide strategies that maximize the clinical and research utility of syndrome-specific ICD codes as precision medicine advances. Who else got them? New DEE Codes effective 10/1/2025! https://www.cdc.gov/nchs/icd/icd-10-cm/files.html #FOXG1 Q04.8 https://www.foxg1research.org/news/foxg1-syndrome-icd-10-code #Kabuki Q87.0 #USP7 Q87.87 https://www.linkedin.com/posts/foundation-for-usp7-related-diseases_were-proud-to-share-an-important-milestone-activity-7375555189539348480-77n3 #CTNNB1 Q87.88 https://www.linkedin.com/posts/ctnnb1_ctnnb1-connectandcure-ctnnb1syndrome-activity-7376633308836683777-fRYC #SCN2A QA0.0101 https://www.scn2a.org/from-advocacy-to-action-scn2a-now-has-its-own-icd-10-code/ #CACNA1A QA0.0102 https://www.linkedin.com/posts/cacna1a-foundation_huge-milestone-for-our-cacna1a-community-activity-7358883822282653696-xWr5 #SLC6A1 QA0.0131 https://www.linkedin.com/posts/slc6a1connect_raredisease-icd10-genetics-activity-7374801222056411136-wmAZ #STXBP1 QA0.0141 https://www.stxbp1disorders.org/news/stxbp1-has-an-icd-10-code #DLG4 QA0.0149 #Usher H35.5 CombinedBRAIN Rent a Neuro: https://combinedbrain.org/rent-a-neuroscientist/ CB Slide on ICD-10: https://docs.google.com/presentation/d/1wys1RLbJWBtK9eh7xSd_Lm-xwqbeZMSnM7xcCQznE8M/edit?usp=sharing Everylife Roadmap: https://everylifefoundation.org/icd-code-roadmap/ REN ICD-10 page: https://www.rareepilepsynetwork.org/about-icd-codes EVENTS! Scramble this weekend in Greer, SC! https://donate.curesyngap1.org/event/scramble-for-syngap-2025/e667451 Conference on Dec 4 & 5 in Atlanta, don't miss. https://donate.curesyngap1.org/event/cure-syngap1-conference-2025-hosted-by-srf/e661355 CURE SYNGAP1 CONNECT https://curesyngap1.org/curesyngap1connect/ SOCIAL MATTERS - 4,376 LinkedIn. https://www.linkedin.com/company/curesyngap1/ - 1,450 YouTube. https://www.youtube.com/@CureSYNGAP1 - 11,285 Twitter https://twitter.com/cureSYNGAP1 - 46k Insta https://www.instagram.com/curesyngap1/ NEWLY DIAGNOSED? New families have resources here! https://syngap.fund/Resources Podcasts, give all of these a five star review! https://cureSYNGAP1.org/SRFApple https://podcasts.apple.com/us/channel/syngap1-podcasts-by-srf/id6464522917 Episode 185 of #Syngap10 #CureSynGAP1 #Advocate #PatientAdvocacy #UnmetNeed #SYNGAP1 #SynGAP #SynGAProMMiS
What do global treasury leaders really do to build high-performing teams, navigate massive organizational change, and win industry awards - all while working across time zones? In this live episode from our Dublin event, three senior treasury professionals reveal exactly how they've built careers, led global teams, and driven continuous improvement at some of the world's most recognizable brands.Join Mike Richards as he chats with these three powerhouse treasury leaders:Kiera Agnew, Assistant Vice President, Corporate Assistant Treasurer at KellanovaJulia Donegan, Global Treasury Director at Newell Brands IncKeith Lynch, Senior Director, Global Treasury Centre of Excellence, ViatrisHosted LIVE in Dublin, this episode unpacks the real-world challenges and successes that come with leading treasury in complex, global organizations. From entering the field by chance to shaping the future of the profession, this candid conversation offers a masterclass in what it takes to thrive and lead in modern treasury.What We Cover in This EpisodeHow each guest accidentally fell into treasury and built global careers from the ground up The role of formal education vs. real-world experience in treasury successHow to build and scale global treasury teams, especially post-COVIDThe shift to remote and hybrid work, and how it's changing team dynamicsThe importance of mentorship, leadership, and soft skills in treasuryHow treasury teams earn a seat at the table in strategic business decisionsUsing automation, TMS, and AI to drive transformation - without reducing headcountLessons from award-winning treasury projects in virtual accounts, restructuring, and moreAdvice on career progression, visibility, and getting internal recognitionThe challenges of navigating acquisitions, integrations, and rapid change----
