Codecast | Medical Billing And Coding Insights

Today on the CodeCast podcast, Terry discusses best practices for the -25 Modifier, where to find her latest blog on the AAPC website, and what the MAHA (Make America Healthy Again) movement means to our country. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ […] The post The 25 Modifier and More appeared first on Terry Fletcher Consulting, Inc..

CMS published the 2025 Final Rule on November 1st. Terry breaks down the highlights and gives you the facts on the Telehealth “mess” that could have 85% of Medicare patients without access to virtual care. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube […] The post CMS final rule is out and Telehealth is an issue appeared first on Terry Fletcher Consulting, Inc..

Many practices have engaged in coding for TCM (Transitional Care Management) services but are finding that they are receiving more denials than payments. Terry breaks down why that is, and sheds light on what is needed to qualify billing for these services. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – […] The post Why are TCM services receiving more denials than payments? appeared first on Terry Fletcher Consulting, Inc..

Artificial intelligence (AI) has the potential to make substantial progress toward the goal of making healthcare more personalized, predictive, preventative, and interactive. However, AI-based systems raise concerns regarding data security and privacy. Because health records are important and vulnerable, hackers often target them during data breaches. The absence of standard guidelines for the moral use […] The post AI in Medical Coding: What’s the Reality? appeared first on Terry Fletcher Consulting, Inc..

HIPAA has many privacy issues that most practices have in their HIPAA compliance manuals. However, current HIPAA violations are coming to light when employees purposefully search patient PHI for personal use or curiosity. This is not only a violation of privacy laws but could have a cascading effect if not stopped in its tracks. In […] The post HIPAA violations your organizations should avoid appeared first on Terry Fletcher Consulting, Inc..

In this edition of the CodeCast podcast, Terry discusses the “subtle changes” to look for in the ICD-10-CM updates effective October 1st. Also, Terry clears up understanding the UHC Gold Card Program, and what CMS looks at when they send you a denial. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts […] The post RCM Updates for 4th Quarter appeared first on Terry Fletcher Consulting, Inc..

According to the AMA, most physicians lack training in “webside manner.” Researchers from the University of Michigan Medical School and the Veterans Affairs Ann Arbor Healthcare System surveyed 1,213 patients from their respective institutions to measure preferences regarding the visual background seen during a video visit. Today’s CodeCast podcast brings you the survey results, with […] The post Telemedicine “Webside Manner” appeared first on Terry Fletcher Consulting, Inc..

Many practices offer cash payment options to avoid insurance billing, hoping to reduce administrative burden or boost revenue. However, this practice of charging cash for services that could be billed to and covered by a patient’s insurance plan raises serious compliance concerns. Federal law and insurance contracts generally prohibit this practice because it undermines the healthcare […] The post Charging patients cash for “insurance covered” services appeared first on Terry Fletcher Consulting, Inc..

Sometimes there are coding, compliance, and billing questions that we struggle to find answers to in any published guidance or specific regulatory rules. This week on the CodeCast podcast, Terry brings up three specific questions that we are always hunting for answers to and the best way to deal with them. Subscribe and Listen You […] The post Sometimes the rules are as “clear as mud” appeared first on Terry Fletcher Consulting, Inc..

In this episode Terry discusses the importance of ICD-10-CM codes on billing claims. She also clarifies the ICD-10-CM General Guidelines on Borderline Diagnoses, Laterality, Acute versus Chronic Conditions, and when to leave the symptoms off the claim for definitive diagnoses. Listen in for this important information capture. Subscribe and Listen You can subscribe to our […] The post Does ICD-10-CM Codes Claim Position Matter? appeared first on Terry Fletcher Consulting, Inc..

CMS released their FAQ sheet for the add-on code HCPCS G2211, to office visits. The sheet clarifies where denials and grey areas for reporting. Tune in as Terry goes over twelve FAQs from CMS along with her commentary to best practices for this complexity add-on. Subscribe and Listen You can subscribe to our podcasts via: […] The post G2211 CMS FAQ Sheet Released appeared first on Terry Fletcher Consulting, Inc..

In this episode of the CodeCast podcast, Terry discusses ABI billing, Level 5 Drug Toxicity options, Aortic Stenosis ICD-10-CM coding, and some questions related to the 2025 CMS proposals. Listen this episode to see if any of your Coding Corner questions made the podcast cut! Subscribe and Listen You can subscribe to our podcasts via: […] The post Top 10 Tuesday Q&A – Coding, Billing, and Compliance Questions appeared first on Terry Fletcher Consulting, Inc..

CMS proposes expanding the transfer of care modifiers, -54, -55, and -56 to better “value” the global surgery CPT codes. However, this may cause more confusion for surgeons and medical providers who see patients for surgery or post-op only. Terry talks about the proposal and what to expect for 2025. Also, Terry talks about the […] The post Transfer of Care Modifiers appeared first on Terry Fletcher Consulting, Inc..

This edition of the CodeCast podcast focuses on coding heart caths. When coding for cardiac catheterizations, if you don’t have a working knowledge of this specialty it can be a bit challenging. That’s why it’s time to get back to the basics. Terry provides some tips into this coding concept, and what to look for […] The post Coding a Heart Cath appeared first on Terry Fletcher Consulting, Inc..

Terry takes us down memory lane in an E/M refresher. She covers what changed with the CPT E/M section – that was updated in 2019, 2020, and 2021 – to get to what we have today in 2024. Getting back to basics helps you understand why we must ensure updates in our charting workflows and […] The post E&M Comparison appeared first on Terry Fletcher Consulting, Inc..

This week on the CodeCast podcast Terry returns with her Top 10 Tuesday Q&A series. Join us as Terry covers questions covering risk support for E/M, Telehealth in the hospital setting, missed appointments, follow-up testing protocols, shared visit modifiers, and more. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify […] The post Top 10 Tuesday Q&A – Coding, Billing, and Compliance Questions appeared first on Terry Fletcher Consulting, Inc..

CMS published their PFS on July 10th. You have 90 days to comment and be heard on these changes including the proposed 2.93% reduction to the Physician Fee schedule. In this edition of the CodeCast, Terry goes over the talking points and what Part B providers can expect coming into the new 2025 calendar year. […] The post CMS Newsroom Update: Physician Fee Schedule 2025 appeared first on Terry Fletcher Consulting, Inc..

Terry discusses when it is and isn’t appropriate to report a preventative visit with an office visit on the same date. How did the patient present? What is the share of the cost-to-patient implications? And what will payers want to see for medical necessity? Terry covers it all in this edition of CodeCast podcast. Subscribe […] The post Office Visit with Preventative Med appeared first on Terry Fletcher Consulting, Inc..

In today’s episode of the CodeCast podcast, Terry updates you on the latest CMS NCCI Edits, effective July 1st. She gives you the insight on the PTP and MUEs expected, along with some commentary and best practices on charging patients for no-show appointments. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts […] The post NCCI Updates 30.2 and No Show Appointments appeared first on Terry Fletcher Consulting, Inc..

Principal Care Management (PCM) services are services for a single high-risk disease, 30 minutes a month, personally provided by a physician or NPP. This is for patients with one complex chronic condition expected to last three months which places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or death. Does your patient […] The post Principle Care Management (PCM) appeared first on Terry Fletcher Consulting, Inc..