Insightful audio from the global tech advisory firm.
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Taking the Business of Medicine to the next level
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The Global CCS Institute is an international think tank whose mission is to accelerate the deployment of carbon capture and storage (CCS), a vital technology to tackle climate change and deliver climate neutrality. The Capture, Store, Repeat podcast focuses discussions on CCS, unpacking the importance of the innovative technology as a key climate solution.
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Do you have fond memories of the name Nokia? Adrian Hughes and Justin Cohen, life-long Nokia fans, delve deep into the phones, tablets and other weird and wonderful gadgets that once made Nokia a household name. Also join them for candid interviews with people behind-the-scenes at the tech giant, and discover for yourself what really made Nokia so special. MUSIC CREDIT: =========== Title: Can't Sleep - ÆSTRAL Music Link: https://soundcloud.com/aestral/cant-sleep Artist Link: https://soundclo ...
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Welcome to In Production, conversations on the research and development of time-based artworks. Hosted by EMPAC’s engineering and curatorial staff, we talk to artists, technicians, curators, scholars, and makers associated with the production of new work here at the Curtis R. Priem Experimental Media and Performing Arts Center on the campus of Rensselaer Polytechnic Institute in Troy, New York. Through interdisciplinary exchange, this podcast series contributes insight into the creative and ...
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Partnerships Power the Smart Grid of the Future
1:13:08
1:13:08
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1:13:08Our energy landscape is undergoing rapid transformation. The power grid is no longer just infrastructure; it's a strategic enabler for sustainability across industries, allowing us to electrify processes traditionally reliant on fossil fuels. But this transition requires a modern, collaborative approach. Ian Fogg, Director of Network Innovation at …
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Medicare Rules For Experimental or Investigational Services
15:38
15:38
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15:38Medical necessity is defined as services that are reasonable and necessary for diagnosis or treatment of an illness or injury, or to improve the functioning of a malformed body member and are not excluded under another provision of the Medicare Program. Unfortunately, we have many practices trying to slide under the radar the experimental and/or in…
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Behavioral Health Coding and Documentation
15:33
15:33
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15:33Terry discusses Behavioral Health services, best practices documentation and coding specifics. Also, Terry offers some bonus discussion on RAC auditors trying to bait providers into not responding to ADR requests. Check out this episode for intel on these important topics and more. Subscribe and Listen You can subscribe to our podcasts via: Apple P…
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With all of the AI implementation into EHR and EMR systems, there is concern about how providers rely on these AI shortcuts more than ever. Without proper safeguards, accountability, and compliance perimeters, relying on AI could be problematic. Terry discusses the red flags to look for and how to proceed with caution in this new world of technolog…
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Can you get credit for ordering and interpretation of a test?
13:11
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13:11The 2023 CPT® Errata and Technical Corrections added a one-liner on Independent Interpretations that responds to the question, “Can a practitioner get credit for both ordering and interpretation of a test, if documented?” In this episode of the CodeCast podcast, Terry answers this question referencing the March 2023 CPT® Errata and Technical Correc…
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The 2021/2023 E/M guideline revisions read: “The evaluation and/or treatment should be consistent with the likely nature of the condition.” Before this, the CPT® guidelines did not discuss medical necessity. Guidance was left to the payers, particularly Medicare, via the Social Security Act. CMS’s guidance doesn’t necessarily hold regulatory author…
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Top 10 Tuesday Q&A – Coding, Billing, and Compliance Questions
20:27
20:27
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20:27It’s time for another round of frequently asked questions as Terry’s expertise covers orthopedic surgery, imaging, data points for E/M, and administrative charges for practices. She also answers questions relating to multiple E/Ms on the same date by the same and different physicians from the same group practice. Tune in for a lot of good informati…
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Giving Tests Results to Patients… Where’s the Payment?
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15:02We all know the age-old question, “Where does it say that?” In this episode, Terry brings receipts, explaining it’s been this way since 2003: “Reviewing results of laboratory tests, phoning results to patients, filing such results, etc., are Medicare-covered services. Payment is included in the physician fee schedule payment for the evaluation and …
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An ADR (Additional Documentation Request) is a request from CMS or another insurance payer for additional documentation to review a claim. Most of these requests come from payer investigative units looking for medical necessity support. Terry discusses how to handle these requests, as well as how to ensure they are addressed promptly to meet the de…
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The Rise of Intelligent Networks with 5G and IoT
23:37
23:37
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23:37As demand for the internet of things (IoT) and intelligent solutions continues to grow, the 5G landscape must evolve. Over the next couple of years, we expect AI to gain more traction in this space — enhancing availability, managing traffic and providing self-healing capabilities to the network. Moreover, the rise of private networks and hybrid sol…
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Who Gets the Credit for MDM Risk Element?