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, BA, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Podcast for 4 Years: https://blog.feedspot.com/medical_billing_and_coding_podcasts/Sonal's 16th Season starts up and Episode 4 features Newsworthy updates on the month's fraud, waste, and abuse cases. Sonal's Trusty Tip and compliance recommendations focus on an update made by a payor regarding E/M scrutiny.Spark inspires us all to reflect on resilience based on the inspirational words of Mary Anne Radmacher.Checkout the Workshop for Telehealth Playbook for 2025-2026 on: https://kwadvancedconsulting.com/training-education-2/on-demand-webinars/webinar-registration/Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
Some conditions hide in your genes, without any symptoms. One of these conditions is genetic arrhythmogenic cardiomyopathy, an inherited condition that can lead to sudden cardiac arrest — even if you feel completely fine.In this episode, Sarah and Leslie talk about their shared diagnosis of FLNC cardiomyopathy — from how this gene mutation affects the function of the heart to how they're managing this rare condition. You'll hear how Leslie's ICD has saved her life more than once, how it feels to be shocked back to life, and the resilience that's helped them move forward.This is a raw, real, emotional episode about living with a genetic heart condition. Tune in to learn the signs to watch for, when to get tested, and where to find support!Topics discussed in this episode:What is genetic arrhythmogenic cardiomyopathy?How FLNC-AC differs from other cardiomyopathiesCommon symptoms and some people are diagnosed too lateTreatment and lifestyle managementHow Sarah and Leslie finally got diagnosedLeslie's first cardiac arrest and its impactHow Sarah is processing her diagnosisWhat it feels like to be shocked by your ICDTypes of ICDs: transvenous, SICD, and EV-ICDMental and emotional recovery post-cardiac arrestThe WomenHeart organizationFind support or volunteer with WomenHeart:https://www.womenheart.org/Mentioned in this episode:Voices in NursingCheck out the Voices in Nursing Podcast here: https://www.aacn.org/education/podcast-series/voices-in-nursingCONNECT
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode1060. In this episode, I'll discuss aiming for high-normal potassium to reduce sustained ventricular tachycardia in patients with an ICD. The post 1060: Aiming for high-normal potassium to reduce VTach in patients with an ICD appeared first on Pharmacy Joe.
In this week's episode of the CodeCast Podcast, Terry Fletcher previews potential Telehealth updates and changes set to take effect on October 1. She also discusses how major surgery can be considered a risk factor in Evaluation and Management coding, and explains the importance of properly sequencing ICD-10-CM codes to ensure reimbursement success. Listeners are […] The post Telehealth October 2025 Preview appeared first on Terry Fletcher Consulting, Inc..
In this week's episode of the CodeCast Podcast, Terry Fletcher previews potential Telehealth updates and changes set to take effect on October 1. She also discusses how major surgery can be considered a risk factor in Evaluation and Management coding, and explains the importance of properly sequencing ICD-10-CM codes to ensure reimbursement success. Listeners are […] The post Telehealth October 2025 Preview appeared first on Terry Fletcher Consulting, Inc..
