It’s time for another round of frequently asked questions as Terry’s expertise covers orthopedic surgery, imaging, data points for E/M, and administrative charges for practices. She also answers questions relating to multiple E/Ms on the same date by the same and different physicians from the same group practice. Tune in for a lot of good […]

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We all know the age-old question, “Where does it say that?” In this episode, Terry brings receipts, explaining it’s been this way since 2003: “Reviewing results of laboratory tests, phoning results to patients, filing such results, etc., are Medicare-covered services. Payment is included in the physician fee schedule payment for the evaluation and management (E/M) services to […]

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An ADR (Additional Documentation Request) is a request from CMS or another insurance payer for additional documentation to review a claim. Most of these requests come from payer investigative units looking for medical necessity support. Terry discusses how to handle these requests, as well as how to ensure they are addressed promptly to meet the […]

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If the provider discusses their preferred management options with the patient, do they receive the “risk” credit even if the patient declines it? If yes, how long do they get to capture it? Terry breaks down, citing references, how to handle this MR element and ensure the providers are receiving the correct “risk” value for […]

The post Who Gets the Credit for MDM Risk Element? appeared first on Terry Fletcher Consulting, Inc..

In this episode of the CodeCast podcast, Terry discusses the differences between APCM and CCM services and what is needed to report either. Compliance issues are seen with many care management service records. Terry covers how to follow best practices to ensure you follow the published guidance. Subscribe and Listen You can subscribe to our […]

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Medical Coding provides standardized language that ensures all healthcare providers involved in a patient’s care are on the same page. The coder’s role is to be accurate, communicative, insightful and focused on a positive patient outcome. A patient’s financial health can impact their clinical health, and medical coders need to be recognized for their role […]

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This week’s CodeCast summarizes the recent ICD-10-CM documentation guidelines instructions on sepsis, obesity, and COVID-19 reporting. Terry also provides more guidance on E/M risk in prescription drug management and caution with PSAs in patient documentation. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube […]

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More medical claims denials could be avoided if coders took the extra minute to make sure that the diagnoses that need to be linked to a specific line item were pre-billed. Also, when billing for diagnostic procedures on a complaint that moves to a minor, therapeutic, or surgical procedure, denials will happen when the diagnosis […]

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