CCO.us Podcast | Medical Coding, Billing, Auditing & Risk Adjustment

From Bedside Nurse to Medical Coder: Is It Possible?

Thinking about leaving bedside nursing but still want to use your clinical expertise?

Alicia Scott explains:

• Why nurses make strong coding candidates
• Which certifications to consider
• What coding exams require
• Salary and career opportunities
• CDI and HIM career paths
• How to prepare for the transition

This episode is from the CCO Podcast #1747 webinar.

Watch the full video here: https://youtu.be/UWh0NeoXdeY

Are outdated CPT codes, modifier errors, and claim denials slowing you down?

Alicia Scott shares practical fixes for:

✅ Modifier 25

✅ E/M coding

✅ NCCI edits

✅ Telehealth billing

✅ Prior authorization

✅ AI coding mistakes

✅ Denial management

This episode is from the CCO Podcast #1752 webinar.

Watch the full video here: https://youtu.be/q60V7ZzqXkk

Can you bill both procedures?

Can modifier 59 override the edit?

In this episode, Laureen Jandroep explains:

• NCCI PTP edits
• Column 1 vs. Column 2
• Modifier indicators 0, 1 and 9
• CMS and Find-A-Code lookups
• Modifier 59 and X modifiers
• MUE limits and appeals
• Ophthalmology coding examples

Don't let an outdated edit or unsupported modifier create an avoidable denial!

This episode is from the CCO Club Q&A #1741 webinar.

Watch the full video here: https://youtu.be/NtzFyPGt3Lo

BI-RADS & Breast Density Coding: Are You Choosing the Right ICD-10-CM Code?

A BI-RADS letter is NOT your diagnosis code!

In this episode, Alicia Scott explains how to interpret breast density statements, navigate R92.3 codes, apply laterality, and avoid common mammography billing mistakes.

You'll also learn about:

• FDA reporting vs. CMS billing
• Billable vs. nonbillable codes
• Medicare's 11-month screening rule
• Dense breast tissue and supplemental imaging coverage

This episode is from the CCO Club Q&A #1741 webinar.

Watch the full video here: https://youtu.be/R9Th7noOTMA

What happens when the physician documents a precise anatomical structure, but you can't find that term in your coding manual?

In this episode, Alicia Scott uses the basal ganglia to demonstrate how anatomy is organized differently across ICD-10-CM, CPT, and Medicare coverage policies.

You'll learn:

• Why searching anatomical terms alone can lead to confusing results
• How I61, I63, S06.3, and G23 organize diagnoses differently
• How to distinguish subcortical and cortical hemorrhage
• When to consider I61.0, I61.1, I61.2, and I63.81
• Why mechanism and vessel matter in cerebral infarction coding
• How to navigate the CPT Index for brain procedures
• Why coverage policies and procedure codes serve different purposes
• How documentation queries can help improve specificity

Discover a practical research technique that applies well beyond neurology.

This episode is from the CCO Community #1762 webinar.

Watch the full video here: https://youtu.be/Fu6tmeQHw7I

Does a dangerous medication automatically make an E/M encounter high risk?

In this episode, Alicia Scott explains the two independent drug-related high-risk examples in the E/M risk column, the requirements for intensive toxicity monitoring, decisions involving parenteral controlled substances, and why IV administration alone doesn't establish high risk.

You'll learn:

✔ Moderate vs. high-risk drug management

✔ Intensive monitoring for toxicity

✔ The four-gate monitoring framework

✔ Monitoring for harm vs. therapeutic effect

✔ Parenteral controlled substance decisions

✔ Insulin, diuretic, and antineoplastic examples

✔ Why high risk doesn't automatically mean high MDM

This episode is from the CCO Community Q&A #1762 webinar.

Watch the full video here: https://youtu.be/yvh9ZVQsO7A

A diagnosis can be accurate—and still fail to support a claim if the documentation underneath it doesn't meet applicable requirements.

In this episode, Alicia Scott examines retrospective HCC coding through the lens of a major settlement involving allegations about medical-record amendments and risk adjustment data.

The discussion focuses on documentation provenance, amendment requirements, provider involvement, add-only reviews, audit trails, HCC models, and workflow design.

You'll learn:

• The Identify–Attribute–Preserve test
• EHR amendment and audit-trail considerations
• Why provider sign-off isn't the whole analysis
• Risks of add-only retrospective reviews
• HCC model/date-of-service considerations
• Audit extrapolation concepts
• Five project-design questions
• What to do when you identify a concern

This episode is from the CCO Podcast #1751 webinar.

Watch the full video here: https://youtu.be/OQPXZ6miyw0

Trying to break into healthcare revenue cycle but don't know where to start?

In this episode, Alicia Scott explains the five stages of revenue cycle, professional vs. institutional claims, common transaction numbers, rejected vs. denied claims, important KPIs, entry-level job opportunities, and credentials that can help you build your career.

You'll learn:

• The five stages of revenue cycle
• Where beginners can enter the field
• CMS-1500 vs. UB-04
• 837P vs. 837I
• Common transaction numbers
• Rejections vs. denials
• Revenue cycle KPIs
• Entry-level job titles
• Revenue cycle credentials

This episode is from the  CCO Podcast #1751 webinar.

Watch the full video here: https://youtu.be/2--io3qRajw

Z codes are everywhere—but knowing when to report them and where to sequence them can be surprisingly challenging.

You'll learn:

• First-listed vs. secondary Z codes
• Status vs. history
• Screening vs. diagnostic
• Aftercare vs. follow-up
• SDOH documentation
• Common documentation traps
• FY 2026 Z code changes
• FY 2027 changes to watch

This episode is from the CCO Club Q&A #1740 webinar.

Watch the full video here:  https://youtu.be/dXitt38zso0

Wound and ulcer care coding changed significantly in 2026.

You'll learn:

• 2026 skin substitute payment changes
• Deleted and replacement application codes
• Applied vs. discarded product units
• MAC LCD considerations
• WISeR prior authorization
• Expanded ICD-10-CM ulcer coding
• Diabetic foot ulcer sequencing
• Podiatry CPT® updates
• Routine foot care requirements

This episode is from the  CCO Community Q&A #1740 webinar.

Watch the full video here: https://youtu.be/8_4_f7qU1GU