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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MDM and Prescription Drug Management

MDM and Prescription Drug Management

Did you know Prescription Drug Management MUST include an actual prescription? There is a constant struggle to explain to physicians that providing a “script” to a patient does not always qualify your E/M service as a level 4. We need to do away with that myth and focus on what PDM really means to Medical […]

Why can't we all just get along?

Why can’t we all just get along?

Terry discusses the need for coding audits on the staff; to ensure quality along with good production efforts. What is being looked at in these audits? And how it can help healthcare professionals grow in their job to reach a high standard of job performance? Terry will talk about these topics, as well as conflicts […]

Top 10 Tuesday Q&A – Special Edition Modifiers

Top 10 Tuesday Q&A – Special Edition Modifiers

In the latest edition of the CodeCast Top 10 Tuesday, the “Modifier Spotlight” series returns. On this edition, Terry will focus on Modifiers, 51, 52 and 53: appropriate use, best practices for reimbursement, and the pitfalls of assigning them to the wrong CPT code. Terry also covers how to understand coding for “easy bruising” under […]

Can you charge/code for after hours and special services in your medical practice?

Can you charge/code for after hours and special services in your medical practice?

There are 6 after-hours/special services codes in the Special Service, Procedures, and Reports section of CPT. Four of these codes tend to present a challenge for coders because the vagueness of the guidelines or the inexplicit code descriptors leave coders wondering: “Can we charge for these?” Terry gives some examples and guidance on if and […]

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 […]