Podcasts

The CodeCast™ Podcast | Medical Billing & Coding Insights

The Business Side of Medicine ~ Coding, Reimbursement and Compliance for Physician Practices

Healthcare Consultant, Auditor and Educator, Terry Fletcher CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, , ACS-CA, SCP-CA, QMGC, QMCRC, QMPM, PACS, CPA®-TH knows from over 35 years in the healthcare industry, that Coding, Billing, and Compliance for physician practices and hospitals can be tough to navigate. Her CodeCast™ Podcast series will share insights into CPT® and ICD-10-CM coding, will discuss current rules and regulations the Medicare payer requires, along with Commercial Insurance plans’ rules and reimbursement challenges that all RCM staff deal with every day. Discover revenue opportunities to maximize reimbursement in your medical practice, hear complicated published federal payer rules broken down into easy-to-understand concepts, with a focus on different medical specialties and platforms in each episode.

The weekly CodeCast™ Podcast has run since the fall of 2017. Be sure to catch each episode that drops every #TerryTuesday™ on most popular podcast platforms.

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Modifier 25

The CPT definition of a significant, separately identifiable service relies on determining the correct level of E/M service to be reported. Terry discusses what questions should be asked before you ...

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Understanding Prior Authorization

Prior authorization in health care is a requirement that a healthcare provider gets approval from an insurance plan before prescribing their patient medication or doing a medical procedure. Insurance providers ...

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EM Data Points Confusion Clarifications

The AMA MDM directions when leveling an E/M (Evaluation and Management) code (also known as office and/or hospital visits) are still confusing many providers, coders and auditors. In this week's ...

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Waiving Co-Pays and Deductibles

Providers sometimes waive patients' cost‐sharing amounts (e.g., copays or deductibles) as an accommodation to the patient. However, doing so may violate fraud and abuse laws and/or payor contracts. From a ...

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What’s The Latest Medicare Update?

Medicare has been making some under-the-radar updates that provider practices need to know. You could be seeing ineligible patients, with no current ID card, coming in for services. You could ...

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Can Pre-Op Visits Be Billed?

A question that Terry often fields is one regarding billing for pre-op visits. Should these visits be billing? There is conflicting published guidance on this question from different sources. Terry ...

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ICD10CM Revisited on Laterality

Terry revisits the rule on reporting specificity in the laterality of a diagnosis, when the physician or QHP only gives us unspecified. What can we do as coders? As a ...

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Defining a QHP

QHPs are often certified and must be licensed. Trying to use clinicians that cannot “independently report services to payers” as QHPs will not only flag you for an audit, but ...

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Revisiting The EMR E/M Template

On an abbreviated edition of the CodeCast, it's "out with the old and in with the new" as Terry gives some quick tips on updating your outdated EMR template relating ...

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What are you looking for in an audit?

This week on the CodeCast podcast, Terry discusses external audits, and what you should be looking for when moving from internal to external audits. What are your objectives? Are they ...

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Appropriately Reporting 99211 Services

Reporting 99211 can bring additional revenue into your practice. Appropriately reporting 99211 services can also improve documentation in a practice. Terry discusses the qualifiers for the 99211, such as having ...

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