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, 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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Patient Expectations and Physician Burnout

Patient Expectations and Physician Burnout

What are the patient’s expectations in medical practices today? Terry lists all of the “wants” of patients and discusses whether they are really “needs” of your practice. ‘ Also, it is a challenging time to be a physician. Recent studies report nearly 45% of doctors feel burnout in their work, more than other US workers. […]

Modifier 59 Spotlight

Modifier 59 Spotlight

In today’s spotlight series episode, the focus is on the trickiest modifier of them all: Modifier 59. Terry dedicates an entire episode to this modifier, which also includes the X-modifiers or the subset modifiers that have been effective since 1/7/2015. The most common reason the 59 modifier should be used is to indicate that two […]

Is your practice LGBTQ+ friendly?

Is your practice LGBTQ+ friendly?

In today’s ever-changing patient profile, it is important that healthcare professionals embrace an attitude of change. We must recognize that staff needs training on more than the ICD-10-CM associated conditions for LGBTQ+ patients: they also need training on inclusive-language in the practice for intake forms and conversations in general. Terry discusses what it takes to […]

How to properly append modifiers 25 and 26

How to properly append modifiers 25 and 26

CPT Modifiers are valuable coding tools that explain to payers the specific work that was done by a physician during treatment of a patient. CPT modifiers 25 and 26, are mandatory to justify services performed. More specifically, these codes deal with the intent of other services performed at the same encounter, as well as location […]

ICD-10-CM Update 2020

ICD-10-CM Update 2020

Changes are coming for ICD-10-CM. Terry summarizes the new, revised, and deleted codes for 2020, along with a frequently asked question: “Can we use the result of a diagnostic test as the patient diagnosis? Or do we have to use the clinical indication for the test upon presentation for the test?” Ms. Fletcher will cover […]

Late Physician Signatures

Late Physician Signatures

The rules surrounding signing a physician note are from the general E/M documentation guidelines. The main concern is the timely completion of medical records. This issue has both billing and compliance ramifications. While the issue of legibility has been largely addressed by increased utilization of electronic health records (EHRs), completion of the record through the […]

Top 10 Tuesday Q&A – July 29th, 2019

Top 10 Tuesday Q&A – July 29th, 2019

In the latest edition of the CodeCast Top 10 Tuesday, Terry takes us through Spine ICD-10 coding challenges. From Critical Care situations to Transgender coding (that has been a new topic of late) tune in as Terry responds to the coding and billing questions of the month. Subscribe and Listen You can subscribe to our […]

Establishing Care vs. Preventative Care Coding

Establishing Care vs. Preventative Care Coding

Are your physicians asking you to “Patient here to establish care” and trying to bill this as a Level 5 visit…  when it is actually Preventative Services? Terry clarifies the difference between Preventative Services and EM Problem-oriented Services. She also discusses the billing of both services and the patient share of cost impact, as well […]

Multiple ways healthcare professionalism, or lack thereof, could be costing you patients

Multiple ways healthcare professionalism, or lack thereof, could be costing you patients

There are ways to represent professionalism: but what does it really mean to you? On today’s episode, Terry discusses ways to be inspired on the job to best show professionalism in a Healthcare environment. Her tips will help you feel inspired at your job, but she also goes the extra distance to discuss how professionalism […]

Critical Care Coding: Defined and Audit-Proof

Critical Care Coding: Defined and Audit-Proof

Despite the increased resources and references for critical care billing, critical care reporting issues persist. Medicare data analysis continues to identify 99291 as high risk for claim payment errors, perpetuating prepayment claim edits for outlier utilization and location discrepancies. In this episode, Terry tackles this topic with documentation recommendations to keep you audit-proof with tips […]