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The CodeCast Podcast | Medical Billing & Coding Insights

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

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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Critical Care Inclusions and Carve-Outs

Critical Care Inclusions and Carve-Outs

March 12, 2024

Critical care in 2024 can be tricky, with inclusions, carve-outs, and a time component. Are there exceptions when PA/NPs are involved in critical care services? What has to be documented? …

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Can you bill an E/M service when the patient isn't present?

Can you bill an E/M service when the patient isn’t present?

March 5, 2024

What happens when a provider meets with a family to discuss and develop a care plan for patients? Providers will give the parent the option to have the patient present …

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2-Midnight Rule and MA plans

2-Midnight Rule and MA plans

February 27, 2024

When a Medicare beneficiary arrives at a hospital in need of medical or surgical care, the physician or other qualified practitioner must decide whether to admit the beneficiary as an …

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Did you know this is a HIPAA violation?

Did you know this is a HIPAA violation?

February 20, 2024

In this week’s episode of the CodeCast podcast Terry discusses collecting information on medical practice websites. How you collect data on a website is equally as important as the data …

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E/M Services: Stable or Unstable Chronic Conditions?

E/M Services: Stable or Unstable Chronic Conditions?

February 13, 2024

Terry discusses how to be accurate in your documentation when picking the low, moderate or high element(s) of MDM. When listing “problems addressed” in your E/M record, and considering chronic …

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Coding and Billing The "Unlisted Code"

Coding and Billing The “Unlisted Code”

February 6, 2024

CPT says: “If no specific CPT or HCPCS code exists, then the procedure must be reported using an appropriate unlisted CPT code.” Unlisted CPT codes, when reported with appropriate documentation, …

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Top 10 Tuesday Q&A – Coding, Billing and Compliance Questions

Top 10 Tuesday Q&A – Coding, Billing and Compliance Questions

January 30, 2024

Join Terry Fletcher on this week’s CodeCast as her Top 10 Tuesday returns. Terry has a packed podcast as she answers questions about G2211, 99459, and new versus established patients. This …

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Reporting eVisits 99421-99423

Reporting eVisits 99421-99423

January 23, 2024

Did you know there are CPT codes for online digital E/M services? CPT codes 99421-99423 are for use by physicians, physician assistants, and advanced practice nurse practitioners performing brief online E/M …

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Revisiting the G2211 in 2024

Revisiting the G2211 in 2024

January 16, 2024

We have received questions left and right regarding the new Medicare add-on code +G2211 – for complexity and serious condition provider/patient long-term relationship care. We discussed this code in September …

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2024 Telehealth Checklist

2024 Telehealth Checklist

January 9, 2024

This episode of the CodeCast is sponsored by DecisionHealth LLC, Part B News. The PHE, public health emergency, ended on May 11th, 2023. However, the confusion on reporting Telehealth services …

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Concerns About AI in Healthcare for 2024

Concerns About AI in Healthcare for 2024

January 2, 2024

*** CORRECTED AUDIO *** The generative artificial intelligence (also known as “AI”) boom is in full swing now. Terry has been researching AI in healthcare: some people are thrilled with it, …

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2024 Pelvic Exam Add-On Code

2024 Pelvic Exam Add-On Code

December 26, 2023

This week on the CodeCast Podcast, Terry explains the new 2024 CPT add-on code +99459 for pelvic exams when assistant clinical staff is needed to help the physician. Check out …

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When to use the new SDoH add-on code

When to use the new SDoH add-on code

December 19, 2023

A physician, non-physician practitioner (NPP), or clinical psychologist can assess a patient who they suspect may have unmet needs (defined as Social Determinants of Health or SDoH. In 2024 CMS …

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7 Elements of a Successful Compliance Program via OIG

7 Elements of a Successful Compliance Program via OIG

December 12, 2023

In this episode of the CodeCast Podcast, Terry Fletcher discusses the seven elements of an effective compliance program. Last month, HHS-OIG outlined and updated this guidance. With a broad spectrum …

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Patient History = Medical Necessity

Patient History = Medical Necessity

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 …

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Transitional Care Management Services

Transitional Care Management Services

November 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 …

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Telehealth CPT 2024 Rules

Telehealth CPT 2024 Rules

November 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 …

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E/M Leveling with MDM: Right or Wrong?

E/M Leveling with MDM: Right or Wrong?

November 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 …

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