Codecast | Medical Billing And Coding Insights

Informações:

Sinopsis

Taking the Business of Medicine to the next level

Episodios

  • Are you a Coder or a Biller?

    11/06/2024

    How do you know if your role is classified as a Coder or a Biller? Coders typically work in the back end of the facility, focused on interpreting medical records and assigning appropriate codes. Billers interact directly with patients, collecting payments and entering patient information into the appropriate systems. However, there is also a crossover […] The post Are you a Coder or a Biller? appeared first on Terry Fletcher Consulting, Inc..

  • When To Use The -22 Modifier

    04/06/2024

    All CPT codes have an expected range of complexity and uses, but when a particular procedure or surgery performed has exceeded the normal range of complexity, modifier -22 can come into play. Modifier -22 is defined as increased procedural services and demonstrates when a physician has gone above and beyond the typical framework of a […] The post When To Use The -22 Modifier appeared first on Terry Fletcher Consulting, Inc..

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

    28/05/2024

    This week on the CodeCast podcast Terry returns with her Top 10 Tuesday Q&A series. Join us as Terry covers questions from Urgent Care to the ER, infusion charges, behavioral health, billing for unlisted codes, preventative med group codes, 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 […] The post Top 10 Tuesday Q&A – Coding, Billing, and Compliance Questions appeared first on Terry Fletcher Consulting, Inc..

  • Are you a real SME?

    21/05/2024 Duración: 16min

    Are you a “Subject Matter Expert?” Are you taking on clients, presenting to physicians, or looking for a coding job: with no expertise? Do not “wing it” in the healthcare field. You will hurt yourself or your credibility unless you disclose your limitations to the person you are doing business with. (Not to mention potentially […] The post Are you a real SME? appeared first on Terry Fletcher Consulting, Inc..

  • Is a Medical Record “Errors Disclaimer” Valid?

    14/05/2024 Duración: 15min

    Many of the records Terry audits include a disclaimer to protect a physician from liability. However, does this disclaimer shield a physician who has signed a note or authenticated an electronic encounter? (Under the assumption the physician reviewed it?) In this episode of the CodeCast podcast, Terry discusses the protections of a disclaimer and whether this […] The post Is a Medical Record “Errors Disclaimer” Valid? appeared first on Terry Fletcher Consulting, Inc..

  • Urgent Care to ER Coding

    07/05/2024 Duración: 12min

    In this episode of the CodeCast podcast, Terry discusses the frequent urgent care center encounters that elevate to the patient going to the ER. Is this considered automatically high risk? So many providers want level 5, but what if it’s to get testing or services unavailable at the UC? Terry discusses the complexities and compliance […] The post Urgent Care to ER Coding appeared first on Terry Fletcher Consulting, Inc..

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

    30/04/2024 Duración: 22min

    This week’s CodeCast Podcast is all about coding and billing. Join Terry for a full deck of important information on Coding, Billing, and Compliance. Get answers to our top ten questions including eVisit POS, LE Thombectomy services, SDoH assessment codes, Data Point E/M clarifications, and more. Subscribe and Listen You can subscribe to our podcasts […] The post Top 10 Tuesday Q&A – Coding, Billing, and Compliance Questions appeared first on Terry Fletcher Consulting, Inc..

  • Coding Hernia Repairs in 2024

    23/04/2024 Duración: 19min

    This week on the CodeCast Podcast Terry dives into the new rules for hernia repair codes. Terry discusses when the 0-global-days and 90-day-global-days services are billed on the same date. What applies? What about co-surgery? What about follow-up visits, or add-on codes for staple/suture removal? Tune in to find out details about these topics and […] The post Coding Hernia Repairs in 2024 appeared first on Terry Fletcher Consulting, Inc..

  • What does “separate procedure” mean in CPT?

    16/04/2024 Duración: 16min

    Some procedures in the CPT book are listed as “separate procedures” meaning they are commonly carried out as an integral component of a total service or procedure that has already been identified. In this episode, Terry discusses if, and when, you can report these with a code for the total procedure if modifiers will help, […] The post What does “separate procedure” mean in CPT? appeared first on Terry Fletcher Consulting, Inc..

  • Is This Really Medically Necessary?

    09/04/2024 Duración: 12min

    TPE audits from Medicare, along with private and commercial payer audits are on the rise. It is more important than ever to monitor physician records and make sure that when they submit any level of E/M. (Especially level 4’s and level 5’s.) In this episode, Terry reinforces making sure the visit not only meets the […] The post Is This Really Medically Necessary? appeared first on Terry Fletcher Consulting, Inc..

  • Revisiting SDoH G0136 Reporting

    02/04/2024 Duración: 14min

    There will be more over-coding and overreaching with the additional codes Medicare provides to capture services. This episode explains the distinction for code G0136 and why it isn’t a “screening” service (as per CMS) but an assessment. Terry discusses the new SDoH assessment code and when it should and shouldn’t be billed. We previously discussed how […] The post Revisiting SDoH G0136 Reporting appeared first on Terry Fletcher Consulting, Inc..

  • Top 10 Tuesday Q&A – Auditing Telehealth

    26/03/2024 Duración: 18min

    In this Top Ten Q&A episode, Terry tackles what the focus of any telehealth audit should be. Auditing Telehealth encounters is more that just looking at the coding. It should also include medical necessity, the technical and procedural aspects of the service, and on patient satisfaction and outcomes. She also recommends an external audit if […] The post Top 10 Tuesday Q&A – Auditing Telehealth appeared first on Terry Fletcher Consulting, Inc..

  • Compliance Issues With MD/QHP Collaboration Agreements

    19/03/2024 Duración: 19min

    You must have a collaboration agreement in place when hiring mid-level providers or QHPs (such as nurse practitioners, physician assistants, or clinical nurse specialists) to act on your behalf with treating patients. Collaboration agreements are mandatory in most states but rules differ from state to state. Also, due to failed compliance policies, lack of understanding […] The post Compliance Issues With MD/QHP Collaboration Agreements appeared first on Terry Fletcher Consulting, Inc..

  • Critical Care Inclusions and Carve-Outs

    12/03/2024 Duración: 19min

    Critical care in 2024 can be tricky, with inclusions, carve-outs, and a time component. Are there exceptions when PA/NPs are involved in critical care services? What has to be documented? You may find some rules you didn’t know about. Terry has all of the answers in this episode of the CodeCast podcast, sponsored by Decision […] The post Critical Care Inclusions and Carve-Outs appeared first on Terry Fletcher Consulting, Inc..

  • Can you bill an E/M service when the patient isn’t present?

    05/03/2024 Duración: 12min

    What happens when a provider meets with a family to discuss and develop a care plan for patients? Providers will give the parent the option to have the patient present or just the parent/guardian due to the sensitivity of the discussion. Some scenarios where this may occur are cancer patients where the family wants to […] The post Can you bill an E/M service when the patient isn’t present? appeared first on Terry Fletcher Consulting, Inc..

  • 2-Midnight Rule and MA plans

    27/02/2024 Duración: 14min

    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..

  • Did you know this is a HIPAA violation?

    20/02/2024 Duración: 13min

    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..

  • E/M Services: Stable or Unstable Chronic Conditions?

    13/02/2024 Duración: 14min

    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..

  • Coding and Billing The “Unlisted Code”

    06/02/2024 Duración: 17min

    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..

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

    30/01/2024 Duración: 21min

    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..

página 1 de 3