Podcasts

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.

You can also subscribe to our podcasts via:

If you’d like to become a sponsor of the CodeCast® Podcast please contact us directly for pricing.

Is your CDI compromised by dated EMR entries?

Is your CDI compromised by dated EMR entries?

October 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 Outdated information, or information that doesn’t make sense for that date of service encounter, brings into question the reliability of the entire patient …

More Info
A Look Ahead at the 2024 CPT

A Look ahead to the 2024 CPT codes

October 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 …

More Info
Modifier 25

Modifier 25

October 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 …

More Info
Are you blurring the lines on who's a doctor or a nurse?

Are you blurring the lines on who’s a doctor or a nurse?

September 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 …

More Info
Understanding Prior Authorization

Understanding Prior Authorization

September 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 …

More Info
EM Data Points Confusion Clarifications

EM Data Points Confusion Clarifications

September 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 …

More Info
What is the G2211 complexity add-on for 2024?

What is the G2211 complexity add-on for 2024?

September 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 …

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

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

August 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 …

More Info
Waiving Co-Pays and Deductibles

Waiving Co-Pays and Deductibles

August 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 …

More Info
What's The Latest Medicare Update?

What’s The Latest Medicare Update?

August 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 …

More Info
Can Pre-Op Visits Be Billed?

Can Pre-Op Visits Be Billed?

August 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 …

More Info
Registered Dietitians and Nutritionist Coding and Billing

Registered Dietitians and Nutritionist Coding and Billing

August 1, 2023

When a dietician or nutritionist sees a patient, their services may not covered for bariatric patients aka obesity. It is a nice option to have, but patients, would most likely, …

More Info
Using SDoH (Social Determinates of Health) Correctly

Using SDoH (Social Determinates of Health) Correctly

July 25, 2023

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 …

More Info
Documentation Requirements for Audio-Only Visits

Documentation Requirements for Audio-Only Visits

July 18, 2023

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 …

More Info
ICD10CM Revisited on Laterality

ICD10CM Revisited on Laterality

July 11, 2023

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 …

More Info
Defining a QHP

Defining a QHP

July 4, 2023

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 …

More Info
Revisiting The EMR E/M Template

Revisiting The EMR E/M Template

June 27, 2023

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 …

More Info
What are you looking for in an audit?

What are you looking for in an audit?

June 20, 2023

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 …

More Info