Taking the Business of Medicine to the next level
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 […]
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 […]
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 […]
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 […]
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...
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 […]
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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 […]
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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 […]
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 […]
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 […]
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 […]
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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 […]
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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 […]
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 […]
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 […]
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 […]
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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 […]
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 […]
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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 […]
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 […]
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