CodeCast | Medical Billing and Coding Insights show

CodeCast | Medical Billing and Coding Insights

Summary: National Speaker and Healthcare Consultant, Auditor and Educator, Terry Fletcher CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, CMCS, ACS-CA, SCP-CA, knows from over 25 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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  • Artist: Terry Fletcher
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Podcasts:

 Using SDoH (Social Determinates of Health) Correctly | File Type: audio/mpeg | Duration: 13:15

Social Determinates of Health are important secondary diagnoses to help explain a patient’s circumstances when it comes to access to medical care, adherence to medical advice, and environmental factors that could hinder care. However, many practices are reporting these codes without a direct relationship to the problems addressed in the encounter. This week Terry discusses the dangers of miscoding and how this could be not only a PR nightmare if you get it wrong, but a legal issue if you label patients without their permission. Subscribe and Listen You can subscribe to our podcasts via: * Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 * Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga * Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX * Stitcher – http://www.stitcher.com/s?fid=156874 * TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ * YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg * 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/

 Documentation Requirements for Audio-Only Visits | File Type: audio/mpeg | Duration: 13:12

CMS has not addressed a template for audio-only Telehealth visits. Therefore, Terry offers some best practices for audio-only documentation in order to stand up to and be compliant with payer audits. Terry will also talks about when E/M services are partially complete: is there anything to bill? Subscribe and Listen You can subscribe to our podcasts via: * Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 * Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga * Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX * Stitcher – http://www.stitcher.com/s?fid=156874 * TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ * YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg * 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/

 ICD10CM Revisited on Laterality | File Type: audio/mpeg | Duration: 13:52

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 bonus, Terry also updates us on the latest “No Surprises Act” protections. Subscribe and Listen You can subscribe to our podcasts via: * Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 * Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga * Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX * Stitcher – http://www.stitcher.com/s?fid=156874 * TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ * YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg * 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/

 Defining a QHP | File Type: audio/mpeg | Duration: 12:16

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 you could find yourself in hot water for false billing practices. Terry offers clear guidelines to steer clear of these issues on this episode of the 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 * Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga * Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX * Stitcher – http://www.stitcher.com/s?fid=156874 * TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ * YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg * 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/

 Revisiting The EMR E/M Template | File Type: audio/mpeg | Duration: 7:23

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 to E/M 2023 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 * Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga * Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX * Stitcher – http://www.stitcher.com/s?fid=156874 * TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ * YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg * 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/

 What are you looking for in an audit? | File Type: audio/mpeg | Duration: 17:36

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 SMEs for your practice? What is the scope you need? It’s time to get some piece of mind in your coding, billing and compliance processes. This episode will make sure you are prepared. Subscribe and Listen You can subscribe to our podcasts via: * Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 * Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga * Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX * Stitcher – http://www.stitcher.com/s?fid=156874 * TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ * YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg * 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/

 Patient Initiated Services: What does it mean? | File Type: audio/mpeg | Duration: 12:23

Many virtual visit options are available to patients when they initiate patient-to-physician contact. The definition seems to be lost in all of the Telehealth visits, so in this week’s CodeCast podcast episode, Terry attempts to clarify that definition and help listeners understand how to document that discussion. PIFU is when a patient initiates an appointment when they need one, based on their symptoms and individual circumstances. The physician does not call them, check in on them, or contact them to schedule an appointment. If that is the case then an audio-only visit or eVisit is not appropriate, under the rules. Subscribe and Listen You can subscribe to our podcasts via: * Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 * Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga * Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX * Stitcher – http://www.stitcher.com/s?fid=156874 * TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ * YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg * 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/

 Appropriately Reporting 99211 Services | File Type: audio/mpeg | Duration: 14:04

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 an established patient, the encounter must be F2F and more. Listen for your tips on how to ensure compliance when reporting the 99211. As a bonus, Terry discusses the use of an insurance waiver when needed. Subscribe and Listen You can subscribe to our podcasts via: * Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 * Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga * Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX * Stitcher – http://www.stitcher.com/s?fid=156874 * TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ * YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg * 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/