10:48
10:48
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10:48If the provider discusses their preferred management options with the patient, do they receive the “risk” credit even if the patient declines it? If yes, how long do they get to capture it? Terry breaks down, citing references, how to handle this MR element and ensure the providers are receiving the correct “risk” value for their encounter. Listen …
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In this episode of the CodeCast podcast, Terry discusses the differences between APCM and CCM services and what is needed to report either. Compliance issues are seen with many care management service records. Terry covers how to follow best practices to ensure you follow the published guidance. Subscribe and Listen You can subscribe to our podcast…
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The Crucial Role of the Coder in Quality Patient Care
9:15
9:15
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9:15Medical Coding provides standardized language that ensures all healthcare providers involved in a patient’s care are on the same page. The coder’s role is to be accurate, communicative, insightful and focused on a positive patient outcome. A patient’s financial health can impact their clinical health, and medical coders need to be recognized for th…
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This week’s CodeCast summarizes the recent ICD-10-CM documentation guidelines instructions on sepsis, obesity, and COVID-19 reporting. Terry also provides more guidance on E/M risk in prescription drug management and caution with PSAs in patient documentation. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podc…
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More medical claims denials could be avoided if coders took the extra minute to make sure that the diagnoses that need to be linked to a specific line item were pre-billed. Also, when billing for diagnostic procedures on a complaint that moves to a minor, therapeutic, or surgical procedure, denials will happen when the diagnosis for the latter proc…
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Acute Uncomplicated vs. Acute Complicated E/M Auditing
15:57
15:57
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15:57Terry takes some inspiration from Stephanie Allard’s February 27th for this edition of the CodeCast podcast. Terry discusses the differences and subjective issues between Acute Uncomplicated Illness (or Injury) versus Acute Complicated Illness in the E/M elements of coding and auditing. Subscribe and Listen You can subscribe to our podcasts via: Ap…
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Driving Digital Transformation with Marketplace Partnerships
33:31
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33:31Digital transformation has become a fundamental driver of change across industries, altering how businesses approach procurement, IT infrastructure and decision-making. Procurement is undergoing significant changes as digital transformation reshapes traditional sourcing and supplier management. Organizations are shifting from manual, siloed systems…
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Top 10 Tuesday Q&A – Coding, Billing, and Compliance Questions
23:09
23:09
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23:09Terry’s answering your coding questions in this week’s “Top 10” Q&A. In this episode Terry’s covering APCM, E/M, skin procedures, lab billing, and even a Telehealth bonus. Tune in for insights you won’t want to miss! Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-b…
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Independent Interpretations of E/M Data Points
7:25
7:25
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7:25Terry is under the weather this week, so she gives us a quick segment on the E/M Data point, “independent interpretation”. See page 12 of CPT® under independent interpretation, the last sentence. “A test that is ordered and independently interpreted may count as both a test ordered and interpreted.” Suppose you bill for the professional and technic…
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MWC 2024: The Rise of AI and the Future of Networks
36:40
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36:40MWC 2024 unveiled game-changing innovations that will redefine how we connect, including private mobile networks and AI that learns to optimize performance. Ahead of this year's event, we're revisiting these developments and announcements. In this podcast episode with Christina Cardoza, Editorial Director at insight.tech, and Wei Yeang Toh, General…
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Some coders remain confused about Medically Unlikely Edits (MUEs) — but that’s about to change. In this episode, Terry discusses denials from Part B MACs for what you may think is an undetermined reason. However, a possibility is running up against MUEs. The edits, which are designed to prevent over-payments caused by serious billing errors, often …
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Predictions for 2025 and Beyond: Day Two — Connectivity, Networks, Health and AI
57:01
57:01
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57:01In October 2024, CCS Insight unveiled our top predictions for the world of technology from 2025 and beyond. Over two sessions, our Predictions 2025 and Beyond event explores how emerging technologies in areas like connectivity, artificial intelligence and spatial computing are set to reshape industries and everyday life. We dive into how these adva…
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The third element of MDM for E/M Services is “Risk of Complications and/or Morbidity or Mortality of Patient Management”. Many believe that only the risk in this element is how you level your E/M, but that is false. There are three elements to a E/M service when using MDM. There are several risks including the problems addressed and for the managem…
