CodeCast | Medical Billing and Coding Insights

In today’s ever-changing patient profile, it is important that healthcare professionals embrace an attitude of change. We must recognize that staff needs training on more than the ICD-10-CM associated conditions for LGBTQ+ patients: they also need training on inclusive-language in the practice for intake forms and conversations in general.

Terry discusses what it takes to make your practice LGBTQ friendly for this new alternative medicine patient population.

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CPT Modifiers are valuable coding tools that explain to payers the specific work that was done by a physician during treatment of a patient.

CPT modifiers 25 and 26, are mandatory to justify services performed. More specifically, these codes deal with the intent of other services performed at the same encounter, as well as location of services for the 26 modifier.

Terry will help dispel some of the confusion, and explore some of the most common uses of these modifiers, the reimbursement impact, and when and how to utilize them correctly.

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Changes are coming for ICD-10-CM. Terry summarizes the new, revised, and deleted codes for 2020, along with a frequently asked question: “Can we use the result of a diagnostic test as the patient diagnosis? Or do we have to use the clinical indication for the test upon presentation for the test?”

Ms. Fletcher will cover the AHA policy and also address the CDI implications for ICD-10-CM coding while getting back to basics.

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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/

The rules surrounding signing a physician note are from the general E/M documentation guidelines. The main concern is the timely completion of medical records.

This issue has both billing and compliance ramifications.

While the issue of legibility has been largely addressed by increased utilization of electronic health records (EHRs), completion of the record through the inclusion of proper documentation and a dated signature continues to be of concern.

What does it mean for a medical record to be complete?  Is the record complete when it contains the documentation of the patient encounter but is not signed and dated?

Tune in as Terry covers these topics and more in her latest CodeCast.

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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/

In the latest edition of the CodeCast Top 10 Tuesday, Terry takes us through Spine ICD-10 coding challenges. From Critical Care situations to Transgender coding (that has been a new topic of late) tune in as Terry responds to the coding and billing questions of the month.

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You can subscribe to our podcasts via:

* iTunes – https://itunes.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627

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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/

Are your physicians asking you to “Patient here to establish care” and trying to bill this as a Level 5 visit…  when it is actually Preventative Services?

Terry clarifies the difference between Preventative Services and EM Problem-oriented Services.

She also discusses the billing of both services and the patient share of cost impact, as well as a rant about sleep deprivation. (Are you experiencing it?)

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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/

There are ways to represent professionalism: but what does it really mean to you?

On today’s episode, Terry discusses ways to be inspired on the job to best show professionalism in a Healthcare environment. Her tips will help you feel inspired at your job, but she also goes the extra distance to discuss how professionalism can be perceived by the way patients view your office. What are some of the tell-tale signs that a practice may need a makeover?

Those signs fall into three broad categories: space, appearance, and productivity.

Terry discusses how to identify if your practice is costing you patients simply from a design and workflow situation, and how to fix it.

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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/

Despite the increased resources and references for critical care billing, critical care reporting issues persist.

Medicare data analysis continues to identify 99291 as high risk for claim payment errors, perpetuating prepayment claim edits for outlier utilization and location discrepancies.

In this episode, Terry tackles this topic with documentation recommendations to keep you audit-proof with tips for how to code these high ticket items.

Also, do you know what the ICD-10-CM code X34.XXXA is?

Yep… there is an earthquake in there somewhere!

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Use care when using “time” to support an E/M service: The Documentation Guidelines are clear that there are History, Exam and MDM elements necessary to support each level of service.

However: “…when counseling and/or coordination of care dominates (more than 50%) of the encounter with the patient and/or family (face-to-face time in the office or other outpatient setting or hospital) then time shall be considered the key or controlling factor to qualify for a particular level of service.”

Not all situations will allow for this exception, and certain situations need to be clarified for appropriateness. Can you pass an audit if you use time?

Terry will also discuss your documentation evidence that a counseling and/or discussion was had with the patient.

Plus, a bonus topic: Are your patients having you dropped from your commercial contracts? Listen in to find out.

Subscribe and Listen

You can subscribe to our podcasts via:

* iTunes – https://itunes.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627

* Google Play Music – 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

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 latest Q&A, Terry gives advice on how to email like a boss and own your job in healthcare.

Also, Terry talks about the new wave of AI (Artificial Intelligence) and how no one is talking about the potential pitfalls on relying on technology without the “human factor” in healthcare algorithms.

Subscribe and Listen

You can subscribe to our podcasts via:

* iTunes – https://itunes.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627

* Google Play Music – 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

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