CodeCast | Medical Billing and Coding Insights

Terry Fletcher
  • 4.6 (203)
  • BUSINESS
  • UPDATED WEEKLY

Taking the Business of Medicine to the next level

  1. 3D AGO

    APCM Is Not a Gym Membership

    A recurring question in Advanced Primary Care Management (APCM) is whether practices can bill every month for a patient once they’re enrolled — even if no services were provided during that month. Terry’s stance is clear: no. APCM isn’t a subscription model or a gym membership. These are medically necessary services tied to ongoing clinical need, and billing without documented work invites unnecessary audit risk. On today’s CodeCast, Terry breaks down why monthly billing without services is problematic, how other consultants interpret the rules, and what practices should consider to stay compliant. Subscribe and Listen Find all of Terry’s official links in one place: https://www.terryfletcher.net/links The post APCM Is Not a Gym Membership appeared first on Terry Fletcher Consulting, Inc..

    9 min

  2. MAR 3

    Pre‑Populated EMRs Are Not Templates

    Are your EMR templates helping—or hurting—your documentation? Terry dives into the difference between pre‑formatted templates and pre‑populated medical records, and why that distinction matters more than most providers realize. Pre‑populated fields can create inaccurate documentation, audit red flags, and even malpractice risk. Terry also reviews a NAMAS article that sheds light on how this issue is showing up in real audits and what practices should watch for. Subscribe and Listen Find all of Terry’s official links in one place: https://www.terryfletcher.net/links The post Pre‑Populated EMRs Are Not Templates appeared first on Terry Fletcher Consulting, Inc..

    12 min

  3. FEB 24

    Are You Misusing Modifier 25?

    Modifier 25 remains one of the most audited—and most overused—modifiers in medical coding. But the problem isn’t just coding mechanics. It’s about appropriateness, credibility, and documentation. Designed to represent a significant, separately identifiable E/M service performed on the same day as a procedure, Modifier 25 is too often applied automatically, like scotch tape slapped on to avoid an edit denial. When the documentation doesn’t support it—or when the service isn’t truly separate—misuse doesn’t just trigger denials. It invites deeper scrutiny and puts the entire visit under the microscope. Terry breaks down why Modifier 25 is so frequently misapplied and shares her smart, reliable method for determining when it’s actually necessary. Listen to today’s CodeCast to learn how to protect your claims, your documentation, and your credibility. Subscribe and Listen Find all of Terry’s official links in one place: https://www.terryfletcher.net/links The post Are You Misusing Modifier 25? appeared first on Terry Fletcher Consulting, Inc..

    12 min

  4. FEB 17

    Who’s Doing the Coding — Providers or Coders?

    Many EMRs now embed ICD‑10 and CPT codes directly into the medical record. But is that advisable? The safest approach is still to let the documentation stand on its own. The content of the record should support the coding choices, and coders and auditors should base their work on the medical facts as documented. Codes can—and should—be applied only after the documentation is complete. On today’s CodeCast episode, Terry explains that when providers insert billing codes into the note, the intention may be good, but the risk of contradictions or inaccuracies can outweigh any perceived benefit. Should medical record documentation stand alone, without templated teaching language that was never meant to be included? Should codes appear in the record simply to give the impression of accuracy, rather than allowing the documentation to speak for itself? Subscribe and Listen Find all of Terry’s official links in one place: https://www.terryfletcher.net/links The post Who’s Doing the Coding — Providers or Coders? appeared first on Terry Fletcher Consulting, Inc..

    13 min

  5. FEB 10

    The Compliance Gap in Ambient AI Scribing and Informed Consent

    When performing audits, the same macro statements keep appearing in progress notes: ambient AI scribing was used to create the documentation, and the note may contain errors. The pattern mirrors what happened when early talk‑to‑text tools rolled out. From a patient’s perspective—especially someone with little or no understanding of ambient AI scribing—this raises real questions about whether they truly understood what was used during their visit and what they were consenting to. Terry breaks down this issue this week, drawing on an excellent article by Stephanie Allard, RHIT, to explore informed‑consent workflows, compliance expectations, and liability concerns surrounding Ambient AI Scribing. Subscribe and Listen Find all of Terry’s official links in one place: https://www.terryfletcher.net/links The post The Compliance Gap in Ambient AI Scribing and Informed Consent appeared first on Terry Fletcher Consulting, Inc..

    12 min

  6. FEB 3

    Cardiology PCI Coding Made Clear

    The 2026 updates introduced new and revised PCI CPT codes, and even experienced coders are feeling the impact. With fresh code options and shifting applications, accurately capturing Coronary Intervention services—and protecting revenue—has become more challenging. In this episode, Terry breaks down what’s changed, how to navigate the nuances, and what you need to know about bundling rules to stay compliant and confident. Subscribe and Listen Find all of Terry’s official links in one place: https://www.terryfletcher.net/links The post Cardiology PCI Coding Made Clear appeared first on Terry Fletcher Consulting, Inc..

    13 min

  7. JAN 27

    The Pros and Cons of ChatGPT for Healthcare

    OpenAI’s launch of ChatGPT Health is reigniting a familiar debate about patient‑facing AI — how much it can empower people to access medical information, and how much it might amplify misinformation, anxiety, or privacy risks. ChatGPT Health allows users to securely enter personal health information and use ChatGPT’s AI to better understand and manage their health concerns. Physicians note, however, that its impact on care will depend heavily on guardrails around accuracy, transparency, and how patients use the tool between visits. In this episode, Terry breaks down the pros and cons of AI in healthcare and highlights what providers should be cautious about as these tools become more common. Subscribe and Listen Find all of Terry’s official links in one place: https://www.terryfletcher.net/links The post The Pros and Cons of ChatGPT for Healthcare appeared first on Terry Fletcher Consulting, Inc..

    17 min

  8. JAN 20

    Time Based EM and Care Management Compliance

    Time-based coding can be a powerful, defensible approach for E/M services—when it’s documented the right way. But vague or incomplete time notes can open the door to denials, audits, and compliance problems. In this episode, Terry breaks down the exact language, documentation elements, and inclusions you need to make time-based E/M coding hold up. She also covers Care Management Services, their time requirements, and how to avoid overlapping time pitfalls. Tune in for a clear, practical walkthrough. 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 Time Based EM and Care Management Compliance appeared first on Terry Fletcher Consulting, Inc..

    12 min
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