Medical Billing and Coding in Geriatrics: Peter Hollmann, Ken Koncilja, and Audrey Chun
GeriPal - A Geriatrics and Palliative Medicine Podcast
Release Date: 10/30/2025
Deprescribing at the End of Life: Jennifer Tjia, Jon Furuno, Simon Mooijaart
GeriPal - A Geriatrics and Palliative Medicine Podcast
Philippe Pinel that “It is an art of no little importance to administer medicines properly, but it is an art of much greater and more difficult acquisition to know when to suspend or altogether to omit them.” This insight remains profoundly relevant today, especially in hospice care, where inappropriate prescribing is a common issue. Studies show that 20%–70% of hospice patients receive at least one unnecessary medication near the end of life, including drugs like antihypertensives, statins, and vitamins. In this episode of the GeriPal Podcast, we tackle the pressing topic of...
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Unilateral DNR? Gina Piscitello, Erin DeMartino, Will Parker
GeriPal - A Geriatrics and Palliative Medicine Podcast
Do you think your hospital should allow unilateral DNR orders? Under what circumstances? Through what process? Do you think that when you obtain the assent of a family to not code their loved one, that assent DNR should be counted as a unilateral DNR order? Should we document unilateral DNR and the rationale? Why for DNR, when we don’t document unilateral dialysis not offered, or unilateral no ECMO offered? Is the assent of a family member to a statement that we will not code their loved one a nudge, and is the assent approach ? Reasonable people will disagree, as we do on this...
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Embedding Care in the ED: Liz Goldberg and Lauren Southerland
GeriPal - A Geriatrics and Palliative Medicine Podcast
The idea of embedding various forms of non-emergency care in the emergency department makes a WORLD of sense. If an older adult comes into the ED with a fall, the minimum the ED has to do is address the fall injury and send them out. But many emergency providers realize this is often a band aid. They see that patient again the next time they fall. And again. And again. The same could be said for the patient who is malnourished and dehydrated and admitted for “failure to thrive,” again. And again. Our two guests today, Liz Goldberg and Lauren Southerland, both...
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AI and Healthcare: Bob Wachter
GeriPal - A Geriatrics and Palliative Medicine Podcast
Today we interviewed Bob Wachter about his book, “.” You may recall we , and at that time he was on the fence about AI - more promise or more peril for healthcare? As his book’s title suggests, he’s come down firmly on the promise side of the equation. On our podcast we discuss: Why Bob wrote this book, at this time, and concerns about writing a static book about AI and Healthcare, a field that is dynamic and shifting rapidly. He’s right though - we’ve not had a “ChatGPT”-launch type moment recently. Top 5 or so ways in which Bob uses AI for work,...
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The Role of Specialty Palliative Care in Cancer Surgery: Rebecca Aslakson & Myrick Shinall
GeriPal - A Geriatrics and Palliative Medicine Podcast
Recent randomized controlled trials have shown that routine perioperative palliative care does not improve outcomes for patients undergoing curative-intent cancer surgery. No, that wasn’t a typo. Regardless of how the data were analyzed, the findings remained consistent: perioperative palliative care DID NOT improve outcomes in the only two randomized controlled trials conducted in this area—the and trials. Null trials like these often receive less attention in academic and clinical settings, but they can be profoundly practice-changing. Consider the . While some have argued it...
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The Future of Palliative Care? Community-Based Models with Alan Chiu, Mindy Stewart-Coffee, and Ben Thompson
GeriPal - A Geriatrics and Palliative Medicine Podcast
“I just want to say one word to you. One word. Plastics… There's a great future in plastics.” This iconic line from the movie The Graduate is at the top of my mind when I think about where we are heading in healthcare. I’ve interpreted “plastics” as symbolizing a dystopian, mass-produced future of medicine—where artificiality and inauthenticity dominate in the pursuit of efficiency and profit margins. After listening to today’s podcast on the growth of community-based palliative care, I find my perspective shifting on this quote. Perhaps the advice given for a...
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Uncertainty In Medicine: Jonathan Ilgen and Gurpreet Dhaliwal
GeriPal - A Geriatrics and Palliative Medicine Podcast
The only certainty in medicine is uncertainty. It touches every aspect of clinical practice, from diagnosis to treatment to prognosis. Despite this, many clinicians view uncertainty as something to tolerate at best or eliminate at worst. But what if we need to rethink and reframe our relationship with uncertainty in medicine? In this episode, we sit down with Jonathan Ilgen and Gurpreet Dhaliwal, co-authors of the New England Journal of Medicine article, “.” Together, we explore the nature of uncertainty in clinical practice, its effects on trainees and seasoned clinicians, and strategies...
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Why We Need QI Collaboratives: Guests Steve Pantilat, David Currow, and Arif Kamal
GeriPal - A Geriatrics and Palliative Medicine Podcast
In a recent episode of the GeriPal podcast, we explored —and, if so, how to save it—with guests Ira Byock, Kristi Newport, and Brynn Bowman. Today, we shift focus to one actionable way to improve palliative care: through quality improvement (QI) collaboratives, registries, and benchmarking. To guide this discussion, we’ve invited three leading experts in the field—Drs. Steve Pantilat, David Currow, and Arif Kamal—who bring invaluable experience as pioneers in developing QI collaboratives and registries. Together, they authored a recent paper in JPSM titled “,” which...
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Is Attending to Clinician Distress Our Job? Sara Johnson, Yael Schenker, & Anne Kelly
GeriPal - A Geriatrics and Palliative Medicine Podcast
Have you had one of those consults in which you’re thinking, huh, sounds like the patient’s goals are clear, it’s really that the clinician consulting us disagrees with those goals? To what extent is it our job as consultants to navigate, manage, or attend to clinician distress? What happens when that clinician distress leads eventually to conflict between the consulting clinician and the palliative care team? Today our guests Sara Johnson, Yael Schenker, & Anne Kelly discuss these issues, including: A recent paper first authored by Yael asking if attending to clinician...
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Rehab and Death in Skilled Nursing Facilities: Sarguni Singh, Christian Furman, and Lynn Flint
GeriPal - A Geriatrics and Palliative Medicine Podcast
In this week's podcast, we sit down with Drs. Sarguni Singh, Christian Furman, and Lynn Flint, three authors of the recent The authors dive into the challenges facing seriously ill older adults discharged to Skilled Nursing Facilities (SNFs), where fragmented care transitions, misaligned Medicare policies, and inadequate access to palliative care often result in burdensome hospitalizations and goal-discordant care. The discussion highlights key barriers in Medicare’s SNF and hospice benefits, including the inability to access concurrent hospice and SNF care, and explores...
info_outlineLast 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:
👉 NOTE:
Eric and Alex are giving UCSF Geriatrics Grand Rounds on Wednesday November 5, 4-5pm Pacific Time. The topic is, "What we've learned from nearly 400 GeriPal podcasts." Join us! This will be highly interactive. If you'd like to join via Zoom, you can use this link: https://ucsf.zoom.us/webinar/