CodeCast | Medical Billing and Coding Insights

This week’s CodeCast podcast revisits the topic of “Incident to.”

The last time this was covered on the show was back in February 2021. That is well over a year ago! Now with more and more practices hiring NPs and PAs, we need to make sure we know and follow, the rules.

A recent report by MedPac, the commission that reports on Medicare NPP payments, states “Medicare could save over $94 million a year with no incident to.”

This is an important financial impact topic for your practice. You not only need to be compliant but also make sure you are profitable.

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If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

A healthcare practice must verify the patient’s coverage and eligibility for medical services being sought and determine their responsibility for payment.

Through the patient eligibility and benefits verification process, physician practices can confirm the coverage offered by the health plan and share of cost by the patient in the form of co-payments, deductibles, and coinsurance.

With the NSA and Balance Billing limitations in 2022, healthcare providers must collect payments from patients proactively to prevent. delays in practice cash flow.

Terry discusses her top ten tips for success in this process in this episode of the CodeCast Podcast.

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You can subscribe to our podcasts via:

* Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627

* Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga

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* TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/

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If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

Many payers are starting to put restrictions on payment and submission requirements when billing the 25 modifier on E/M services with minor procedures on the same date.

You will see reductions in payments and new paperwork requirements for submission. Terry tears into the update in this show, plus bonus information on the CPT Errata June 1st, update.

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You can subscribe to our podcasts via:

* Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627

* Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga

* Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX

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* TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/

* YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg

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If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

This week, Terry introduces a new ICD-10-CM topic of HCC (Hierarchical Condition Category) coding relies on ICD-10-CM coding to assign risk scores to patients. Each HCC is mapped to an ICD-10-CM code.

Along with demographic factors such as age and gender, insurance companies use HCC coding to assign patients a risk adjustment factor (RAF) score. Using algorithms, insurance companies can use a patient’s RAF score to predict costs for sick patients.

Terry also discusses the importance of HCC coding and why the OIG is looking at the accuracy or an FCA could be an issue.

Tune in for all of the details.

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You can subscribe to our podcasts via:

* Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627

* Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga

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* TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/

* YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg

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If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

This week on the CodeCast Podcast, Terry Fletcher discusses the differences between the IPPE, AWV and a routine physical exam.

Many providers are billing E/M services to “establish care” and this may not be accurate.

Listen to find out why and how to avoid this common problem.

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You can subscribe to our podcasts via:

* Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627

* Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga

* Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX

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* TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/

* YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg

* Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights

* iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/

If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

In this episode of the CodeCast, Terry continues her Top 10 Tuesday advice on clarifications to the 2021 EM Guidelines for Office and Other Outpatient visits.

There is still a lot of confusion: and with the 2023 rules only months away, we need to figure out how to navigate the newest rules.

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You can subscribe to our podcasts via:

* Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627

* Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga

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* TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/

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If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

This week Terry’s focus on “coding” looks into add on codes and their descriptors: mainly the three types of add-on codes as described by CMS.

Is there ever a time that an add-on code can stand alone? Maybe!

Tune in this week for this new topic on medical billing coding.

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You can subscribe to our podcasts via:

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If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

This week on the CodeCast Podcast, Terry discusses some important tips to successfully negotiate your payer contracts.

By the way: this should include your coders as part of the negotiating process!

Terry also covers other topics such as focusing on payers that are below the Medicare fee schedule, ancillary services coverage, and incorporating coverage policies that speak to a potential recurring or new pandemic.

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You can subscribe to our podcasts via:

* Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627

* Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga

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* TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/

* YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg

* Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights

* iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/

If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

In this episode of the CodeCast Podcast, Terry gives regulatory guidance for Fee-For-Service Time Compensation (previously known as Locum Tenens) billing and coding. She also covers the rules surrounding how to document these services.

Plus, CMS updated their COVID-19 FAQ sheet again, and this time it includes HCC’s and Telehealth inclusion for Risk Adjustment. You don’t want to miss this important episode.

Subscribe and Listen

You can subscribe to our podcasts via:

* Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627

* Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga

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* Stitcher – http://www.stitcher.com/s?fid=156874

* TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/

* YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg

* Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights

* iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/

If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

There should be several goals to meet during a Telehealth patient encounter, such as replicating an in-person clinical encounter as closely as possible. The strategies for incorporating learners into the visit should be the same as for in-person encounters.

Proponents of Telehealth have not addressed this issue, however, Telehealth should be expanded.

Terry discusses the best practices for a Telehealth visit, and also how to make sure your “webside manner” is up to part.

Plus, our bonus coding question addresses an MDM option from a low-to-moderate encounter.

Subscribe and Listen

You can subscribe to our podcasts via:

* Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627

* Google Podcasts – https://play.google.com/music/listen#/ps/Ia47t6quqphhsanlzpajk37yiga

* Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX

* Stitcher – http://www.stitcher.com/s?fid=156874

* TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/

* YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg

* Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights

* iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/

If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/