CodeCast | Medical Billing and Coding Insights Terry Fletcher

CMS published their PFS on July 10th. You have 90 days to comment and be heard on these changes including the proposed 2.93% reduction to the Physician Fee schedule.

In this edition of the CodeCast, Terry goes over the talking points and what Part B providers can expect coming into the new 2025 calendar year.

You don’t want to miss this important episode!

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Terry discusses when it is and isn’t appropriate to report a preventative visit with an office visit on the same date.

How did the patient present? What is the share of the cost-to-patient implications? And what will payers want to see for medical necessity?

Terry covers it all in this edition of CodeCast podcast.

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

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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/

In today’s episode of the CodeCast podcast, Terry updates you on the latest CMS NCCI Edits, effective July 1st. She gives you the insight on the PTP and MUEs expected, along with some commentary and best practices on charging patients for no-show appointments.

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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/

Principal Care Management (PCM) services are services for a single high-risk disease, 30 minutes a month, personally provided by a physician or NPP. This is for patients with one complex chronic condition expected to last three months which places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or death.

Does your patient qualify? Terry covers the details on documentation requirements (on CPT page 55) and its importance for compliance.

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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/

Can you guess the main reason why medical billing claims are rejected? According to recent studies, most clinics account for 15-25% of inaccurately submitted monthly claims. Those inaccuracies must be corrected, resulting in an annual loss of revenue worth tens of thousands of dollars.

Among the most popular reasons medical claims return to a clinic are due to incorrectly entered or missing information. When a clinic is unable to bill the insurance company properly, a rejected claim or frequent denials can put you in a position to provide an unexpected bill to the patient.

Too much confusion around the billing process can discourage patients from visiting your clinic or, much worse, make them put off necessary treatments.

In this episode, Terry discusses the top ten coding and billing mistakes and how to lessen those errors for successful claim submission.

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

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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/

You must make sure your providers and coders understand the overarching LCD criteria for reporting TPIs (Trigger Point Injections).

As of April 1st, five MACs have tightened their rules for TPI coding and reporting. There are new frequencies, ICD-10-CM, anatomical territories, and MUE rules for these services.

Terry outlines the rules and reminds practices that patients need to also be involved in these discussions.

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

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* iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/



If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/