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Everyone knows that you cannot routinely waive or fail to collect the obligation of patient cost-sharing. However, we know that there are instances where (1) the patient has a bad experience, (2) the patient will not pay or is not collectible, and (3) the patient has a hardship. Here are several policies your practices can implement to ensure compl…
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Predictions for 2025 and Beyond: Day One — AI, Regulation and Spatial Computing
1:10:21
1:10:21
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1:10:21In October 2024, CCS Insight unveiled our top predictions for the world of technology from 2025 and beyond. Over the course of two days, our Predictions 2025 and Beyond event explores how emerging technologies in areas like connectivity, artificial intelligence and spatial computing are set to reshape industries and everyday life. We dive into how …
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The Electronic Medical Record (EMR) has many benefits over handwritten entries in a paper chart. EMR entries are always legible, dated, and timed. Patient information can be available at the point of care and remotely. Some EMR systems include computerized physician order entry and decision-support tools to improve patient care and safety. However,…
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Marketplace Momentum: AWS Marketplace and Partners Simplify Procurement
39:31
39:31
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39:31Software marketplaces are an established concept that has been growing in popularity. Marketplaces offer many benefits, especially in easing the procurement and billing of services, presenting opportunities for partner services and simplifying access to them. Other benefits include accelerating and streamlining service implementation, which can sav…
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There’s a lot of confusion – and conjecture – on what to do about audio-only Telehealth while the new CMS and HHS administrations settle in under a new President in 2025. The final rule, the federal register, and the last CR made things more vague for this transition. In this episode Terry attempts to clear up these issues, giving you her best prac…
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In Production: Curatorial Roundtable Spring 2025
33:51
33:51
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33:51Music Curator Amadeus Julian Regucera hosts a roundtable discussion with Associate Time-based Visual Arts Curator Katherine Adams and Dance & Theater Curator-in-Residence Tara Willis to preview the Spring 2025 season as well as talk about curatorial approaches and styles. Projects include the Ephemeral Organ festival featuring Lesie Cuyjet and othe…
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When auditing Annual Wellness Visits (AWV), is the concept still the same as preventive exams concerning modifier 25? The AWV does not include managing medications or managing conditions. However, the rules need to see medical necessity for the E/M on the same date with a -25 modifier. Remember, patients do not have a share of cost of AWV’s so if y…
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Top 10 Tuesday Q&A – Happy New Year Edition
21:43
21:43
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21:43This New Year’s Eve episode of the Top 10 Tuesday Q&A includes E/M Data questions, assistants at surgery, colon screenings, Telehealth extensions, and prescription drug management questions. It’s an episode you don’t want to miss. Happy New Year Everyone! Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.…
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Did We Get a Congressional Telehealth Gift for Christmas?
6:18
6:18
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6:18In the final hour, Congress passed the American Relief Act. Telehealth was addressed and the geographical location was extended through March 2025. Terry give us the details from this HR bill in this short but sweet episode so you can enjoy your Christmas holiday. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://…
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Data Point – Review of Test or Independent Interpretation?
19:01
19:01
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19:01E/M Coding still has confusion when capturing “data points” elements. When deciding to give credit for either an independent interpretation (CAT 2) or a review of test results (CAT 1) is an often misunderstood component of the Medical Decision Making (MDM) table. Proper documentation of independent interpretation is required to impact the MDM, and …
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The 2025 CPT® codes will impact billing and coding across various specialties. The annual CPT® updates include new, revised, and deleted codes and coding guidelines effective Jan 1st, 2025. CPT® 2025 includes 270 new codes, 112 revised codes, and 49 deleted codes. There are no code changes for anesthesia, respiratory, or auditory services. The most…
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Coding Career Opportunities and Challenges
22:44
22:44
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22:44Becoming a certified medical coder can be very exciting but also disheartening if you thought a job in coding would magically appear once you got your certification. In this episode of the CodeCast podcast, Terry discusses studying and test-taking tips for your certification, common misconceptions of job opportunities, and what it takes to persever…
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Thanksgiving ICD-10-CM: Be Safe and Thankful!
