The Pulse

Behind the Scenes of Value-Based Care Performance by The Pulse by AAPC

New technology in kidney stone treatment is raising coding questions for urology teams. In this episode of The Pulse podcast, AAPC sits down with Ellen Evans from Calyxo to discuss how the company worked with CMS to establish a new facility code and what coders need to know when reporting these procedures.

Listen to learn:

Why a new facility procedure code (C9761) was created 

When to report CPT® codes 52353 or 52356 for physician services 

When Modifier 22 may apply — and how documentation supports it 

How physician and facility coding differ for these procedures 

Where coders may encounter prior authorization or denial challenges

How Calyxo’s CVAC system is changing kidney stone treatment workflows 

If your team codes urology procedures, understanding how new technologies affect coding and reimbursement can help prevent denials, support accurate documentation, and ensure procedures are reported correctly.

Want to build stronger, more resilient coding teams? In this episode of The Pulse, Mary Leidy of Nebraska Medicine shares insights from her 30+ years in revenue cycle — including what it takes to build, grow, and support high-performing coding and finance teams. Mary shares proven strategies for:

Developing trust across coding, billing, and revenue cycle teams

Keeping morale high during high-stress times like audits and year-end

Creating a supportive culture where feedback is educational, not punitive

Supporting ongoing professional development and closing skill gaps

Onboarding new staff quickly and effectively

From Homelessness to Health: Elevating SDOH in Clinical Documentation by The Pulse by AAPC

Decoding G2211: Answers to Your Questions by The Pulse by AAPC

Healthcare professionals are under increasing pressure to do more with less. Enter AI — a powerful tool designed to ease documentation burdens and improve coding accuracy. In this episode of The Pulse, Dr. Will Morris, Chief Medical Officer at Ambience Healthcare, discusses how AI is: 

Reducing provider burnout by streamlining clinical documentation. 

Improving coding accuracy for better revenue cycle outcomes. 

Supporting, not replacing healthcare teams.  

Whether you're in CDI, coding, or revenue cycle management, this episode offers insights on how AI can elevate your work.

In the latest episode of The Pulse, we dive into the world of healthcare finance, focusing on the complexities of coding, billing, and revenue cycle management. Featuring Stephanie DeBarge, a seasoned expert in hematology and oncology practice management, this episode provides insights into the challenges and solutions in managing new and emerging drugs, and best practices for ensuring compliance and optimizing revenue. You’ll learn:

The multi-step FDA drug approval process and its impact on billing

Strategies for managing clinical trials and billing for new drugs

The importance of accurate National Drug Code (NDC) numbers and compliance

How to implement and document drug waste using the JZ modifier

Essential lab work and documentation practices for administering drugs

Valuable resources for coders to find up-to-date drug information

Join us as we explore the benefits of outsourcing coding support to manage staffing shortages, overcome backlogs, improve efficiency, and save money. In this episode of The Pulse, Lori Cox is joined by Melinda Craig, RHIA, CCS, AAPC Director of Coding Services, to discuss how outsourcing coding can provide a much-needed boost for healthcare organizations. They’ll explore why 90% of hospital leaders are considering third-party vendors for coding support and how outsourcing can free up valuable resources for essential tasks. From quality assurance to data security, they address common concerns and provide practical tips for vetting potential outsourcing partners.

Discover the power of leveraging third-party coding support to:

• Address staffing shortages

• Overcome backlogs

• Enhance operational efficiency

• Save money

In this episode of The Pulse, Lori Cox is joined by Lamon Willis, a seasoned expert with 20+ years of experience in healthcare auditing, billing, coding, and consulting, now serving as Solutions Director at AAPC Audit Services. Together, they dive into the challenges and opportunities facing healthcare institutions today, highlighting key areas to identify root causes for gaps in reimbursement. From navigating the complexities of hospital margins to leveraging price transparency regulations, this episode offers insights to empower you to make decisions that lead to financial success. 

Key Discussion Points: 

Hospital margins and financial challenges 

Price transparency and competitive dynamics 

Contract negotiation and management 

AI and technology in revenue optimization 

Identifying revenue drain areas 

Pre and post charge audit reviews

As audits are increasing across the country, you need to know how to defend your reimbursements from payers and CMS. In this podcast of The Pulse, Lori Cox sits down with Michael Miscoe, an accomplished attorney, coding and software development professional, and former President of AAPC’s National Advisory Board.

They discuss post-payment audits and clawbacks, dive into statistical samples, and share insights on defending coding accuracy, when to seek legal advice, and how to leverage third-party support if audited or fined.

Listen now to:

Explore the best approach for compliance plans, especially for smaller physician practices.

Uncover the complexities of auditing medical claims, including identifying and correcting errors in E/M services.

Discover distinctions between federal healthcare program claims and non-federal claims, unraveling the obligations triggered by potential incorrect payments.