Alessandro Bogliari, CEO and Co-Founder of The Influencer Marketing Factory, a global influencer marketing agency, talks with great guests about influencer marketing, social media, the creator economy, social commerce and much more.
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Player FM - Internet Radio Done Right
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محتوای ارائه شده توسط Terry Fletcher. تمام محتوای پادکست شامل قسمت‌ها، گرافیک‌ها و توضیحات پادکست مستقیماً توسط Terry Fletcher یا شریک پلتفرم پادکست آن‌ها آپلود و ارائه می‌شوند. اگر فکر می‌کنید شخصی بدون اجازه شما از اثر دارای حق نسخه‌برداری شما استفاده می‌کند، می‌توانید روندی که در اینجا شرح داده شده است را دنبال کنید.https://fa.player.fm/legal
مشابه CodeCast | Medical Billing and Coding Insights
Big tech is transforming every aspect of our world. But how, and at what cost? This season of Land of the Giants – The Disney Dilemma – focuses on Disney’s ability to weather the ups and downs of the business cycle and changing tastes and explores what has kept it successful for over 100 years. The entertainment giant has leveraged nostalgia and its intellectual property to build a beloved brand, but after an acquisition spree that included Marvel, Lucasfilm, and 20th Century Fox, can it sus ...
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A top podcast for healthcare leaders, with over one million downloads, Radio Advisory is your weekly download on how to untangle the industry's most pressing challenges to help leaders like you make the best business decisions for your organization. From unpacking major trends in care delivery—like site-of-care shifts and the rise of high-cost drugs—to demystifying stakeholder dynamics, to shining a spotlight on priorities that may get overlooked, we're here to help. Our hosts and seasoned r ...
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It didn’t all change in March 2020. Not really. The UK high street has been in the throes of a gradual revolution for decades. From the rise of ecommerce, to the birth of mobile, social commerce, and a growing emphasis on experience, change has been underway for a while. In fact for many, the pandemic has acted as a wake-up call. Digital transformation was no longer a ‘nice to have’ but a matter of survival. Necessity sparked innovation and customers are enjoying more flexibility and conveni ...
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Can you get credit for ordering and interpretation of a test?
Manage episode 482510938 series 2490675
محتوای ارائه شده توسط Terry Fletcher. تمام محتوای پادکست شامل قسمت‌ها، گرافیک‌ها و توضیحات پادکست مستقیماً توسط Terry Fletcher یا شریک پلتفرم پادکست آن‌ها آپلود و ارائه می‌شوند. اگر فکر می‌کنید شخصی بدون اجازه شما از اثر دارای حق نسخه‌برداری شما استفاده می‌کند، می‌توانید روندی که در اینجا شرح داده شده است را دنبال کنید.https://fa.player.fm/legal
The 2023 CPT® Errata and Technical Corrections added a one-liner on Independent Interpretations that responds to the question, “Can a practitioner get credit for both ordering and interpretation of a test, if documented?”
In this episode of the CodeCast podcast, Terry answers this question referencing the March 2023 CPT® Errata and Technical Corrections. She also covers the reality of this change and what an independent interpretation means, so that you are not upcoding based on assumptions.
Subscribe and Listen
You can subscribe to our podcasts via:
- Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627
- Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX
- TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/
- YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg
- YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ
- Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874
- Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights
- iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/
If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/
The post Can you get credit for ordering and interpretation of a test? appeared first on Terry Fletcher Consulting, Inc..
80 قسمت
اشتراک گذاریManage episode 482510938 series 2490675
محتوای ارائه شده توسط Terry Fletcher. تمام محتوای پادکست شامل قسمت‌ها، گرافیک‌ها و توضیحات پادکست مستقیماً توسط Terry Fletcher یا شریک پلتفرم پادکست آن‌ها آپلود و ارائه می‌شوند. اگر فکر می‌کنید شخصی بدون اجازه شما از اثر دارای حق نسخه‌برداری شما استفاده می‌کند، می‌توانید روندی که در اینجا شرح داده شده است را دنبال کنید.https://fa.player.fm/legal
The 2023 CPT® Errata and Technical Corrections added a one-liner on Independent Interpretations that responds to the question, “Can a practitioner get credit for both ordering and interpretation of a test, if documented?”
