In this episode of the CodeCast podcast, Terry discusses the differences between APCM and CCM services and what is needed to report either.

Compliance issues are seen with many care management service records. Terry covers how to follow best practices to ensure you follow the published guidance.

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Medical Coding provides standardized language that ensures all healthcare providers involved in a patient’s care are on the same page.

The coder’s role is to be accurate, communicative, insightful and focused on a positive patient outcome. A patient’s financial health can impact their clinical health, and medical coders need to be recognized for their role in this process.

Terry shares her thoughts on what makes a coder valuable, even if they are less visible than the providers.

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The post The Crucial Role of the Coder in Quality Patient Care appeared first on Terry Fletcher Consulting, Inc..

This week’s CodeCast summarizes the recent ICD-10-CM documentation guidelines instructions on sepsis, obesity, and COVID-19 reporting.

Terry also provides more guidance on E/M risk in prescription drug management and caution with PSAs in patient documentation.

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The post ICD-10-CM April 1st Updates appeared first on Terry Fletcher Consulting, Inc..

More medical claims denials could be avoided if coders took the extra minute to make sure that the diagnoses that need to be linked to a specific line item were pre-billed.

Also, when billing for diagnostic procedures on a complaint that moves to a minor, therapeutic, or surgical procedure, denials will happen when the diagnosis for the latter procedure is not updated.

Terry covers all the issues with denials that can be avoided with a careful step back.

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Terry takes some inspiration from Stephanie Allard’s February 27th for this edition of the CodeCast podcast.

Terry discusses the differences and subjective issues between Acute Uncomplicated Illness (or Injury) versus Acute Complicated Illness in the E/M elements of coding and auditing.

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The post Acute Uncomplicated vs. Acute Complicated E/M Auditing appeared first on Terry Fletcher Consulting, Inc..

Terry’s answering your coding questions in this week’s “Top 10” Q&A.

In this episode Terry’s covering APCM, E/M, skin procedures, lab billing, and even a Telehealth bonus.

Tune in for insights you won’t want to miss!

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The post Top 10 Tuesday Q&A – Coding, Billing, and Compliance Questions appeared first on Terry Fletcher Consulting, Inc..

Terry is under the weather this week, so she gives us a quick segment on the E/M Data point, “independent interpretation”. See page 12 of CPT® under independent interpretation, the last sentence.  “A test that is ordered and independently interpreted may count as both a test ordered and interpreted.”

Suppose you bill for the professional and technical components, meaning you are billing for the test ordered. In that case, you can’t double dip or get additional credit for the order, the review, or a professional interpretation.

You can get credit for ordering a test and for an independent interpretation, as long as your documentation meets the criteria for what an independent interpretation is.

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Some coders remain confused about Medically Unlikely Edits (MUEs) — but that’s about to change.

In this episode, Terry discusses denials from Part B MACs for what you may think is an undetermined reason. However, a possibility is running up against MUEs.

The edits, which are designed to prevent over-payments caused by serious billing errors, often confuse even veteran coders.

Terry uncovers the truth about four aspects of these edits to ensure you’re not letting MUEs wreak havoc on your practice’s coding and reimbursement efforts.

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The post How do MUEs Work in Coding? appeared first on Terry Fletcher Consulting, Inc..

The third element of MDM for E/M Services is “Risk of Complications and/or Morbidity or Mortality of Patient Management”. Many believe that only the risk in this element is how you level your E/M, but that is false.

There are three elements to a E/M service when using MDM. There are several risks including the problems addressed and for the management and treatment for the patient.

Terry discusses the difference and how to make sure you don’t over or under-code in the process.

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Everyone knows that you cannot routinely waive or fail to collect the obligation of patient cost-sharing.

However, we know that there are instances where (1) the patient has a bad experience, (2) the patient will not pay or is not collectible, and (3) the patient has a hardship.

Here are several policies your practices can implement to ensure compliance and have good compliance. The NSA can also make things tricky, but Terry clears up what you can and cannot do with professional courtesy.

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The post Professional Courtesy appeared first on Terry Fletcher Consulting, Inc..