National Speaker and Healthcare Consultant, Auditor and Educator, Terry Fletcher CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, , ACS-CA, SCP-CA, QMGC, QMCRC, QMPM knows from over 30 years medical reimbursement industry experience that Coding, Billing and Compliance for physician practices and hospitals can be tough to navigate. Her CodeCast® Podcast series will share insights to current rules and regulations the Medicare payer requires, along with Commercial Insurance plans’ rules and reimbursement challenges. Discover revenue opportunities to maximize reimbursement in your medical practice, focusing on different medical specialties and platforms each episode.
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December 5, 2023
In the ICD-10-CM guidelines, there is an entry for only history codes at I.C.21.c.4, and there are two types of history Z codes: personal and family. History codes can be …
Podcast: Play in new window | Download (Duration: 17:41 — 24.5MB)
More InfoNovember 28, 2023
Care Management services are being reported at an all-time high but they are not all alike. Before submitting claims, many providers have not read the directions — or CPT-published guidance …
Podcast: Play in new window | Download (Duration: 17:20 — 24.0MB)
More InfoNovember 21, 2023
After all of the CMS continued updates for Telehealth, we finally got an update from the AMA, that was added to CPT 2024. This gives us the “criteria” on how …
Podcast: Play in new window | Download (Duration: 13:05 — 18.1MB)
More InfoNovember 14, 2023
Leveling an E/M visit can be considered very subjective. Clinicians and auditors alike can come to one conclusion or another. It is important that when you take online advice, you …
Podcast: Play in new window | Download (Duration: 13:50 — 19.2MB)
More InfoNovember 7, 2023
The 2024 Medicare Final Rule was published on November 2nd, and the Split/Shared visit guidance will parallel the CPT guidance. However, CMS will still expect the -FS modifier from the …
Podcast: Play in new window | Download (Duration: 15:16 — 21.2MB)
More InfoOctober 31, 2023
Join us for a great Halloween episode as Terry provides the top ten spookiest ICD-10-CM codes. She also discusses preventative and OV on the same date. And what happens when …
Podcast: Play in new window | Download (Duration: 12:24 — 17.2MB)
More InfoOctober 24, 2023
CMS recently updated their published guidance, MLN909160 July 2023, with further examples and instructions on how to gather information and documentation when a CERT Audit issues a request for an …
Podcast: Play in new window | Download (Duration: 16:57 — 23.5MB)
More InfoOctober 17, 2023
Clinical Documentation Integrity, or CID, is important. Outdated information, or information that doesn’t make sense for that date of service encounter, brings into question the reliability of the entire patient …
Podcast: Play in new window | Download (Duration: 16:29 — 22.8MB)
More InfoOctober 10, 2023
The 2024 CPT codes have been released. Terry briefly looks at the additions, revisions, and deletions and what the E/M code descriptors are revising. Terry will also offer her last …
Podcast: Play in new window | Download (Duration: 11:21 — 15.8MB)
More InfoOctober 3, 2023
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 …
Podcast: Play in new window | Download (Duration: 18:26 — 25.5MB)
More InfoSeptember 26, 2023
Physicians are educated and trained more extensively than any other healthcare professional. A misrepresentation of a practitioner’s level of licensing, i.e., using the clinical term “doctor” when there is no …
Podcast: Play in new window | Download (Duration: 14:04 — 19.5MB)
More InfoSeptember 19, 2023
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 …
Podcast: Play in new window | Download (Duration: 20:46 — 28.7MB)
More InfoSeptember 12, 2023
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 …
Podcast: Play in new window | Download (Duration: 16:46 — 23.2MB)
More InfoSeptember 5, 2023
In 2024, there will be a new add-on code for Medicare. This is a complexity code for specific long-term patients, where the provider is taking the treatment journey with the …
Podcast: Play in new window | Download (Duration: 17:33 — 24.1MB)
More InfoAugust 29, 2023
In this week’s CodeCast podcast, Terry discusses the top ten coding, billing, and compliance questions from the last month. In this information-filled episode, she covers coding for staff prolonged services …
Podcast: Play in new window | Download (Duration: 21:57 — 30.3MB)
More InfoAugust 22, 2023
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 …
Podcast: Play in new window | Download (Duration: 19:45 — 27.3MB)
More InfoAugust 15, 2023
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 …
Podcast: Play in new window | Download (Duration: 12:45 — 17.7MB)
More InfoAugust 8, 2023
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 …
Podcast: Play in new window | Download (Duration: 15:04 — 20.9MB)
More Info