In this episode of the CodeCast podcast, Terry answers this question referencing the March 2023 CPT® Errata and Technical Corrections. She also covers the reality of this change and what an independent interpretation means, so that you are not upcoding based on assumptions.
Subscribe and Listen
You can subscribe to our podcasts via:
- Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627
- Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX
- TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/
- YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg
- YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ
- Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874
- Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights
- iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/
If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/
The post Can you get credit for ordering and interpretation of a test? appeared first on Terry Fletcher Consulting, Inc..
80 قسمت
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In this essential episode, we dive deep into the heightened scrutiny surrounding split/shared visits, particularly high-level 99223 initial hospital visits. Join Terry as she breaks down the latest payer audits impacting these services. We’ll explore critical compliance issues and offer actionable strategies to help your providers and practices proactively protect themselves from unwanted scrutiny and audit risk. Don’t let coding complexities expose your practice. Whether you’re a medical coder, healthcare provider, or practice manager, this episode provides the vital information you need to confidently navigate split/shared visit guidelines and maintain audit readiness. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Navigating Split/Shared Visit Audit Risks appeared first on Terry Fletcher Consulting, Inc. .…
Determining whether HCPCS code G2211 can be billed when a patient sees a different physician or practitioner within the same group practice, even colleagues in the same specialty, presents an interesting coding challenge. The key consideration revolves around whether the new provider serves as the “continuing focal point for all needed services or provides ongoing care for that complex or serious single condition.” Expert analysis by specialists like Terry is crucial in breaking down these nuances to ensure accurate coding for the G2211 complexity add-on. The code’s intent is to recognize the inherent complexity of visits that are part of a longitudinal patient-provider relationship, either where the practitioner is the primary point of contact for all healthcare needs, or where they manage a single, serious, or complex condition over time. When a patient transitions to a new provider within the same group, even in the same specialty, the question arises whether the new provider has established or intends to establish the same level of consistent, ongoing care that would justify billing G2211. This requires careful consideration of the documentation and the nature of the relationship being built with the new practitioner. Terry, our coding expert, unpacks these nuances to help you avoid over or under-coding. Tune in to ensure your practice is accurately capturing the true complexity of patient care! Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Revisiting G2211 with a Change of Provider appeared first on Terry Fletcher Consulting, Inc. .…
In today’s episode of the CodeCast podcast, Terry untangles the complexities of Protected Health Information (PHI) and HIPAA as they relate to workers’ compensation cases. She’ll clarify the rights of both patients and employers when requests for PHI reach a healthcare provider’s office. This can be a tricky area, especially given potential state-specific regulations. This episode could be an invaluable resource for navigating these complicated scenarios. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post HIPAA and Workers Comp Patients appeared first on Terry Fletcher Consulting, Inc. .…
A question I’m often asked is, “Why do physicians charge so much?” There’s no easy answer, as there isn’t a fixed price list for medical services. Due to the healthcare system’s complexity and the absence of set prices, providers are largely free to charge what the market will bear. However, can there be consequences for over-pricing or egregiously overcharging payers? Yes. It’s crucial to pay close attention to this issue, as it could lead to trouble not only legally but also in terms of regulatory compliance. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Can physicians charge whatever they want to Insurance Payers? appeared first on Terry Fletcher Consulting, Inc. .…
Engaging with “bad actors” in medical billing can have serious consequences for both patients and healthcare providers. More and more providers are engaging without checking. Here’s what could happen. Terry discusses it all with examples. Legal repercussions: Providers can face hefty fines, civil or criminal charges, and even loss of their medical license for engaging in fraudulent billing. Financial impact: Audits, penalties, and required repayments can lead to significant financial losses for the provider’s practice. Reputational damage: Being associated with fraud can significantly damage a provider’s reputation, leading to decreased patient volume and referral issues. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Watch out for “bad actors” on billing advice appeared first on Terry Fletcher Consulting, Inc. .…