CAC 0 takes a gut punch, ICD therapies cannot be surrogates for benefit, and two important trials from ESC are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I CAC 0 LDL-C and CVD Risk With CAC Score 0 https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehaf497/8228645 II ICD Therapies Contemporary ICD Benefit https://www.jacc.org/doi/10.1016/j.jacep.2025.06.028 PROFID Trial https://profid-project.eu/profid-ehra-trial/ MADIT-RIT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1211107 Declining Risk of Sudden Death in HF https://www.nejm.org/doi/full/10.1056/NEJMoa1609758 III Digit-HF DIGIT-HF Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2415471 Digoxin–Mortality: Comparison in the DIG trial https://academic.oup.com/eurheartj/article/40/40/3336/5520008 IV POTCAST POTCAST trial https://www.nejm.org/doi/full/10.1056/NEJMoa2509542 ESC Preview IV HTN Guidelines New Blood Pressure Guidelines: 4 Things I Like and 2 Concerns https://www.medscape.com/viewarticle/new-blood-pressure-guidelines-4-thing-i-and-2-concerns-2025a1000m1x You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net
CardioNerds guest host Dr. Colin Blumenthal joins Dr. Juma Bin Firos and Dr. Aishwarya Verma from the Trinity Health Livonia Hospital to discuss a fascinating case involving malignant ventricular arrhythmias. Expert commentary is provided by Dr. Mohammed Ali-Jazayeri. Audio editing for this episode was performed by CardioNerds Intern, Julia Marques Fernandes. This case explores the puzzling presentation of exercise-induced ventricular tachycardia in a young, otherwise healthy male who suffered recurrent out-of-hospital cardiac arrests. With no traditional risk factors and an unremarkable ischemic workup, the challenge lay in uncovering the underlying cause of his malignant arrhythmias. Electrophysiology studies and advanced imaging played a pivotal role in systematically narrowing the differentials, revealing an unexpected arrhythmogenic substrate. This episode delves into the diagnostic dilemma, the role of EP testing, and the critical decision-making surrounding ICD placement in a patient with a concealed but life-threatening condition. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls- Malignant Ventricular Arrhythmias This case highlights the challenges and importance of diagnosing and managing ventricular arrhythmias in young, seemingly healthy individuals. Here are five key takeaways from the episode: Electrophysiology (EP) studies play a crucial role in identifying arrhythmogenic substrates in patients with exercise-induced ventricular tachycardia (VT) without obvious structural heart disease. In this case, substrate mapping revealed late abnormal ventricular afterdepolarizations in the basal inferior left ventricle, providing valuable insights into the underlying mechanism. Cardiac MRI can be a powerful tool for detecting subtle myocardial abnormalities. The subepicardial late gadolinium enhancement (LGE) in the lateral and inferior LV walls suggested an underlying myocardial process, even when other imaging modalities appeared normal. The VT morphology can provide clues about the underlying mechanism. In this case, the right bundle branch block pattern with a northwest axis and shifting exit sites pointed towards a scar-mediated mechanism rather than a channelopathy or idiopathic VT. Implantable cardioverter-defibrillator (ICD) placement is crucial for secondary prevention of sudden cardiac death (SCD) in patients with malignant ventricular arrhythmias, even in young individuals. The patient's initial deferral of ICD implantation highlights the importance of shared decision-making and patient education in these complex cases. "Scar-mediated VT introduces the risk of new arrhythmogenic substrates over time, reinforcing the need for ICD therapy even when catheter ablation is considered." This pearl emphasizes the dynamic nature of the arrhythmogenic substrate and the importance of long-term risk mitigation strategies. Notes - Malignant Ventricular Arrhythmias Notes were drafted by Juma Bin Firos. 1. What underlying pathologies cause ventricular arrhythmias in young patients without overt structural heart disease? Myocardial fibrosis: Detected via late gadolinium enhancement (LGE) on cardiac MRI Present in 38% of nonischemic cardiomyopathy cases Increases sudden cardiac death (SCD) risk 5-fold Often localized to subepicardial regions, particularly in the inferolateral left ventricle (LV) May precede overt systolic dysfunction by years Subclinical cardiomyopathy: 67% of young VT patients show subtle cardiac dysfunction Suggests VT may be the first manifestation of cardiomyopathy
© 2020-2026 Ivy Podcast Discovery LLC
