CodeCast | Medical Billing and Coding Insights

The AMA has published the 2021 E/M changes that they intend to make in 2021. We’ve seen when Medicare and CPT do not agree on how to report a specific service, or group of services, Medicare may produce a HCPCS code(s) with specific guidance for Medicare-contracted providers to follow.

In this breaking news segment, Terry discusses the final changes, how it will impact your practice, when to start training, and how your “clinical team” factors into all of this.

Also, Warafin (anticoagulant management) is the coding topic of the day, with details on the why a patient takes it, why they need to be monitored, and how to code for 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/

The practice of cloned (or copy and pasted) documentation is a significant issue in the use of Electronic Health Records (EHRs). AMA found in a recent study that only 18% of medical records documentation was newly entered.

Terry discusses how the use of cloned notations and documentation can damage the integrity and trustworthiness of a medical record: and also that of a physician.

The growing abuse of this practice or “EHR feature” is an area of government audit focus. We need to act on how this can affect the safety and quality of care for patients, as well as the potential for fraud and abuse allegations.

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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/

Arguably the most important of the three key components of E/M Coding, the Medical Decision-Making ( MDM ) reflects the intensity of the cognitive labor performed by the physician. There are four levels of MDM of incrementally increasing complexity. Terry navigates you through the process, identifying errors that can lead to over and under coding, but also non-compliance.

Terry also discusses the newest ICD-11 diagnosis of “burnout”. Yes, it is a real diagnosis now.

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You can subscribe to our podcasts via:

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

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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 Top 10 Tuesday, Terry discusses the top things you must have for your medical billing software to be efficient, effective, and generate revenue success.

Terry also shares her top 5 coding questions this month, including Trigger Point Injections, ICD-10 coding for shin splints, and more.

Join us for an episode packed full of healthcare information you won’t want to miss.

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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

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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/

Do you have “burning” E/M questions that you can’t get a straight answer to?

Terry covers many of those “burning” topics in today’s episode, such as:

* Can I use HPI elements for my ROS scoring?

* Can I get a point if I order an EKG and read the EKG?

* What if the patient is just seen for follow up chronic conditions and how do we report that in the history?

* And more!

Terry also revisits the consult versus new patient visit for payer plans still using those codes.

Hopefully this episode of the CodeCast finally gets your questions answered!

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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/

Sometimes as coders and billers we tend to look at a report and think, “Well, what my physician meant to say was…”

We then code from that assumption… and there is nothing more dangerous than assumptive coding!

Yet, it happens all of the time, especially when a coder gets comfortable in their job or with their physician’s documentation.

Terry looks at specific language in today’s CodeCast and asks: “Can we code for it? Yes, or No?”

You will be the judge on this one as Terry expertly gives you the answers on when you are right, and also when you are wrong.

As an added bonus, Terry also leads a discussion on how to “ace” the modifier-59 coding.

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/

Transitional Care Management (TCM) is increasing in its utilization and billing… but are you doing it right? Is your patient eligible? It is worth the administrative work versus the revenue generated?

Tune in to the CodeCast this week as Terry answers these questions and more. Plus, there’s a bonus discussion on finding your professional bliss.

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/

Among one of the most popular questions Terry receives is about reducing prior authorization hassles.

Primary care providers and specialty physicians alike rank prior authorizations as one of the greatest frustrations in clinical practice. Aimed at reducing unnecessary or unwarranted spending, the practice of requiring prior authorizations has been blamed by clinicians for delaying or preventing needed care and adding yet another layer of administrative burden to the practice of medicine.

Terry shares 10 proven tricks of the trade to help pare back this burden in your practice and get to the business of taking care of patients.

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/

What are the most common claim denials?

In this episode of the CodeCast Podcast, Terry looks at a recent survey of over 100 medical insurance payers to determine 13 of the most common reasons claims are denied and how practices can eliminate them.

The survey, based on over 100 insurance payers (including Medicare Contractors) reveals reasons which are becoming as routine as submitting a claim!

Using Terry’s recommendations, practices will experience a smoother revenue cycle plus find greater financial success.

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/

Interoperability refers to the basic ability of computerized systems to connect and communicate with one another readily: even if they were developed by widely different manufacturers in different industries.

Being able to exchange information between applications, databases, and other computer systems is crucial for the modern economy and healthcare today. But is this HIPAA compliant?

Terry shares her insight on this matter, as well as authoritative references, so you can make sure you are above reproach as technology moves healthcare forward.

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/