CodeCast | Medical Billing and Coding Insights

Latest Episodes:

Obstetrics Coding for 2027 Oct 06, 2026

Show notes

Obstetric coders have likely started to report E/M visits for newly pregnant patients, but they still have a few months before they need to use the full set of new and revised codes and guidelines for maternity care services as we head into 2027.

Terry brings in some recent questions and answers to to help train your team and determine where more research or training is necessary before the full code system goes into effect Jan. 1, 2027. A contributing article in Part B news from 9/28 also was used for this episode.

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ER and Critical Care Services Coding Sep 29, 2026

Show notes

Emergency Department and Critical Care Services are often incorrectly coded because the documentation lacks clarity. Terry discusses the elements necessary to have compliant ER documentation and also what CC services need to make sure they are supported for billing.

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Telehealth when the physician is at home Sep 22, 2026

Show notes

CMS has made permanent the policy that allows a practitioner who furnishes Medicare telehealth services from home, even what the height of COVID is over 3 years in the past. There is also confusion is what is listed as the physician’s practice location?

Terry discusses the answer to this question, as the CCHPCA has now a specific position, and also talks about the difference between Medicare enrollment vs. POS where services are performed. Different rules apply when the practitioner or group operates virtually and has no other physical practice location, and teleradiology is subject to separate enrollment rules.

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ICD-10-CM Coding for Diabetes Sep 15, 2026

Show notes

How does documentation specificity affect diabetes code assignment?

The details included in a medical record can significantly affect ICD-10-CM code assignments. Terry discusses several examples to show how documentation specificity, provider links between conditions, and medication use can influence diabetes coding.

There are certain conditions for which a cause-and-effect relationship with diabetes can be assumed under coding guidelines; however, not every condition can automatically be considered related to diabetes. When a provider specifically links a condition to diabetes, that documentation can provide crucial support for accurate code assignment.

Tune in today for some insights into the frequent, although challenging condition to code.

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E/M Coding: What Not To Do Sep 08, 2026

Show notes

Terry gives us scenarios that are examples of work that doesn’t amount to an E/M service or can’t be counted toward an E/M service, followed by discussion of the reason why along with similar situations where it might be appropriate to report a stand-alone E/M service or count it toward an E/M service. We have to make sure we are not caught in the FWA that is happening all over the country. Listen in this week to protect your practice.

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The post E/M Coding: What Not To Do appeared first on Terry Fletcher Consulting, Inc..

Technically correct and pre-ops Sep 01, 2026

Show notes

The AMA specifically states that the risk element concerns patient-management decisions made by the physician/QHP reporting the E/M service. It also emphasizes that surgical risk depends on the particular patient’s circumstances and risk factors as assessed by that physician. Terry discusses “pre-op clearance” visits today and their level of risk, along with the billing of 76937 controversy.

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Top 10 Tuesday Medical Coding Q and A Aug 25, 2026

Show notes

Terry discusses the 1op 10 Coding Corner Membership questions of the quarter, including Telehealth, the reality of voice recognition transcription disclaimers and some of the new proposals from CMS slated for 2027. Tune in to get the rundown.

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E/M Auditing Specialty Providers Aug 18, 2026

Show notes

Today on the CodeCast Podcast, Terry discusses a topic that comes up in auditing conversations frequently: “that an auditor needs to specialize in a certain specialty before they can audit E/M services for that specialty.” That is not necessarily true.

I understand where that thought comes from.

It can absolutely help for an auditor to be familiar with the anatomy, medications, terminology, and common treatment plans within a specific specialty. That knowledge can make the note easier to follow. It may also help the auditor know when they need to ask a question or do additional research. But does it also create a bias?

Let’s chat about this today on the CodeCast.

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CMS Fee Schedule Proposals Aug 11, 2026

Show notes

What are we anticipating for 2027 in the MPFS? This week Terry gives us a rundown on what to expect, how to respond before the comment period ends, and what needs to happen to strengthen our private practice providers. Listen in…

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Incident to Update: Commercial Plans Aug 04, 2026

Show notes

Incident-to Billing Update: More Blue Cross Blue Shield plans, along with the three largest commercial insurance carriers, are tightening their policies on the reporting and reimbursement of services billed under Medicare’s “incident-to” guidelines.

In today’s episode of the CodeCast Podcast, Terry reviews these recent policy changes, highlights key effective dates, and explains what physicians, coders, billers, and practice managers need to know before submitting claims. Tune in to learn how these evolving payer requirements could impact your reimbursement and the compliance steps you should be taking now.