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.

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Top 10 Coding and Billing Mistakes – Let's Fix It!

Top 10 Coding and Billing Mistakes – Let’s Fix It!

June 25, 2024

Can you guess the main reason why medical billing claims are rejected? According to recent studies, most clinics account for 15-25% of inaccurately submitted monthly claims. Those inaccuracies must be …

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Trigger Point Injections and LCDs

Trigger Point Injections and LCDs

June 18, 2024

You must make sure your providers and coders understand the overarching LCD criteria for reporting TPIs (Trigger Point Injections). As of April 1st, five MACs have tightened their rules for …

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Are you a Coder or a Biller?

Are you a Coder or a Biller?

June 11, 2024

How do you know if your role is classified as a Coder or a Biller? Coders typically work in the back end of the facility, focused on interpreting medical records …

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When To Use The -22 Modifier

When To Use The -22 Modifier

June 4, 2024

All CPT codes have an expected range of complexity and uses, but when a particular procedure or surgery performed has exceeded the normal range of complexity, modifier -22 can come …

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

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

May 28, 2024

This week on the CodeCast podcast Terry returns with her Top 10 Tuesday Q&A series. Join us as Terry covers questions from Urgent Care to the ER, infusion charges, behavioral …

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Are you a real SME?

Are you a real SME?

May 21, 2024

Are you a “Subject Matter Expert?” Are you taking on clients, presenting to physicians, or looking for a coding job: with no expertise? Do not “wing it” in the healthcare …

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Is a Medical Record "Errors Disclaimer" valid?

Is a Medical Record “Errors Disclaimer” Valid?

May 14, 2024

Many of the records Terry audits include a disclaimer to protect a physician from liability. However, does this disclaimer shield a physician who has signed a note or authenticated an electronic …

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Urgent Care to ER Coding

Urgent Care to ER Coding

May 7, 2024

In this episode of the CodeCast podcast, Terry discusses the frequent urgent care center encounters that elevate to the patient going to the ER. Is this considered automatically high risk? …

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

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

April 30, 2024

This week’s CodeCast Podcast is all about coding and billing. Join Terry for a full deck of important information on Coding, Billing, and Compliance. Get answers to our top ten …

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Coding Hernia Repairs in 2024

Coding Hernia Repairs in 2024

April 23, 2024

This week on the CodeCast Podcast Terry dives into the new rules for hernia repair codes. Terry discusses when the 0-global-days and 90-day-global-days services are billed on the same date. …

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What does "separate procedure" mean in CPT?

What does “separate procedure” mean in CPT?

April 16, 2024

Some procedures in the CPT book are listed as “separate procedures” meaning they are commonly carried out as an integral component of a total service or procedure that has already …

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Is This Really Medically Necessary?

Is This Really Medically Necessary?

April 9, 2024

TPE audits from Medicare, along with private and commercial payer audits are on the rise. It is more important than ever to monitor physician records and make sure that when …

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Revisiting SDoH G0136 Reporting

Revisiting SDoH G0136 Reporting

April 2, 2024

There will be more over-coding and overreaching with the additional codes Medicare provides to capture services. This episode explains the distinction for code G0136 and why it isn’t a “screening” service …

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Top 10 Tuesday Q&A – Auditing Telehealth

Top 10 Tuesday Q&A – Auditing Telehealth

March 26, 2024

In this Top Ten Q&A episode, Terry tackles what the focus of any telehealth audit should be. Auditing Telehealth encounters is more that just looking at the coding. It should …

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Compliance Issues With MD/QHP Collaboration Agreements

Compliance Issues With MD/QHP Collaboration Agreements

March 19, 2024

You must have a collaboration agreement in place when hiring mid-level providers or QHPs (such as nurse practitioners, physician assistants, or clinical nurse specialists) to act on your behalf with …

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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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