In this episode, Terry challenges all medical professionals. What is your role in managing the patient experience? A lack of patient prep can lead to an incomplete encounter for the physician including excessive visits. It can also lead to leakage in all departments, including the RCM staff’s ability to perform their job. Terry offers her tips for accountability in all departments, starting with scheduling, to ensure the provider is “prepared” to see the patient. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Is the provider “prepared” to see the patient? appeared first on Terry Fletcher Consulting, Inc. .…
Since the implementation of the No Surprises Act (NSA) in January 2022, out-of-network (OON) reimbursement has become a complex and resource-heavy challenge for hospital and health system revenue cycle leaders. Although designed to shield patients from unexpected medical bills, the legislation has placed continuous financial pressure on physician practices and hospital systems. It has led to delayed payments, operational burdens, and strained resources. In this episode of the CodeCast Podcast, Terry runs through how the NSA works not only for your RCM staff but also how she dealt with a personal “balance bill” for the win! Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post No Surprises Act and OON Claims appeared first on Terry Fletcher Consulting, Inc. .…
Medical necessity is defined as services that are reasonable and necessary for diagnosis or treatment of an illness or injury, or to improve the functioning of a malformed body member and are not excluded under another provision of the Medicare Program. Unfortunately, we have many practices trying to slide under the radar the experimental and/or investigational services that are considered not medically necessary or a covered benefit under most payers. Terry discusses the ins and outs of this practices and how to make sure you are not falling into a false claim trap. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Medicare Rules For Experimental or Investigational Services appeared first on Terry Fletcher Consulting, Inc. .…
Terry discusses Behavioral Health services, best practices documentation and coding specifics. Also, Terry offers some bonus discussion on RAC auditors trying to bait providers into not responding to ADR requests. Check out this episode for intel on these important topics and more. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Behavioral Health Coding and Documentation appeared first on Terry Fletcher Consulting, Inc. .…
With all of the AI implementation into EHR and EMR systems, there is concern about how providers rely on these AI shortcuts more than ever. Without proper safeguards, accountability, and compliance perimeters, relying on AI could be problematic. Terry discusses the red flags to look for and how to proceed with caution in this new world of technology. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Did you know AI is integrated into EMRs? appeared first on Terry Fletcher Consulting, Inc. .…
The 2023 CPT® Errata and Technical Corrections added a one-liner on Independent Interpretations that responds to the question, “Can a practitioner get credit for both ordering and interpretation of a test, if documented?” In this episode of the CodeCast podcast, Terry answers this question referencing the March 2023 CPT® Errata and Technical Corrections. She also covers the reality of this change and what an independent interpretation means, so that you are not upcoding based on assumptions. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Can you get credit for ordering and interpretation of a test? appeared first on Terry Fletcher Consulting, Inc. .…
The 2021/2023 E/M guideline revisions read: “The evaluation and/or treatment should be consistent with the likely nature of the condition.” Before this, the CPT® guidelines did not discuss medical necessity. Guidance was left to the payers, particularly Medicare, via the Social Security Act. CMS’s guidance doesn’t necessarily hold regulatory authority. However, it often reflects a new, shared understanding that medical services reported should meet documentation standards for level selection. Those standards should also appropriately indicate why the patient is visiting the provider, based on the presenting problems. This episode of the CodeCast echoes Terry’s insights that auditors, coders, and medical professionals focus on medical necessity first, then look to coding. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Medical Necessity Comes Before Coding appeared first on Terry Fletcher Consulting, Inc. .…
It’s time for another round of frequently asked questions as Terry’s expertise covers orthopedic surgery, imaging, data points for E/M, and administrative charges for practices. She also answers questions relating to multiple E/Ms on the same date by the same and different physicians from the same group practice. Tune in for a lot of good information covered on this week’s show. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Top 10 Tuesday Q&A – Coding, Billing, and Compliance Questions appeared first on Terry Fletcher Consulting, Inc. .…