5:10
5:10
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5:10Terry makes it quick and to the point in this Thanksgiving Day episode of the CodeCast Podcast. Terry gives you a fun list of ICD-10-CM related to our beloved family and friends’ holiday. Be safe and careful out there this holiday weekend: and enjoy! Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple…
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Top 10 Tuesday Q&A – RCM Workflow Mistakes
14:51
14:51
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14:51Terry is back with another Top Ten Tuesday discussion. In this episode, she discusses front desk to billing office workflow mistakes, looking at patient demographics, insurance information, HMO referrals, PA’s, and data backups. Tune in to reset your RCM workflows. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https:/…
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Today on the CodeCast podcast, Terry discusses best practices for the -25 Modifier, where to find her latest blog on the AAPC website, and what the MAHA (Make America Healthy Again) movement means to our country. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billi…
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CMS final rule is out and Telehealth is an issue
23:56
23:56
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23:56CMS published the 2025 Final Rule on November 1st. Terry breaks down the highlights and gives you the facts on the Telehealth “mess” that could have 85% of Medicare patients without access to virtual care. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-codi…
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Why are TCM services receiving more denials than payments?
15:07
15:07
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15:07Many practices have engaged in coding for TCM (Transitional Care Management) services but are finding that they are receiving more denials than payments. Terry breaks down why that is, and sheds light on what is needed to qualify billing for these services. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcast…
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AI in Medical Coding: What’s the Reality?
15:11
15:11
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15:11Artificial intelligence (AI) has the potential to make substantial progress toward the goal of making healthcare more personalized, predictive, preventative, and interactive. However, AI-based systems raise concerns regarding data security and privacy. Because health records are important and vulnerable, hackers often target them during data breach…
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HIPAA violations your organizations should avoid
15:39
15:39
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15:39HIPAA has many privacy issues that most practices have in their HIPAA compliance manuals. However, current HIPAA violations are coming to light when employees purposefully search patient PHI for personal use or curiosity. This is not only a violation of privacy laws but could have a cascading effect if not stopped in its tracks. In this episode, Te…
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In this edition of the CodeCast podcast, Terry discusses the “subtle changes” to look for in the ICD-10-CM updates effective October 1st. Also, Terry clears up understanding the UHC Gold Card Program, and what CMS looks at when they send you a denial. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.appl…
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According to the AMA, most physicians lack training in “webside manner.” Researchers from the University of Michigan Medical School and the Veterans Affairs Ann Arbor Healthcare System surveyed 1,213 patients from their respective institutions to measure preferences regarding the visual background seen during a video visit. Today’s CodeCast podcast…
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Charging patients cash for “insurance covered” services
15:26
15:26
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15:26Many practices offer cash payment options to avoid insurance billing, hoping to reduce administrative burden or boost revenue. However, this practice of charging cash for services that could be billed to and covered by a patient’s insurance plan raises serious compliance concerns. Federal law and insurance contracts generally prohibit this practice…
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Sometimes the rules are as “clear as mud”
19:17
19:17
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19:17Sometimes there are coding, compliance, and billing questions that we struggle to find answers to in any published guidance or specific regulatory rules. This week on the CodeCast podcast, Terry brings up three specific questions that we are always hunting for answers to and the best way to deal with them. Subscribe and Listen You can subscribe to …
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Does ICD-10-CM Codes Claim Position Matter?
24:41
24:41
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24:41In this episode Terry discusses the importance of ICD-10-CM codes on billing claims. She also clarifies the ICD-10-CM General Guidelines on Borderline Diagnoses, Laterality, Acute versus Chronic Conditions, and when to leave the symptoms off the claim for definitive diagnoses. Listen in for this important information capture. Subscribe and Listen Y…
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Collaboration and communication tools have evolved significantly, progressing from early email and instant messaging to the cloud-based, integrated and AI-powered platforms used by workforces today. The Covid-19 pandemic accelerated this evolution as businesses had to swiftly digitize processes and working models. As a result, workplaces have becom…
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CMS released their FAQ sheet for the add-on code HCPCS G2211, to office visits. The sheet clarifies where denials and grey areas for reporting. Tune in as Terry goes over twelve FAQs from CMS along with her commentary to best practices for this complexity add-on. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://p…
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Top 10 Tuesday Q&A – Coding, Billing, and Compliance Questions
22:12
22:12
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22:12In this episode of the CodeCast podcast, Terry discusses ABI billing, Level 5 Drug Toxicity options, Aortic Stenosis ICD-10-CM coding, and some questions related to the 2025 CMS proposals. Listen this episode to see if any of your Coding Corner questions made the podcast cut! Subscribe and Listen You can subscribe to our podcasts via: Apple Podcast…
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