Ep. 607 Interventional Radiology Coding & Compliance Essentials with Dr. David Zielske

The modes and methods of medical education have changed drastically in the past decade. Social media, podcasts (like this one), and other on-demand learning formats have fundamentally shifted how healthcare professionals stay up to date and advance their practice. So what’s next? Dr. Rusty Hofmann, former chief of interventional radiology at Stanford, current Chief of Industry Partnerships for Stanford Healthcare, and Medical Director of Cardiac and Interventional Services at Stanford, joins host Dr. Aaron Fritts to discuss how he’s redefining the future of personalized learning. --- SYNPOSISDr. Hofmann shares an update on his company, Grand Rounds—now called Included Health—a personalized healthcare platform delivering virtual primary and specialty care to millions of Americans. Dr. Hofmann reflects on the journey behind Included Health and introduces his latest venture, Wysdom, a next-generation learning platform reimagining medical education through short, TikTok-style videos created by clinicians, for clinicians. He dives into the innovation of building a peer-reviewed, clinician-driven video library centered on real-world clinical cases. He discusses both the challenges and transformative potential of technology in medical education, spanning learners from trainees to seasoned clinicians. The episode concludes with his perspective on what’s next—and where the company is ultimately headed. --- TIMESTAMPS 00:00 - Introduction03:23 - Grand Rounds and Included Health05:29 - Challenges in Healthcare and Entrepreneurship12:28 - The Evolution of Medical Education16:37 - Creating and Sharing Medical Content20:52 - Curation and Organization of Medical Content27:41 - Morning Rounds: A Social Media Platform for Healthcare Professionals30:08 - Educational Content and Industry Collaboration35:08 - Creating Engaging and Practical Medical Videos40:55 - The Future of Medical Education48:18 - Final Thoughts and Reflections --- RESOURCES VI Episode 100https://www.backtable.com/shows/vi/podcasts/100/why-dr-rusty-hofmann-built-an-innovative-digital-health-company Wysdom Websitehttps://www.medicalwysdom.ai/home

11 Jan 51min

Is the open thoracotomy becoming outdated as robotic surgery and advanced ablation techniques take center stage in lung cancer treatment? In the final discussion of the 2025 NSCLC Creator Weekend™ series, our virtual tumor board of interventional radiologists and pulmonologists from leading medical institutions discuss recent surgical and interventional advancements in the treatment of lung cancer. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS The conversation covers the contemporary role of PET scans, endobronchial ultrasound (EBUS), mediastinal staging, and the importance of perioperative systemic therapy. The doctors explore surgical and non-surgical methods for treating lung cancer, including lymph node dissection, criteria for resection, and the advantages of minimally invasive approaches such as video-assisted thoracoscopic surgery (VATS) and robotic-assisted surgeries.A key focus of this episode is the decision-making process for treating multifocal lung cancers while preserving lung function, and the use of combined therapies like ablation and radiation. The episode concludes with a detailed case study illustrating the long-term management of a patient with multiple lung adenocarcinomas over several years, highlighting the multidisciplinary approach required in such complex scenarios. --- TIMESTAMPS 00:00 - Introduction10:07 - Patient Selection and Comorbid Conditions27:29 - Surgical Margins and Resection Strategies42:11 - Understanding Upstaging in Cancer Treatment53:27 - Technical and Clinical Resectability56:13 - Case Study: Managing Multifocal Lung Cancer01:11:41 - Long-Term Outcomes and Treatment Strategies --- RESOURCES CALGB 140503 Trialhttps://www.nejm.org/doi/full/10.1056/NEJMoa2212083 JCOG0802 Trialhttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02333-3/abstract

