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CodeCast | Medical Billing and Coding Insights

Podcasts

Taking the Business of Medicine to the next level

Location:

United States

Genres:

Podcasts

Description:

Taking the Business of Medicine to the next level

Twitter:

@TerryCoder1

Language:

English


Episodes

2-Midnight Rule and MA plans

2/27/2024
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 inpatient or treat him or her as an outpatient. These decisions have significant implications for hospital payment and beneficiary cost sharing. Not all care provided […] The post 2-Midnight Rule and MA plans appeared first on Terry Fletcher Consulting, Inc..

Duration:00:14:06

Did you know this is a HIPAA violation?

2/20/2024
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 itself. If a patient doesn’t mention a medical condition, their information may still be considered as PHI. Terry covers requirements, such as PHE and ePHI […] The post Did you know this is a HIPAA violation? appeared first on Terry Fletcher Consulting, Inc..

Duration:00:13:33

E/M Services: Stable or Unstable Chronic Conditions?

2/13/2024
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 conditions, the definition of a stable, chronic illness, per AMA/CPT states, “stable” to categorize MDM as defined by the specific treatment goals for an individual […] The post E/M Services: Stable or Unstable Chronic Conditions? appeared first on Terry Fletcher Consulting, Inc..

Duration:00:14:44

Coding and Billing The “Unlisted Code”

2/6/2024
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, should be reimbursed. It is the responsibility of the surgeon, and the coding or billing staff, to report unlisted CPT codes and follow up with […] The post Coding and Billing The “Unlisted Code” appeared first on Terry Fletcher Consulting, Inc..

Duration:00:17:38

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

1/30/2024
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 is one episode you don’t want to miss for insights and resources to your most important coding, billing, and compliance questions. Subscribe and Listen You […] The post Top 10 Tuesday Q&A – Coding, Billing and Compliance Questions appeared first on Terry Fletcher Consulting, Inc..

Duration:00:21:08

Reporting eVisits 99421-99423

1/23/2024
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 services via a secure platform. (Like a patient portal.) What is required to bill for these services? Consent? Interactive Conversation? Modifiers? POS? And what is […] The post Reporting eVisits 99421-99423 appeared first on Terry Fletcher Consulting, Inc..

Duration:00:18:34

Revisiting the G2211 in 2024

1/16/2024
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 2023, when it was a CMS proposal, but now that it is effective let’s look at the realities. The Modifier -25, when reported on an […] The post Revisiting the G2211 in 2024 appeared first on Terry Fletcher Consulting, Inc..

Duration:00:16:39

2024 Telehealth Checklist

1/9/2024
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 continues. It is imperative to be up-to-date on all of the current published guidance. In this episode, Terry shares her Telehealth services tips and checklist […] The post 2024 Telehealth Checklist appeared first on Terry Fletcher Consulting, Inc..

Duration:00:19:47

Concerns About AI in Healthcare for 2024

1/2/2024
*** 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, while others are not. Is scraping the web for training data ethical? Who decides whether AI documentation and “expertise” is any good? How should copyright […] The post Concerns About AI in Healthcare for 2024 appeared first on Terry Fletcher Consulting, Inc..

Duration:00:16:39

Concerns About AI in Healthcare for 2024

1/2/2024
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, while others are not. Is scraping the web for training data ethical? Who decides whether AI documentation and “expertise” is any good? How should copyright law apply to AI-generated […] The post Concerns About AI in Healthcare for 2024 appeared first on Terry Fletcher Consulting, Inc..

Duration:00:07:55

2024 Pelvic Exam Add-On Code

12/26/2023
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 today’s episode to make sure you know what the documentation and coding rules are before diving into this situation. Subscribe and Listen You can subscribe […] The post 2024 Pelvic Exam Add-On Code appeared first on Terry Fletcher Consulting, Inc..

Duration:00:07:55

When to use the new SDoH add-on code

12/19/2023
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 is adding another G-code for SDoH assessment during an E/M encounter. This is for an assessment: not a screening. This service is not intended to […] The post When to use the new SDoH add-on code appeared first on Terry Fletcher Consulting, Inc..

Duration:00:12:05

7 Elements of a Successful Compliance Program via OIG

12/12/2023
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 of healthcare entities, staff, and providers playing a role in healthcare delivery today, this information can be generally applied across the entire healthcare industry or […] The post 7 Elements of a Successful Compliance Program via OIG appeared first on Terry Fletcher Consulting, Inc..

Duration:00:21:23

Patient History = Medical Necessity

12/5/2023
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 used on any medical encounter regardless of the reason for the visit. A history of an illness may alter what treatment is ordered for a […] The post Patient History = Medical Necessity appeared first on Terry Fletcher Consulting, Inc..

Duration:00:17:41

Transitional Care Management Services

11/28/2023
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 and criteria. Terry breaks down the confusion and discusses why this is more of a value-based service than a monetary windfall. Listen to this informative […] The post Transitional Care Management Services appeared first on Terry Fletcher Consulting, Inc..

Duration:00:17:20

Telehealth CPT 2024 Rules

11/21/2023
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 a service can be CPT considered for Telehealth inclusion. Terry shares this insight, plus her commentary on how to implement it into your updated compliance […] The post Telehealth CPT 2024 Rules appeared first on Terry Fletcher Consulting, Inc..

Duration:00:13:05

E/M Leveling with MDM: Right or Wrong?

11/14/2023
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 also consider “best practices” and payer-published guidance before you do only the minimum (or what is “technically” correct). Terry makes this clear distinction in today’s […] The post E/M Leveling with MDM: Right or Wrong? appeared first on Terry Fletcher Consulting, Inc..

Duration:00:13:50

Final Rule 2024 Shared/Split Visit

11/7/2023
The 2024 Medicare Final Rule was published on November 2nd, and the Split/Shared visit guidance will parallel the CPT guidance. However, CMS will still expect the -FS modifier from the billing provider. Terry breaks down the rules in this episode to ensure misinterpretations do not have providers reporting incorrectly. Also, Terry takes a look at […] The post Final Rule 2024 Shared/Split Visit appeared first on Terry Fletcher Consulting, Inc..

Duration:00:15:16

Top 10 Tuesday Q&A – Halloween Episode

10/31/2023
Join us for a great Halloween episode as Terry provides the top ten spookiest ICD-10-CM codes. She also discusses preventative and OV on the same date. And what happens when a Telehealth video visit loses feed? Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga Spotify […] The post Top 10 Tuesday Q&A – Halloween Episode appeared first on Terry Fletcher Consulting, Inc..

Duration:00:12:24

CMS clarifies how to respond to a CERT audit

10/24/2023
CMS recently updated their published guidance, MLN909160 July 2023, with further examples and instructions on how to gather information and documentation when a CERT Audit issues a request for an ADR (Additional Documentation Request). You don’t want to ignore this, but embrace the process and understand that this oversight helps everyone. Terry breaks it down. […] The post CMS clarifies how to respond to a CERT audit appeared first on Terry Fletcher Consulting, Inc..

Duration:00:16:57