CodeCast | Medical Billing and Coding Insights

CodeCast | Medical Billing and Coding Insights

Taking the Business of Medicine to the next level

Episodes

May 4, 2021 20 min

Many commercial payers voluntarily waived all deductibles, co-pays, and other costs for insured patients who fell sick with COVID-19. Many of these patients were hospitalized and needed intensive care, doctor visits, medications, or other treatments. Setting aside those fees was a good move from a public relations standpoint. The industry got credit for helping customers […]

The post Insurers have started rollbacks of patient...

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We all know that Medicare has their definition of “Medical Necessity” under Title 18 of the Social Security Act. But did you know that the AMA, The American College of Medical Quality, AAFP, and many Payer Contracts have their own defined language of what “Medical Necessity” means? This week Terry discusses all of them to […]

The post Medical Necessity: What rules are you following? appeared first on Terry Fletcher Consulting...

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Terry discusses the recent CMS alerts and new coding questions relating to the 2021 EM Rules. Medical Decision Making has everyone confused. Can vaccines and immunizations be considered in the management of a patient? Where does a pre-op visit for surgery fall in the presenting problems addressed? Terry discusses these topics and more in this […]

The post PHE Extended and more EM2021 MDM Clarifications appeared first on Terry...

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April 13, 2021 15 min

This week’s CodeCast focuses on the 21st Century Cures Act or the “Information Blocking” regulations. The regulation became effective last Monday, April 5th, so you must know what is necessary when a patient requests their records and how you could get into monetary trouble if not compliant with their request. Also, when coding for Atherosclerotic […]

The post Information Blocking: Cures Act 2021 appeared first on Terry Fletc...

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March Madness wasn’t only about college basketball! Medicare made the first quarter of 2021 all about announcements. Listen to this week’s episode as Terry runs down the new CMS/Medicare announcements, regulation effective dates, and the AAP repayment start. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 G...

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We are working so many hours since the pandemic hit in January 2020. Over a year into the COVID Public Health Emergency, healthcare professionals, like other employees, had to emergently pivot to working remotely. This has blurred the boundaries between work and home. Let’s talk about how to “Zoom” out our Fridays with Terry this […]

The post Home and work boundaries blurred for remote healthcare workers appeared first on Ter...

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Every year CMS releases an updated inpatient-only surgery list: and the surgeries on this list are not arbitrarily selected. Due to the complexity of the procedure, the risk for complications, the need for post-operative monitoring, and an anticipated prolonged time for recovery, CMS understands that these surgeries require a high level of care. Terry discusses […]

The post What is an “Inpatient-Only Surgery List”? appeared f...

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So many providers have been looking into setting up either an OBL (Office-Based Lab) or an ASC (Ambulatory Surgery Center) with their partners. Terry discusses the topic in general terms before you dive in to determine if this could be a way for your providers to get back to a profitable practice. After the year […]

The post OBL vs ASC: Are you ready to invest in your own? appeared first on Terry Fletcher Consulting, Inc..

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Virtual Check-ins have been confusing: not only on when to use them, but CMS added more to the list in 2021! The confusion continues for physicians, NPs, PAs and therapy ancillary staff on when to use these HCPCS G-codes, or what Terry refers to as, “G-we are watching you!” The episode of the CodeCast should […]

The post Virtual Check-Ins: “G-We Are Watching You!” appeared first on Terry Fletcher Consulting, Inc..

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March 2, 2021 21 min

This week Terry talks about 99211 compliance, and when it is appropriate to report the “nurse” code. Also, Medicare as a Secondary Payer (MSP) can see many denials. CMS issued a new policy on the topic: we have the details. CMS also added a new “virtual check in” G code for other ancillary staff. Find […]

The post When should I report the 99211 Code? appeared first on Terry Fletcher Consulting, Inc..

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It’s Top Ten Tuesday time as Terry answers questions on depression screening, alcohol misuse screening, and smoking cessation. There are also ABN compliance questions along with coding for burning your mouth… on hot sauce! Also, have you ever heard of DM 1.5? We have the coding details. Subscribe and Listen You can subscribe to our […]

The post Top 10 Tuesday Q&A – Screening, ABN Use, and Hot Sauce! appeared first on Terr...

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On this episode of the CodeCast, Terry focuses on February’s Heart Health Month, where many of us are wearing red to bring awareness to good cardiovascular habits and good heart healthy habits. Taking that to heart, Terry takes a look at cardiology coding as a focus, since so much has been addressed with COVID during […]

The post Cardiology Coding Spotlight for Heart Health Month appeared first on Terry Fletcher Consulting, I...

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When COVID-19 emerged in early 2020, new ICD-10-CM codes to identify this condition were not available. Subsequently, they were added by the CDC mid-year, and the guidelines for reporting COVID-19 changed many times as the pandemic evolved throughout 2020. Terry discusses the correct application of ICD-10-CM “Z” codes to report encounters for COVID-19 testing and […]

The post COVID-19 ICD-10-CM Coding Timeline For Outpatient ...

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February 2, 2021 17 min

Incident to rules have been a target of compliance lately with payers. Terry revisits the rules and gives some scenarios on when services can be billed under the physician and/or the APP. Audits have arrived: let’s make sure we are compliant in all aspects of our billing processes for our NPs and PAs. Subscribe and […]

The post Incident To Rules Revisited appeared first on Terry Fletcher Consulting, Inc..

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After presenting over 30 Webinars on the 2021 E/M Guidelines, Terry continues receiving questions about clarifications on what AMA and CMS are expecting when medical providers are documenting in a patient’s chart. This week, our Top 10 Tuesday Q&A addresses many of those questions and more! Subscribe and Listen You can subscribe to our podcasts […]

The post Top 10 Tuesday Q&A – 2021 E/M Guidelines appeared first on Te...

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With a new administration coming into the White House, what CMS policies will continue and which ones will be halted or rolled back? Terry discusses what a new administration could mean for patients and hospitals, but also your bottom line if certain regulations are changed under the Biden administration. The 2021 inpatient surgery list elimination […]

The post Will The New Administration Keep Existing Policies? appeared firs...

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January 12, 2021 15 min

This week on the CodeCast Podcast, CMS once again threw us for a loop by not only doubling the 3.75% increase to the 2021 Fee Schedule but also the extending the PHE. What does that mean for medical practices? Join us this week for important updates as Terry discusses the impact of these changes as […]

The post PHE Extended and EM 2021 Clarifications appeared first on Terry Fletcher Consulting, Inc..

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Join us for this important update, as we are now into the New Year. It’s time to make sure we understand the Myths and Realities of the MPFS and what the December 28th COVID Relief Bill signed by President Trump did to the projected Medicare reimbursement. Terry will also discuss the PHE services that have […]

The post Myths and Realities of 2021 Medicare Final Rule and Fee Schedule appeared first on Terry Fletcher Consulting...

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December 29, 2020 16 min

This week Terry has some fun with coding by giving you the Top 10 holiday related ICD-10-CM codes for your last week of the year. These will show up as chief complaints of patients! Is there a Code for a Christmas tree falling on you? Yes, there is a code for that. Also, Terry updates […]

The post Top 10 Holiday ICD10-CM Codes appeared first on Terry Fletcher Consulting, Inc..

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While it is true that during the PHE Medicare and other commercial insurance plans are covering E/M Telephone visits (99441-99443) on a temporary basis, practices should not take this as a license to over-utilize these codes. They should not forget about the ‘virtual check in” options either. Terry discusses what it takes to support a […]

The post Medical Necessity for Audio-Only Telehealth appeared first on Terry Fletcher Co...

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