CodeCast | Medical Billing and Coding Insights

The FY 2027 update takes effect October 1, 2026, for outpatient encounters and inpatient discharges beginning on that date. Both the diagnosis code changes and the updated Official Guidelines for Coding and Reporting deserve attention.

When Terry reviews an annual update, she thinks about the entire process. The provider documents the condition, the physician or coder selects the diagnosis, and that selection makes it onto the claim. In today’s CodeCast Podcast, Terry gives a specialized overview of the new ICD-10-CM codes for the 2027 FY effective date October 1st, along with some educational tips for providers and coders.

Find all of Terry’s official links in one place: https://www.terryfletcher.net/links

The post ICD-10-CM 2027 Update appeared first on Terry Fletcher Consulting, Inc..

Few questions get a stronger reaction from Terry than, “How can I get around that rule?”

When providers, coders, or other healthcare professionals ask how to work around a coding, billing, or regulatory requirement, Terry’s response is clear: compliance isn’t about finding a loophole—it’s about understanding the rules and applying them correctly.

In this episode, Terry breaks down her position using regulatory guidance, coding and billing requirements, and established compliance principles. The goal isn’t simply to get a claim paid; it’s to support accurate reporting, defensible documentation, ethical billing practices, and the highest standards of professional integrity.

Listen in for the latest discussion in our ongoing pursuit of the truth—where facts, guidance, and compliance come before shortcuts.

Find all of Terry’s official links in one place: https://www.terryfletcher.net/links

The post Please don’t try to get around the Healthcare System appeared first on Terry Fletcher Consulting, Inc..

Terry discusses the specialty of Podiatry procedural coding, to include some ankle surgeries, and other complex foot surgeries. She also strongly advises not to add CPT or ICD-10-CM codes to operative reports as this now handcuffing the provider to those codes whether they are over or under coded or incorrect as this report would suggest. Listen in to get the details.

Find all of Terry’s official links in one place: https://www.terryfletcher.net/links

The post Podiatry Procedural Coding appeared first on Terry Fletcher Consulting, Inc..

Obstetric coders have likely started to report E/M visits for newly pregnant patients, but they still have a few months before they need to use the full set of new and revised codes and guidelines for maternity care services as we head into 2027.

Terry brings in some recent questions and answers to to help train your team and determine where more research or training is necessary before the full code system goes into effect Jan. 1, 2027. A contributing article in Part B news from 9/28 also was used for this episode.

Find all of Terry’s official links in one place: https://www.terryfletcher.net/links

The post Obstetrics Coding for 2027 appeared first on Terry Fletcher Consulting, Inc..

Emergency Department and Critical Care Services are often incorrectly coded because the documentation lacks clarity. Terry discusses the elements necessary to have compliant ER documentation and also what CC services need to make sure they are supported for billing.

Find all of Terry’s official links in one place: https://www.terryfletcher.net/links

The post ER and Critical Care Services Coding appeared first on Terry Fletcher Consulting, Inc..

CMS has made permanent the policy that allows a practitioner who furnishes Medicare telehealth services from home, even what the height of COVID is over 3 years in the past. There is also confusion is what is listed as the physician’s practice location?

Terry discusses the answer to this question, as the CCHPCA has now a specific position, and also talks about the difference between Medicare enrollment vs. POS where services are performed. Different rules apply when the practitioner or group operates virtually and has no other physical practice location, and teleradiology is subject to separate enrollment rules.

Find all of Terry’s official links in one place: https://www.terryfletcher.net/links

The post Telehealth when the physician is at home appeared first on Terry Fletcher Consulting, Inc..

How does documentation specificity affect diabetes code assignment?

The details included in a medical record can significantly affect ICD-10-CM code assignments. Terry discusses several examples to show how documentation specificity, provider links between conditions, and medication use can influence diabetes coding.

There are certain conditions for which a cause-and-effect relationship with diabetes can be assumed under coding guidelines; however, not every condition can automatically be considered related to diabetes. When a provider specifically links a condition to diabetes, that documentation can provide crucial support for accurate code assignment.

Tune in today for some insights into the frequent, although challenging condition to code.

Find all of Terry’s official links in one place: https://www.terryfletcher.net/links

The post ICD-10-CM Coding for Diabetes appeared first on Terry Fletcher Consulting, Inc..

Terry gives us scenarios that are examples of work that doesn’t amount to an E/M service or can’t be counted toward an E/M service, followed by discussion of the reason why along with similar situations where it might be appropriate to report a stand-alone E/M service or count it toward an E/M service. We have to make sure we are not caught in the FWA that is happening all over the country. Listen in this week to protect your practice.

Find all of Terry’s official links in one place: https://www.terryfletcher.net/links

The post E/M Coding: What Not To Do appeared first on Terry Fletcher Consulting, Inc..

The AMA specifically states that the risk element concerns patient-management decisions made by the physician/QHP reporting the E/M service. It also emphasizes that surgical risk depends on the particular patient’s circumstances and risk factors as assessed by that physician. Terry discusses “pre-op clearance” visits today and their level of risk, along with the billing of 76937 controversy.

Find all of Terry’s official links in one place: https://www.terryfletcher.net/links

The post Technically correct and pre-ops appeared first on Terry Fletcher Consulting, Inc..

Terry discusses the 1op 10 Coding Corner Membership questions of the quarter, including Telehealth, the reality of voice recognition transcription disclaimers and some of the new proposals from CMS slated for 2027. Tune in to get the rundown.

Find all of Terry’s official links in one place: https://www.terryfletcher.net/links

The post Top 10 Tuesday Medical Coding Q and A appeared first on Terry Fletcher Consulting, Inc..