We all know the age-old question, “Where does it say that?” In this episode, Terry brings receipts, explaining it’s been this way since 2003: “Reviewing results of laboratory tests, phoning results to patients, filing such results, etc., are Medicare-covered services. Payment is included in the physician fee schedule payment for the evaluation and management (E/M) services to the patient. The CPT lists different levels of E and M services for both new and established patients and describes services that are included as E/M services. Such activities include obtaining, reviewing, and analyzing appropriate diagnostic tests.” Tune in to this episode for an in-depth discussion as Terry details trying to report a telehealth visit for giving test results may be considered double-dipping: and can get you into hot water! Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Giving Tests Results to Patients… Where’s the Payment? appeared first on Terry Fletcher Consulting, Inc. .…
An ADR (Additional Documentation Request) is a request from CMS or another insurance payer for additional documentation to review a claim. Most of these requests come from payer investigative units looking for medical necessity support. Terry discusses how to handle these requests, as well as how to ensure they are addressed promptly to meet the deadlines typically associated with them. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post ADR Workflow Tips appeared first on Terry Fletcher Consulting, Inc. .…
If the provider discusses their preferred management options with the patient, do they receive the “risk” credit even if the patient declines it? If yes, how long do they get to capture it? Terry breaks down, citing references, how to handle this MR element and ensure the providers are receiving the correct “risk” value for their encounter. Listen to this episode for all of the details. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Who Gets the Credit for MDM Risk Element? appeared first on Terry Fletcher Consulting, Inc. .…
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CodeCast | Medical Billing and Coding Insights
In this episode of the CodeCast podcast, Terry discusses the differences between APCM and CCM services and what is needed to report either. Compliance issues are seen with many care management service records. Terry covers how to follow best practices to ensure you follow the published guidance. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post APCM Focus appeared first on Terry Fletcher Consulting, Inc. .…
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CodeCast | Medical Billing and Coding Insights
Medical Coding provides standardized language that ensures all healthcare providers involved in a patient’s care are on the same page. The coder’s role is to be accurate, communicative, insightful and focused on a positive patient outcome. A patient’s financial health can impact their clinical health, and medical coders need to be recognized for their role in this process. Terry shares her thoughts on what makes a coder valuable, even if they are less visible than the providers. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post The Crucial Role of the Coder in Quality Patient Care appeared first on Terry Fletcher Consulting, Inc. .…
This week’s CodeCast summarizes the recent ICD-10-CM documentation guidelines instructions on sepsis, obesity, and COVID-19 reporting. Terry also provides more guidance on E/M risk in prescription drug management and caution with PSAs in patient documentation. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post ICD-10-CM April 1st Updates appeared first on Terry Fletcher Consulting, Inc. .…
More medical claims denials could be avoided if coders took the extra minute to make sure that the diagnoses that need to be linked to a specific line item were pre-billed. Also, when billing for diagnostic procedures on a complaint that moves to a minor, therapeutic, or surgical procedure, denials will happen when the diagnosis for the latter procedure is not updated. Terry covers all the issues with denials that can be avoided with a careful step back. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Avoiding Insurance Denials appeared first on Terry Fletcher Consulting, Inc. .…
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CodeCast | Medical Billing and Coding Insights
Terry takes some inspiration from Stephanie Allard’s February 27th for this edition of the CodeCast podcast. Terry discusses the differences and subjective issues between Acute Uncomplicated Illness (or Injury) versus Acute Complicated Illness in the E/M elements of coding and auditing. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Acute Uncomplicated vs. Acute Complicated E/M Auditing appeared first on Terry Fletcher Consulting, Inc. .…
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CodeCast | Medical Billing and Coding Insights
Terry’s answering your coding questions in this week’s “Top 10” Q&A. In this episode Terry’s covering APCM, E/M, skin procedures, lab billing, and even a Telehealth bonus. Tune in for insights you won’t want to miss! Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Top 10 Tuesday Q&A – Coding, Billing, and Compliance Questions appeared first on Terry Fletcher Consulting, Inc. .…
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CodeCast | Medical Billing and Coding Insights
