Care Management services are being reported at an all-time high but they are not all alike. Before submitting claims, many providers have not read the directions — or CPT-published guidance and criteria.

Terry breaks down the confusion and discusses why this is more of a value-based service than a monetary windfall. Listen to this informative episode for more details.

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The post Transitional Care Management Services appeared first on Terry Fletcher Consulting, Inc..

After all of the CMS continued updates for Telehealth, we finally got an update from the AMA, that was added to CPT 2024. This gives us the “criteria” on how a service can be CPT considered for Telehealth inclusion.

Terry shares this insight, plus her commentary on how to implement it into your updated compliance programs.

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• 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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The post Telehealth CPT 2024 Rules appeared first on Terry Fletcher Consulting, Inc..

Leveling an E/M visit can be considered very subjective. Clinicians and auditors alike can come to one conclusion or another.

It is important that when you take online advice, you also consider “best practices” and payer-published guidance before you do only the minimum (or what is “technically” correct).

Terry makes this clear distinction in today’s CodeCast Podcast.

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The post E/M Leveling with MDM: Right or Wrong? appeared first on Terry Fletcher Consulting, Inc..

The 2024 Medicare Final Rule was published on November 2nd, and the Split/Shared visit guidance will parallel the CPT guidance. However, CMS will still expect the -FS modifier from the billing provider.

Terry breaks down the rules in this episode to ensure misinterpretations do not have providers reporting incorrectly.

Also, Terry takes a look at abdominal aortic coding.

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The post Final Rule 2024 Shared/Split Visit appeared first on Terry Fletcher Consulting, Inc..

Join us for a great Halloween episode as Terry provides the top ten spookiest ICD-10-CM codes. She also discusses preventative and OV on the same date.

And what happens when a Telehealth video visit loses feed?

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The post Top 10 Tuesday Q&A – Halloween Episode appeared first on Terry Fletcher Consulting, Inc..

CMS recently updated their published guidance, MLN909160 July 2023, with further examples and instructions on how to gather information and documentation when a CERT Audit issues a request for an ADR (Additional Documentation Request).

You don’t want to ignore this, but embrace the process and understand that this oversight helps everyone.

Terry breaks it down. Also, some insights on Telehospital expansions assisting rural communities.

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The post CMS clarifies how to respond to a CERT audit appeared first on Terry Fletcher Consulting, Inc..

Clinical Documentation Integrity, or CID, is important. Outdated information, or information that doesn’t make sense for that date of service encounter, brings into question the reliability of the entire patient record.

Have you updated the language to fit with the current times?

Terry shares a few examples of issues that can raise red flags during an audit.

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The post Is your CDI compromised by dated EMR entries? appeared first on Terry Fletcher Consulting, Inc..

The 2024 CPT codes have been released. Terry briefly looks at the additions, revisions, and deletions and what the E/M code descriptors are revising.

Terry will also offer her last clarification into MNT coding since there continues to be a push to report these codes when the diagnosis is not covered.

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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
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The post A Look ahead to the 2024 CPT codes appeared first on Terry Fletcher Consulting, Inc..

The CPT definition of a significant, separately identifiable service relies on determining the correct level of E/M service to be reported.

Terry discusses what questions should be asked before you determine whether an E/M service justifies the use of modifier 25 according to CPT guidelines, CMS rules, and payer policy language.

Also, this episode’s coding question is a reminder of how to use the TCM rules.

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• TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/
• YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg
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The post Modifier 25 appeared first on Terry Fletcher Consulting, Inc..

Physicians are educated and trained more extensively than any other healthcare professional. A misrepresentation of a practitioner’s level of licensing, i.e., using the clinical term “doctor” when there is no MD or DO behind the term, is not only misleading but can jeopardize patient safety, expectations and outcomes.

Terry dives into this controversial topic, stating where the blurred lines are and the importance of staying in our respective lanes.

Also, this episode’s coding question focuses on the new patient visit 99205.

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

The post Are you blurring the lines on who’s a doctor or a nurse? appeared first on Terry Fletcher Consulting, Inc..