Unraveling Medical Coding

The coding changes to Office / Outpatient Services implemented on January 1, 2021 and the complimentary changes to Hospital Services implemented on January 1, 2023 were designed to minimize documentation burden and allow providers to focus more on patient care. This episode discusses one major unintended consequence of these changes: the shift of the E/M CPT coding bell curves to higher levels.

Topics discussed in this

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NEW: Coding Solutions Evaluation and Management Services, 2024: Coding Solutions Evaluation and Management Services, 2024

Coding Solutions General Surgery, 2024: Coding Solutions General Surgery, 2024

These are our 4 wishes to improve documentation, coding, and healthcare from our hosts Neal Sheth and Dr. Piyush Sheth. There is also a free gift for our listeners.

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This episode discusses the clinical issues, proper coding (using CPT and modifiers), and current payment policies regarding colonoscopies. Unfortunately, because these three aspects are intimately entwined, colonoscopy coding can get quite complex. Hosts Neal Sheth and Dr. Piyush Sheth try to simplify and clarify the concepts behind coding for colonoscopies.

2023 brings a host of changes to medical coding and billing. Dr. Piyush Sheth talks about ICD, CPT, and reimbursement changes including changes to RVU values.

Episode Summary: Medical Documentation has suffered a decline in integrity due to adoption of  Electronic Medical Records and an incomplete understanding of Documentation Guidelines. Hosts Neal Sheth and Dr. Piyush Sheth explore this topic and provide solutions that can strengthen your medical record documentation and make them stand up to scrutiny during audits.

Visit our blog: www.unravelingmedicalcoding.com

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CODING SURGERY: General Surgery, 2022 available on Amazon.

Episode Summary: RVU’s (Relative Value Units) are the currency of healthcare. Hosts and General Surgery Certified Coders Neal Sheth and Dr. Piyush Sheth explore the concept of RVU’s and Geographic Practice Cost Indices and how CMS makes payments.

Visit our blog: unravelingmedicalcoding.com

Don’t forget to subscribe to our podcast: Unraveling Medical Coding

Coding Solutions: General Surgery, 2022 is available now on Amazon

Episode Summary: Modifiers are two-digit codes that can be appended to a CPT code in special situations to justify payment for the service when payment otherwise would be denied. Understanding the proper use of modifiers can lead to better reimbursement. Hosts Neal Sheth and Dr. Piyush Sheth explore some of the most common modifiers used.

Visit our blog: unravelingmedicalcoding.com

Don’t forget to subscribe to our podcast: Unraveling Medical Coding

Coding Solutions: General Surgery, 2022 is available now on Amazon

Episode Summary: Modifiers are two-digit codes that can be appended to a CPT code in special situations to justify payment for the service when payment otherwise would be denied. Understanding the proper use of modifiers can lead to better reimbursement. Hosts Neal Sheth and Dr. Piyush Sheth explore some of the most common modifiers used.

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Full Transcript Available at: www.unravelingmedicalcoding.com

Episode Summary: CMS released their Calendar Year 2022 Medicare Physician Fee Schedule Final Rule on November 2nd. There are significant changes to the PFS conversion factor, billing for Shared/Split inpatient services, Critical Care services, Telehealth services, and Colorectal Screening procedure co-insurance payments among others. Hosts Neal Sheth and Dr. Piyush Sheth try to make sense of these changes and how they affect documentation, coding, and billing.

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CMS CY2022 MPFS Final Rule

Summary of CMS CY2022 MPFS Final Rule

Full Transcript Available at www.unravelingmedicalcoding.com

Episode Summary: Our previous episode dealt with EMR issues relating to documentation quality and ease of use. In this follow-up episode, hosts Neal Sheth and Dr. Piyush Sheth explore concepts on creating a better user environment in EMRs and on a more global level, improving EMR infrastructure.

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Topics discussed in this episode: EMR, EHR, EPIC, Infrastructure

Full Transcript available at: unravelingmedicalcoding.com