CodeCast | Medical Billing and Coding Insights

For physician practices that use injectable drugs for stress tests, paid injections, or therapeutic services, some modifiers can assist in reporting to Medicare if there were discarded vials or if the drug was used in its entirety. CMS originally had one modifier – the JW – to represent single-dose containers or single-use packages. Because of some misuses or misunderstandings on how to apply the modifier, a new modifier was created for 2023. Terry discusses this update along with some possible physician query scenarios in this week’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 * 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 variety of channels have produced education on the 2021 and 2021 AMA E/M changes. Those channels include articles in CPT Assistant, AMA’s live and on-demand webinars, NAMAS, and even our own Terry Fletcher Consulting. If that’s not enough, the AMA webinar on technical corrections added more clarification in key areas! In this episode, Terry provides FAQs – Frequently Asked Questions – that were generated during these educational sessions, to level your E/M services with the new 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/

It’s time for another Top 10 Tuesday Q&A podcast, featuring our coding questions of the month. Terry Fletcher will discuss a variety of topics including timely documentation rules for screening tests, what codes can be used for shared or split visits, and different rules for similar services. Don’t miss this episode packed full of information for the coder, biller, administrator, and provider. 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/

The CPT Errata came out this week to clear up some confusion on coding for prolonged services. Time can be an audit trap for E/M services Are you supporting your prolonged-services when adding on CPT or HCPCS codes to E/M office and/or hospital services? You don’t want this to be your audit trap: listen to this episode to make sure you stay compliant. 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/

Advance care planning (ACP) is a voluntary, face-to-face service between a physician or other Qualified Healthcare Professional (QHP) and a patient, family member, caregiver, or surrogate to discuss the patient’s healthcare wishes if they become unable to make their own medical decisions. In this week’s CodeCast Podcast, Terry discusses why the OIG has been getting involved in pointing out the non-compliant reporting and what Medicare’s newest directive includes on the service to be able 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/

Can “under-coding” fall under the FWA (Fraud Waste and Abuse) regulations for CMS? If you are falsely submitting a claim, yes! Terry discusses the dangers of under-coding, how that could misrepresent your claim and also cause future payer audits. We also talk about shoulder surgery coding and audio-only services that are changing once the PHE ends. 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/

Time has become a factor in almost every Healthcare patient encounter, It makes you wonder if physicians and providers are being baited into a false sense of security. When E/M only allowed time to document the visit if 50% or more was spent counseling, it was easier to quantify the time thresholds. However, with “non-face-to-face” time also part of the total encounter, and a focus on new prolonged service codes, it begs the question: are we spending too much time with our patients? Terry discusses this and more in this week’s Top Ten Tuesday 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/

This edition of the CodeCast Podcast dives into denial management and appeals assistance for EKGs, and how to handle medical necessity denials. Your host, Terry Fletcher, will also discuss some other topics, such as being accurate on UTIs (Urinary Tract Infections) ICD-10-CM codes. The split/shared visits continue to confuse coders and providers on how to document and report: Terry answers these questions and clears up the confusion. 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/

This editions of the CodeCast Podcast dives into denial management and appeals assistance for EKGs, and how to handle medical necessity denials. Your host, Terry Fletcher, will also discuss some other topics, such as being accurate on UTIs (Urinary Tract Infections) ICD-10-CM codes. The split/shared visits continue to confuse coders and providers on how to document and report: Terry answers these questions and clears up the confusion. 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/

On this edition of the CodeCast Podcast, Terry Fletcher shares insights into the new SDoH ICD-10-CM coding when reporting a level 4 or moderate E/M service. Terry also talks about finding joy in your job. What makes you happy when you are doing certain tasks in your healthcare career? Let’s focus on finding that happiness to stay motivated. 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/

It seems like the Telehealth ERA exploded not only virtual healthcare but also “digital healthcare” platforms. In this episode of the CodeCast Podcast, Terry discusses when virtual and digital should intersect in in-person and the impact of the now, scheduled end of the PHE this spring. Also, discussions of CCM activities that can be counted towards time thresholds, and how to use better language when emailing and communicating with your colleagues. 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/

With new legislation in the 2023 Omnibus Bill (signed into law 12/29/22), extending many 1135 PHE waivers through 2024, there are also some scaled-back rules that healthcare professionals will need to know, and not assume are still in effect, as you report 2023 services. Remember to always read the fine print before moving forward. Too many coders, billers, and providers rely only on TV for their news. We have a clear update for you today on 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/

Many Coders tend to read a physician’s note and make assumptions without first reading the coding guidelines. One particular entry, which is found in many admission notes is “elevated troponin”. An elevated troponin does not always mean that a heart attack has occurred, many many coders will leap to that conclusion before reviewing the documentation. In this week’s CodeCast Podcast, Terry will clarify when this clinical symptom is a potential AMI and what to look for to confirm correct ICD-10-CM coding.  Also on the podcast is the POS war between inpatient and hospital observation coding for 2023. 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/

Instructional notes in ICD-10-CM are there for a reason. “Code First” denials are happening more often, when these directions are not followed. In this jam-packed episode, Terry discusses when certain conditions have instructional notes that mandate sequencing, the rules for them, and how this impacts your reimbursement. Also, Terry shares some recent changes to the NSA rules for arbitration. 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/

In this episode, Terry discusses late entries, addendums, or corrections to a medical record that are legitimate occurrences in the documentation of clinical services. Compliance is always an issue in this act and Terry clears up the confusion. A late entry, an addendum or a correction to the medical record, must bear the current date of that entry – and is signed by the person making the addition or change. Also, some discussion of coding NSTEMI myocardial infractions. 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/