Terry is under the weather this week, so she gives us a quick segment on the E/M Data point, “independent interpretation”. See page 12 of CPT® under independent interpretation, the last sentence. “A test that is ordered and independently interpreted may count as both a test ordered and interpreted. ” Suppose you bill for the professional and technical components, meaning you are billing for the test ordered. In that case, you can’t double dip or get additional credit for the order, the review, or a professional interpretation. You can get credit for ordering a test and for an independent interpretation, as long as your documentation meets the criteria for what an independent interpretation is. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Independent Interpretations of E/M Data Points appeared first on Terry Fletcher Consulting, Inc. .…
Some coders remain confused about Medically Unlikely Edits (MUEs) — but that’s about to change. In this episode, Terry discusses denials from Part B MACs for what you may think is an undetermined reason. However, a possibility is running up against MUEs. The edits, which are designed to prevent over-payments caused by serious billing errors, often confuse even veteran coders. Terry uncovers the truth about four aspects of these edits to ensure you’re not letting MUEs wreak havoc on your practice’s coding and reimbursement efforts. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post How do MUEs Work in Coding? appeared first on Terry Fletcher Consulting, Inc. .…
The third element of MDM for E/M Services is “Risk of Complications and/or Morbidity or Mortality of Patient Management”. Many believe that only the risk in this element is how you level your E/M, but that is false. There are three elements to a E/M service when using MDM. There are several risks including the problems addressed and for the management and treatment for the patient. Terry discusses the difference and how to make sure you don’t over or under-code in the process. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post E/M MDM Third Element Complications appeared first on Terry Fletcher Consulting, Inc. .…
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CodeCast | Medical Billing and Coding Insights
Everyone knows that you cannot routinely waive or fail to collect the obligation of patient cost-sharing. However, we know that there are instances where (1) the patient has a bad experience, (2) the patient will not pay or is not collectible, and (3) the patient has a hardship. Here are several policies your practices can implement to ensure compliance and have good compliance. The NSA can also make things tricky, but Terry clears up what you can and cannot do with professional courtesy. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Professional Courtesy appeared first on Terry Fletcher Consulting, Inc. .…
The Electronic Medical Record (EMR) has many benefits over handwritten entries in a paper chart. EMR entries are always legible, dated, and timed. Patient information can be available at the point of care and remotely. Some EMR systems include computerized physician order entry and decision-support tools to improve patient care and safety. However, recent audits reflect that CDI can be compromised when copy-paste or pull-forward information is not updated or reviewed. Terry discusses the importance of the medical record’s integrity and ensuring your providers listen. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post EMR Clinical Documentation Integrity appeared first on Terry Fletcher Consulting, Inc. .…
There’s a lot of confusion – and conjecture – on what to do about audio-only Telehealth while the new CMS and HHS administrations settle in under a new President in 2025. The final rule, the federal register, and the last CR made things more vague for this transition. In this episode Terry attempts to clear up these issues, giving you her best practices to remain compliant until further notice. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Audio-Only Telehealth in 2025 appeared first on Terry Fletcher Consulting, Inc. .…
When auditing Annual Wellness Visits (AWV), is the concept still the same as preventive exams concerning modifier 25? The AWV does not include managing medications or managing conditions. However, the rules need to see medical necessity for the E/M on the same date with a -25 modifier. Remember, patients do not have a share of cost of AWV’s so if you add an E/M it comes out of their pocket too. Terry also adds more commentary for the audio-only Telehealth rules for 2025. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post AWV and Medical Necessity Extras appeared first on Terry Fletcher Consulting, Inc. .…
This New Year’s Eve episode of the Top 10 Tuesday Q&A includes E/M Data questions, assistants at surgery, colon screenings, Telehealth extensions, and prescription drug management questions. It’s an episode you don’t want to miss. Happy New Year Everyone! Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Top 10 Tuesday Q&A – Happy New Year Edition appeared first on Terry Fletcher Consulting, Inc. .…
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CodeCast | Medical Billing and Coding Insights
In the final hour, Congress passed the American Relief Act. Telehealth was addressed and the geographical location was extended through March 2025. Terry give us the details from this HR bill in this short but sweet episode so you can enjoy your Christmas holiday. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Did We Get a Congressional Telehealth Gift for Christmas? appeared first on Terry Fletcher Consulting, Inc. .…