9 Jan 1h 16min

A negative angiogram in a patient with recurrent lower GI bleeding often calls for provocative angiography. In this episode of the BackTable Podcast, IR hosts Mike Barraza and Sabeen Dhand team up to talk tools, techniques, and tPA dosing for safe and effective treatment of lower GI bleeds with provocative mesenteric angiography.---This podcast is supported by:RADPAD® Radiation Protectionhttps://www.radpad.com/---SYNPOSISDr. Dhand describes the utility of provocative angiography in recurrent lower GI bleed patients with negative CTA and angiography, addressing common myths and concerns that may contribute to its underutilization. The conversation covers detailed procedure steps for both targeted and untargeted angiography, including access sites, dosing of tPA, and angiographic technique. Dr. Dhand emphasizes the importance of gradual increases in tPA dosage in 2 mg increments, and clear communication with care teams and the patient about the nature of the procedure. He also emphasizes the effectiveness and safety of this procedure by sharing real-world cases.---TIMESTAMPS00:00 - Introduction02:04 - Provocative Angiography for Lower GI Bleeds04:09 - Detailed Protocol for Provocative Angiography11:13 - Technical Details and Best Practices20:07 - Challenges in GI Bleeding Studies22:40 - Selective Embolization Techniques27:44 - Handling Negative Angiograms32:56 - Real-World Case Studies35:15 - Final Thoughts---RESOURCESThiry et al. Provocative Mesenteric Angiography: Outcomes and Standardized Protocol for Management of Recurrent Lower Gastrointestinal Hemorrhagehttps://pubmed.ncbi.nlm.nih.gov/34506023/

6 Jan 37min

Why might simultaneous ablation and biopsy be the new standard for high-probability lung cancer cases where surgery isn’t an option? In the penultimate episode of the 2025 NSCLC Creator Weekend™ series, our multidisciplinary tumor board panel discusses the intricacies and decision-making processes surrounding biopsy and ablation procedures in thoracic oncology. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS Topics include the prioritization of treatment versus tissue acquisition, the nuances of bronchoscopic versus percutaneous biopsies, and the latest advancements in robotic and cryo-biopsy techniques. The experts also share their approaches to managing pneumothorax, the value of multidisciplinary collaboration, and case studies that highlight personalized patient care. Listeners gain valuable insights into the evolving landscape of thoracic oncology procedures and the importance of patient-centered decision-making. --- TIMESTAMPS 00:00 - Introduction04:12 - Cryobiopy vs. Non-Cryobiopsy08:43 - Biopsy and Ablation: Strategies and Considerations15:31 - Post-Therapy Imaging and Follow-Up25:18 - Treatment Options and Patient Decisions27:08 - Evaluating Ablation Techniques28:59 - Managing Lung Cancer Recurrence39:41 - Case Study: Young Male with Ground Glass Nodule43:15 - Concluding Thoughts

2 Jan 39min

What considerations drive your decision between bland embolization, TACE, and radioembolization in managing neuroendocrine tumors? In this BackTable episode, Dr. Daniel DePietro, interventional radiologist at the University of Pennsylvania joins host Dr. Kavi Krishnasamy for an in-depth discussion on the interventional management of neuroendocrine tumors. --- SYNPOSIS The physicians start by discussing the intricacies of primary and metastatic neuroendocrine tumors, focusing on how treatment decisions are shaped by factors such as symptom burden, extent of disease requiring debulking, and symptom progression despite systemic therapy. Dr. DePietro shares insights from his clinical experience and emphasizes the critical role of interdisciplinary collaboration in optimizing patient outcomes. Dr. DePietro then shares his approach to using Y90 radioembolization in patients with biliary contraindications to TACE or bland embolization—such as those with prior Whipple surgery, sphincterotomy, or biliary stents—where the risk of hepatic abscess with ischemia-based therapies is higher. He also notes that patients who derive less than a year of benefit from prior TACE or bland embolization may be good candidates for radioembolization. The conversation also covers the role of thermal ablation in select patients with solitary lesions, and also touches on several key trials, including the ongoing CapTemY90 study. --- 00:00 - Introduction02:09 - Specialization in Neuroendocrine Tumors06:32 - Patient Selection and Treatment Criteria10:40 - Grading and Treatment of Neuroendocrine Tumors16:09 - Systemic Therapy Options22:22 - Rebiopsy and Its Importance28:01 - Technical Aspects of Local Regional Therapies39:14 - Radioembolization: When and How43:33 - Segmentectomy and Multimodal Approaches45:22 - CapTemY90 Trial and Promising Results49:52 - Hormone Release During Local Regional Therapies53:12 - Combining Radioembolization with PRT56:12 - Thermal Ablation in Neuroendocrine Tumor Patients58:06 - Follow-Up Imaging and Tumor Markers01:02:40 - Updates from Nanets Conference01:05:08 - Collaborating Across Specialties01:07:56 - Managing High Tumor Burden Patients01:13:59 - Treating Carcinoid Heart Disease01:19:37 - Closing Remarks and Acknowledgments --- RESOURCES NETTER-1 Trialhttps://www.nejm.org/doi/full/10.1056/NEJMoa1607427 REMINET Trialhttps://ascopubs.org/doi/10.1200/JCO.2016.34.15_suppl.TPS4148 CapTemY90 Trialhttps://www.clinicaltrials.gov/study/NCT04339036#contacts-and-locations

