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CodeCareer.io

CodeCareer.io

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Chatting, learning and sharing life's successes & failures with cool people in the development, tech & startup space. Support this podcast: https://podcasters.spotify.com/pod/show/codecareer/support
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CodeCast Zambia

CodeCast Media

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CodeCast is a Zambian podcast that focuses on everything technology. We highlight innovations in AI and Machine Learning as well as the latest in data science. We cover releases from major technology companies and the effect these releases have on the developer and consumer community. We celebrate the role developers play in shaping the future of technology, both from a uniquely Zambian perspective to the repercussions on a global scale.
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show series
 
In this Top Ten Q&A episode, Terry tackles what the focus of any telehealth audit should be. Auditing Telehealth encounters is more that just looking at the coding. It should also include medical necessity, the technical and procedural aspects of the service, and on patient satisfaction and outcomes. She also recommends an external audit if interna…
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You must have a collaboration agreement in place when hiring mid-level providers or QHPs (such as nurse practitioners, physician assistants, or clinical nurse specialists) to act on your behalf with treating patients. Collaboration agreements are mandatory in most states but rules differ from state to state. Also, due to failed compliance policies,…
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Critical care in 2024 can be tricky, with inclusions, carve-outs, and a time component. Are there exceptions when PA/NPs are involved in critical care services? What has to be documented? You may find some rules you didn’t know about. Terry has all of the answers in this episode of the CodeCast podcast, sponsored by Decision Health, LLC. Subscribe …
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What happens when a provider meets with a family to discuss and develop a care plan for patients? Providers will give the parent the option to have the patient present or just the parent/guardian due to the sensitivity of the discussion. Some scenarios where this may occur are cancer patients where the family wants to talk to the provider alone on …
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When a Medicare beneficiary arrives at a hospital in need of medical or surgical care, the physician or other qualified practitioner must decide whether to admit the beneficiary as an inpatient or treat him or her as an outpatient. These decisions have significant implications for hospital payment and beneficiary cost sharing. Not all care provided…
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In this week’s episode of the CodeCast podcast Terry discusses collecting information on medical practice websites. How you collect data on a website is equally as important as the data itself. If a patient doesn’t mention a medical condition, their information may still be considered as PHI. Terry covers requirements, such as PHE and ePHI access, …
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Terry discusses how to be accurate in your documentation when picking the low, moderate or high element(s) of MDM. When listing “problems addressed” in your E/M record, and considering chronic conditions, the definition of a stable, chronic illness, per AMA/CPT states, “stable” to categorize MDM as defined by the specific treatment goals for an ind…
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CPT says: “If no specific CPT or HCPCS code exists, then the procedure must be reported using an appropriate unlisted CPT code.” Unlisted CPT codes, when reported with appropriate documentation, should be reimbursed. It is the responsibility of the surgeon, and the coding or billing staff, to report unlisted CPT codes and follow up with payors if a…
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Join Terry Fletcher on this week’s CodeCast as her Top 10 Tuesday returns. Terry has a packed podcast as she answers questions about G2211, 99459, and new versus established patients. This is one episode you don’t want to miss for insights and resources to your most important coding, billing, and compliance questions. Subscribe and Listen You can s…
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Did you know there are CPT codes for online digital E/M services? CPT codes 99421-99423 are for use by physicians, physician assistants, and advanced practice nurse practitioners performing brief online E/M services via a secure platform. (Like a patient portal.) What is required to bill for these services? Consent? Interactive Conversation? Modifi…
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We have received questions left and right regarding the new Medicare add-on code +G2211 – for complexity and serious condition provider/patient long-term relationship care. We discussed this code in September 2023, when it was a CMS proposal, but now that it is effective let’s look at the realities. The Modifier -25, when reported on an E/M claim w…
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This episode of the CodeCast is sponsored by DecisionHealth LLC, Part B News. The PHE, public health emergency, ended on May 11th, 2023. However, the confusion on reporting Telehealth services continues. It is imperative to be up-to-date on all of the current published guidance. In this episode, Terry shares her Telehealth services tips and checkli…
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*** CORRECTED AUDIO *** The generative artificial intelligence (also known as “AI”) boom is in full swing now. Terry has been researching AI in healthcare: some people are thrilled with it, while others are not. Is scraping the web for training data ethical? Who decides whether AI documentation and “expertise” is any good? How should copyright law …
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This week on the CodeCast Podcast, Terry explains the new 2024 CPT add-on code +99459 for pelvic exams when assistant clinical staff is needed to help the physician. Check out today’s episode to make sure you know what the documentation and coding rules are before diving into this situation. Subscribe and Listen You can subscribe to our podcasts vi…
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A physician, non-physician practitioner (NPP), or clinical psychologist can assess a patient who they suspect may have unmet needs (defined as Social Determinants of Health or SDoH. In 2024 CMS is adding another G-code for SDoH assessment during an E/M encounter. This is for an assessment: not a screening. This service is not intended to be a scree…
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In this episode of the CodeCast Podcast, Terry Fletcher discusses the seven elements of an effective compliance program. Last month, HHS-OIG outlined and updated this guidance. With a broad spectrum of healthcare entities, staff, and providers playing a role in healthcare delivery today, this information can be generally applied across the entire h…
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In the ICD-10-CM guidelines, there is an entry for only history codes at I.C.21.c.4, and there are two types of history Z codes: personal and family. History codes can be used on any medical encounter regardless of the reason for the visit. A history of an illness may alter what treatment is ordered for a patient, so it is important information to …
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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 episo…
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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. Subscribe and Listen You …
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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…
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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 a…
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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? Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing…
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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 br…
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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…
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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. Subscribe and Listen You can subscribe to our p…
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