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CodeCast | Medical Billing and Coding Insights
E/M Coding still has confusion when capturing “data points” elements. When deciding to give credit for either an independent interpretation (CAT 2) or a review of test results (CAT 1) is an often misunderstood component of the Medical Decision Making (MDM) table. Proper documentation of independent interpretation is required to impact the MDM, and consequently, reimbursement. Terry breaks down the compliance issues and best practices to make sure you are not over-coding. (Also, a shout out to Shannon DeConda and her excellent article on the topic on the NAMAS blog.) Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Data Point – Review of Test or Independent Interpretation? appeared first on Terry Fletcher Consulting, Inc. .…
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CodeCast | Medical Billing and Coding Insights
The 2025 CPT® codes will impact billing and coding across various specialties. The annual CPT® updates include new, revised, and deleted codes and coding guidelines effective Jan 1st, 2025. CPT® 2025 includes 270 new codes, 112 revised codes, and 49 deleted codes. There are no code changes for anesthesia, respiratory, or auditory services. The most significant changes are to telemedicine evaluation and management (E/M) services, skin substitutes, laboratory and pathology services, and Category III codes. Terry overviews the changes by section in today’s CodeCast Podcast. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post CPT 2025 Looksee appeared first on Terry Fletcher Consulting, Inc. .…
Becoming a certified medical coder can be very exciting but also disheartening if you thought a job in coding would magically appear once you got your certification. In this episode of the CodeCast podcast, Terry discusses studying and test-taking tips for your certification, common misconceptions of job opportunities, and what it takes to persevere for a career in Coding or the Business in Medicine. Shout out to AAPC member LeAndrea Mack and her article in the October 2024 issue of AAPC Magazine on this topic as well. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Coding Career Opportunities and Challenges appeared first on Terry Fletcher Consulting, Inc. .…
Terry makes it quick and to the point in this Thanksgiving Day episode of the CodeCast Podcast. Terry gives you a fun list of ICD-10-CM related to our beloved family and friends’ holiday. Be safe and careful out there this holiday weekend: and enjoy! Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Thanksgiving ICD-10-CM: Be Safe and Thankful! appeared first on Terry Fletcher Consulting, Inc. .…
Terry is back with another Top Ten Tuesday discussion. In this episode, she discusses front desk to billing office workflow mistakes, looking at patient demographics, insurance information, HMO referrals, PA’s, and data backups. Tune in to reset your RCM workflows. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Top 10 Tuesday Q&A – RCM Workflow Mistakes appeared first on Terry Fletcher Consulting, Inc. .…
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CodeCast | Medical Billing and Coding Insights
Today on the CodeCast podcast, Terry discusses best practices for the -25 Modifier, where to find her latest blog on the AAPC website, and what the MAHA (Make America Healthy Again) movement means to our country. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post The 25 Modifier and More appeared first on Terry Fletcher Consulting, Inc. .…
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CodeCast | Medical Billing and Coding Insights
CMS published the 2025 Final Rule on November 1st. Terry breaks down the highlights and gives you the facts on the Telehealth “mess” that could have 85% of Medicare patients without access to virtual care. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post CMS final rule is out and Telehealth is an issue appeared first on Terry Fletcher Consulting, Inc. .…
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CodeCast | Medical Billing and Coding Insights
Many practices have engaged in coding for TCM (Transitional Care Management) services but are finding that they are receiving more denials than payments. Terry breaks down why that is, and sheds light on what is needed to qualify billing for these services. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Why are TCM services receiving more denials than payments? appeared first on Terry Fletcher Consulting, Inc. .…
Artificial intelligence (AI) has the potential to make substantial progress toward the goal of making healthcare more personalized, predictive, preventative, and interactive. However, AI-based systems raise concerns regarding data security and privacy. Because health records are important and vulnerable, hackers often target them during data breaches. The absence of standard guidelines for the moral use of AI and ML (machine learning) in healthcare has only worsened the situation. There is debate about how far artificial intelligence (AI) may be utilized ethically in healthcare settings since there are no universal guidelines for its use. Therefore, maintaining the confidentiality of medical records is crucial. Terry scratches the surface and discusses some concerns about AI in healthcare predictive models and what to also look for as we continue to use AI scribes. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post AI in Medical Coding: What’s the Reality? appeared first on Terry Fletcher Consulting, Inc. .…