 Top 10 Telehealth Changes NOW! | File Type: audio/mpeg | Duration: 13:31

On this edition of the CodeCast Podcast, Terry gives you the top ten Telehealth changes to implement or get ready for now. Now that the PHE is over, there’s no time to wait to make sure you are compliant with your Telehealth delivery of 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 * Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga * Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX * Stitcher – http://www.stitcher.com/s?fid=156874 * TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ * YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg * 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/

 Should you code the definitive condition or signs/symptoms? [Fixed Audio] | File Type: audio/mpeg | Duration: 17:23

There is an ongoing debate about ICD-10-CM and diagnosis coding: should we code the patient complaints, the signs and symptoms, or go straight to the definitive diagnosis? When is it appropriate to code both? Do the payers really look at diagnoses? And how does this affect MA and value-based care and HCC capture? Tune in this week as Terry answers these questions and sets the record straight. Subscribe and Listen You can subscribe to our podcasts via: * Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 * Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga * Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX * Stitcher – http://www.stitcher.com/s?fid=156874 * TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ * YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg * 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/

 A Warning About AI Charting | File Type: audio/mpeg | Duration: 15:47

It’s important to take stock of what could be lost in a technological transition from physician charting to “Dr. Echo” charting as it is referred to. AI (Artificial Intelligence) chatbots (such as ChatGPT) are known to have what the coders call “hallucinations” or making up words that might follow another word. Do we want the patient record to reflect what an AI physician thinks should be documented? Terry talks about this topic in the latest CodeCast with a warning about what needs to be tackled before a national or worldwide rollout of this latest 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 * Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga * Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX * Stitcher – http://www.stitcher.com/s?fid=156874 * TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ * YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg * 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/

 Can I Really Bill For That? | File Type: audio/mpeg | Duration: 22:27

With the current climate of audits, medical practices must have knowledgeable healthcare professionals who are up-to-date with regulatory guidance, CPT rules, ICD-10-CM rules, and all things related to pre-PHE and post-PHE regulations. On this episode of the CodeCast Podcast, Terry Fletcher addresses concerns over what practices can and cannot bill for. “Can I code for that?” Tune in to find out! Subscribe and Listen You can subscribe to our podcasts via: * Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 * Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga * Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX * Stitcher – http://www.stitcher.com/s?fid=156874 * TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ * YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg * 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/

 Denials Management and EM Realities | File Type: audio/mpeg | Duration: 24:10

In this episode of the CodeCast Podcast, Terry talks about denial management codes, finding the patient’s MBI number, and understanding the realities of some Digital EM visits and ChatGBT responses to patients. Subscribe and Listen You can subscribe to our podcasts via: * Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 * Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga * Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX * Stitcher – http://www.stitcher.com/s?fid=156874 * TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ * YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg * 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/

 Top 10 Tuesday Q&A – Are You Compliant With Regulatory Guidance? | File Type: audio/mpeg | Duration: 27:58

There is so much published guidance out there for medical practices and professionals to use when setting policies in their offices. Every practice should have a compliance program, but most do not. What happens when there is an infraction of regulatory rules? Do you have a plan, policy, or legal team in place to help? Or an external consultant like Terry Fletcher to turn to for help? Tune in to this edition of the CodeCast podcast to determine if you are compliant – or if you are letting your providers push back on mandates. Subscribe and Listen You can subscribe to our podcasts via: * Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 * Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga * Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX * Stitcher – http://www.stitcher.com/s?fid=156874 * TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ * YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg * 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/

 Reporting add-on codes with no base code | File Type: audio/mpeg | Duration: 22:49

In this episode of the CodeCast, Terry discusses the challenges of reporting an add-on service when no base code was performed. Terry also covered urgent care versus retail care rules, and if it is appropriate to follow incident-to for these entities. Subscribe and Listen You can subscribe to our podcasts via: * Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 * Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga * Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX * Stitcher – http://www.stitcher.com/s?fid=156874 * TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ * YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg * 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/

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