30 Des 20251h 21min

The ultimate challenge of operating an OBL is staying profitable. In this episode of BackTable, we bring on healthcare administrator Laurie Bouzarelos and interventional radiologist Dr. Mary Costantino to talk through the intricacies of revenue cycle management as an IR managing an OBL. --- SYNPOSIS The conversation covers the full lifecycle of getting paid in an IR practice, from initial patient contact through final claim resolution. Key topics include credentialing, determining medical necessity, coordination of benefits, prior authorizations, and the importance of working with billing and practice management teams experienced in interventional radiology. The episode also examines how EHR and practice management platform selection impacts clinical workflows and reimbursement, and closes with a discussion on payment plans and how emerging technologies, including AI, may shape the future of revenue management in IR-led OBLs. --- TIMESTAMPS 00:00 - Introduction 01:08 - The Importance of Revenue Cycle Management09:29 - The No Surprises Act and Data Transparency12:03 - Professional Societies and Continuing Education17:50 - Credentialing and Taxonomy Codes40:28 - Impact of Insurance Credentialing on Patient Care42:08 - Revenue Cycle Management Walkthrough48:18 - Challenges with Medicare Advantage and Coordination of Benefits54:20 - Covered vs. Non-Covered Services59:03 - Medical Necessity and Insurance Policies01:01:04 - Prior Authorization and Payment Issues01:13:11 - Payment Plans and Compliance01:23:10 - Practice Management Software01:31:10 - AI in Healthcare and Compliance01:38:57 - Final Thoughts --- RESOURCES Medical Group Management Administration (MGMA)https://www.mgma.com/

26 Des 20251h 40min

OpenEvidence was founded in 2022. In just 3 short years, it has become a household name amongst aspiring and established healthcare providers. AI-based tools are now being used to augment workflows, improve productivity, streamline busy work, and assist with clinical decision making. Is AI coming for our jobs? Time will tell. But in the meantime, you can (and probably should) use it to enhance yours. In this episode of BackTable, computer scientist and interventional radiologist Dr. Emil Cohen joins Dr. Chris Beck to share how he’s integrated AI tools into his IR practice. --- SYNPOSIS Dr. Cohen and Dr. Beck discuss both the advantages and key limitations of AI resources and tools like OpenEvidence and ChatGPT. They also explore application of AI in daily workflows, structured reports, procedural guidance, and predicting outcomes. Dr. Cohen dives into integrating AI to solve clinical problems and enhance existing technology, such as maskless subtraction angiography and rotational cone beam CT. Finally, Dr. Cohen speaks on the claim of AI replacing interventional radiology, informing those that are nervous about artificial intelligence. --- TIMESTAMPS 00:00 - Introduction05:09 - Computer Science and Medicine09:37 - AI Fundamentals for IRs17:59 - Practical Applications of AI in IR28:14 - The Value and Risks of Patient Data31:22 - Developing Advanced Imaging Techniques34:16 - Maskless Subtraction Angiography40:29 - AI in Clinical Problem Solving45:55 - The Future of AI in IR49:51 - Getting Involved with AI and Volunteering53:01 - Final Thoughts and Resources --- RESOURCES No Mask Subtraction with AI:https://www.smartangio.com/bone_subtraction/

23 Des 202557min