CodeCast | Medical Billing and Coding Insights

Terry Fletcher

Taking the Business of Medicine to the next level

  1. 11 NOV

    Leveling a Visit for an Acute Uncomplicated Illness

    The September 2025 issue of CPT® Assistant raised important questions about how to appropriately level an evaluation and management (E/M) encounter when the presenting problem is an acute, uncomplicated illness or injury. A growing number of providers have been assigning Level 4 codes simply because an antibiotic was prescribed. However, this approach may not be accurate when considering the full scope of the encounter and its required documentation elements. Terry examines this trend and explains why many payers have responded by implementing automatic down-coding policies to address potential overcoding. 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 – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ The post Leveling a Visit for an Acute Uncomplicated Illness appeared first on Terry Fletcher Consulting, Inc..

    16 min
  2. 4 NOV

    Claim Denials: Coding Mistake or Billing Oversight?

    Medical billing and coding encompasses a wide range of responsibilities—from patient registration and claim reimbursement to final payment delivery to the provider. Navigating this process requires close collaboration among billers, coders, insurance companies, patients, and various healthcare professionals. Although often grouped together as a single discipline, billing and coding are distinct roles that work in tandem to support the healthcare revenue cycle. If you’re considering a career in medical billing and coding, it’s essential to understand that these are separate professions, each demanding unique skills and personality traits. Terry breaks down the individual roles and how they work together to keep the system running smoothly. 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 – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ The post Claim Denials: Coding Mistake or Billing Oversight? appeared first on Terry Fletcher Consulting, Inc..

    11 min
  3. 28 OCT

    Understanding Who Can Bill Preventive G Codes

    As more practices begin offering screening services, questions around billing for Medicare-specific G codes are becoming more common. In this episode, Terry breaks down when it’s appropriate to bill for preventive services, which providers are eligible, and what requirements must be met. To bill G codes, providers must be enrolled as Medicare suppliers and follow specific program rules. Eligibility varies by service type—some require enrollment in specialized programs like the Medicare Diabetes Prevention Program (MDPP). For instance, pharmacists can only bill for certain services if certified as DSMT practitioners. Tune in for real-world examples and expert guidance on navigating preventive service billing. 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 – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ The post Understanding Who Can Bill Preventive G Codes appeared first on Terry Fletcher Consulting, Inc..

    18 min
  4. 14 OCT

    Tips on Reviewing MRs for Coding Accuracy

    In this episode, Terry tackles a common pitfall in coding and CDI workflows: skipping straight to the Assessment and Plan (A/P) section of an E/M note to determine service level. Are you overlooking key documentation that could support medical decision-making, risk, or time? She also calls out a frequent habit among surgery coders—coding from the report header instead of the full operative detail. What assumptions are being made based on titles alone? What critical elements might be missed or misinterpreted? Terry breaks down why accuracy isn’t enough. Coders must be diligent, thorough, and intentional in their medical record reviews and extrapolation processes. Lazy shortcuts can lead to compliance issues, missed revenue, and flawed data. Tune in for practical insights on how to elevate your coding practices and avoid costly oversights. 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 – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ The post Tips on Reviewing MRs for Coding Accuracy appeared first on Terry Fletcher Consulting, Inc..

    12 min

About

Taking the Business of Medicine to the next level

You Might Also Like