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CodeCast | Medical Billing and Coding Insights
HIPAA has many privacy issues that most practices have in their HIPAA compliance manuals. However, current HIPAA violations are coming to light when employees purposefully search patient PHI for personal use or curiosity. This is not only a violation of privacy laws but could have a cascading effect if not stopped in its tracks. In this episode, Terry discusses these issues at length and what safeguards to take in this political climate. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post HIPAA violations your organizations should avoid appeared first on Terry Fletcher Consulting, Inc. .…
In this edition of the CodeCast podcast, Terry discusses the “subtle changes” to look for in the ICD-10-CM updates effective October 1st. Also, Terry clears up understanding the UHC Gold Card Program, and what CMS looks at when they send you a denial. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post RCM Updates for 4th Quarter appeared first on Terry Fletcher Consulting, Inc. .…
According to the AMA, most physicians lack training in “webside manner.” Researchers from the University of Michigan Medical School and the Veterans Affairs Ann Arbor Healthcare System surveyed 1,213 patients from their respective institutions to measure preferences regarding the visual background seen during a video visit. Today’s CodeCast podcast brings you the survey results, with some surprising details. Also, Terry gives her insights on how to prepare for virtual visits. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Telemedicine “Webside Manner” appeared first on Terry Fletcher Consulting, Inc. .…
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CodeCast | Medical Billing and Coding Insights
Many practices offer cash payment options to avoid insurance billing, hoping to reduce administrative burden or boost revenue. However, this practice of charging cash for services that could be billed to and covered by a patient’s insurance plan raises serious compliance concerns. Federal law and insurance contracts generally prohibit this practice because it undermines the healthcare payment system and can lead to regulatory violations. Terry discusses the compliance ramifications of this policy with a little health from a NAMAS article. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Charging patients cash for “insurance covered” services appeared first on Terry Fletcher Consulting, Inc. .…
Sometimes there are coding, compliance, and billing questions that we struggle to find answers to in any published guidance or specific regulatory rules. This week on the CodeCast podcast, Terry brings up three specific questions that we are always hunting for answers to and the best way to deal with them. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Sometimes the rules are as “clear as mud” appeared first on Terry Fletcher Consulting, Inc. .…
In this episode Terry discusses the importance of ICD-10-CM codes on billing claims. She also clarifies the ICD-10-CM General Guidelines on Borderline Diagnoses, Laterality, Acute versus Chronic Conditions, and when to leave the symptoms off the claim for definitive diagnoses. Listen in for this important information capture. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Does ICD-10-CM Codes Claim Position Matter? appeared first on Terry Fletcher Consulting, Inc. .…
CMS released their FAQ sheet for the add-on code HCPCS G2211, to office visits. The sheet clarifies where denials and grey areas for reporting. Tune in as Terry goes over twelve FAQs from CMS along with her commentary to best practices for this complexity add-on. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post G2211 CMS FAQ Sheet Released appeared first on Terry Fletcher Consulting, Inc. .…
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CodeCast | Medical Billing and Coding Insights
In this episode of the CodeCast podcast, Terry discusses ABI billing, Level 5 Drug Toxicity options, Aortic Stenosis ICD-10-CM coding, and some questions related to the 2025 CMS proposals. Listen this episode to see if any of your Coding Corner questions made the podcast cut! Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Top 10 Tuesday Q&A – Coding, Billing, and Compliance Questions appeared first on Terry Fletcher Consulting, Inc. .…
CMS proposes expanding the transfer of care modifiers, -54, -55, and -56 to better “value” the global surgery CPT codes. However, this may cause more confusion for surgeons and medical providers who see patients for surgery or post-op only. Terry talks about the proposal and what to expect for 2025. Also, Terry talks about the proposals for Telehealth. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/ The post Transfer of Care Modifiers appeared first on Terry Fletcher Consulting, Inc. .…
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مشابه CodeCast | Medical Billing and Coding Insights
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