Welcome to the Living Connected podcast, hosted by Dr. Arti Masturzo, where healthcare professionals share inspiring stories, innovative solutions, and expert insights on pressing medical topics. Join us for conversations that connect and empower the healthcare community. Listen now! Produced by Slice of Media, Inc.
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Taking the Business of Medicine to the next level
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Not Elsewhere Classified is a podcast where we create conversations and share stories with individuals in the medical coding, health information technology, and clinical documentation integrity community. This podcast is hosted by Brian Cui, RHIA, CDIP and presented by MedicalCodingGeek.com
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The Alpha Coding Podcast series was developed by Toni Elhoms, CCS, CPC, CPMA, CRC, AHIMA-Approved ICD-10-CM /PCS Trainer, CEO of Alpha Coding Experts, for professionals working in the medical coding, reimbursement, clinical documentation, and compliance industry. With new episodes dropping every Monday, the series provides an all-access pass to industry Pro-Tips that help you start your week off smarter! The series includes healthcare industry news, coding updates, career advice, personal de ...
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This edition of the CodeCast podcast focuses on coding heart caths. When coding for cardiac catheterizations, if you don’t have a working knowledge of this specialty it can be a bit challenging. That’s why it’s time to get back to the basics. Terry provides some tips into this coding concept, and what to look for in your report to capture the corre…
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Join us on the latest episode of Living Connected, hosted by Arti Masturzo! Today's Guest: Kathy Driscoll, SVP & CNO at Humana. What you’ll get out of this episode: The critical role of nurses in healthcare and patient care. Current challenges and the fragile state of the nursing profession. The impact of AI and technology on nursing practices. Str…
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Terry takes us down memory lane in an E/M refresher. She covers what changed with the CPT E/M section – that was updated in 2019, 2020, and 2021 – to get to what we have today in 2024. Getting back to basics helps you understand why we must ensure updates in our charting workflows and EMRs continue. Subscribe and Listen You can subscribe to our pod…
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Top 10 Tuesday Q&A – Coding, Billing, and Compliance Questions
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20:39
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This week on the CodeCast podcast Terry returns with her Top 10 Tuesday Q&A series. Join us as Terry covers questions covering risk support for E/M, Telehealth in the hospital setting, missed appointments, follow-up testing protocols, shared visit modifiers, and more. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – http…
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CMS Newsroom Update: Physician Fee Schedule 2025
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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 e…
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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. Subscribe and Listen You can subsc…
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NCCI Updates 30.2 and No Show Appointments
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10:56
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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. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podc…
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#3 - Vasanta Pundarika, Co-Founder & Managing Director of Healthcare Group at Matrix Capital Markets Group Inc.
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Join us on the latest episode of Living Connected, hosted by Arti Masturzo! Today's Guest: Vasanta Pundarika, Co-Founder & Managing Director of Healthcare Group at Matrix Capital Markets Group Inc. What you’ll get out of this episode: Vasanta Pundarika's journey from healthcare investment banking to women's health advocacy. Challenges female founde…
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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 decl…
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Top 10 Coding and Billing Mistakes – Let’s Fix It!
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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 clini…
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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 p…
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#2 - Dr. Samuel Hammerman, Executive VP & CMO at Select Medical
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Join us on the latest episode of Living Connected, hosted by Arti Masturzo! Today's Guest: Dr. Samuel Hammerman, Executive VP & CMO at Select Medical. What you’ll get out of this episode: Meet Dr. Samuel "Buddy" Hammerman: Dr. Buddy Hammerman, Chief Medical Officer at Select Medical, discusses his career and passion for healthcare. Addressing Physi…
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How do you know if your role is classified as a Coder or a Biller? Coders typically work in the back end of the facility, focused on interpreting medical records and assigning appropriate codes. Billers interact directly with patients, collecting payments and entering patient information into the appropriate systems. However, there is also a crosso…
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All CPT codes have an expected range of complexity and uses, but when a particular procedure or surgery performed has exceeded the normal range of complexity, modifier -22 can come into play. Modifier -22 is defined as increased procedural services and demonstrates when a physician has gone above and beyond the typical framework of a particular pro…
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#1 - Dr. Robert Lash, CMO at Endocrine Society
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Join us on the very first episode of our new show Living Connected, hosted by Arti Masturzo! Today's Guest: Dr. Robert Lash, CMO at Endocrine Society. What you’ll get out of this episode: The Origins of Living Connected: Arti Masturzo shares how her journey through the healthcare industry inspired the podcast. Meeting by Chance: Arti and Dr. Robert…
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This week on the CodeCast podcast Terry returns with her Top 10 Tuesday Q&A series. Join us as Terry covers questions from Urgent Care to the ER, infusion charges, behavioral health, billing for unlisted codes, preventative med group codes, and more. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple…
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Are you a “Subject Matter Expert?” Are you taking on clients, presenting to physicians, or looking for a coding job: with no expertise? Do not “wing it” in the healthcare field. You will hurt yourself or your credibility unless you disclose your limitations to the person you are doing business with. (Not to mention potentially hurting the physician…
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Is a Medical Record “Errors Disclaimer” Valid?
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Many of the records Terry audits include a disclaimer to protect a physician from liability. However, does this disclaimer shield a physician who has signed a note or authenticated an electronic encounter? (Under the assumption the physician reviewed it?) In this episode of the CodeCast podcast, Terry discusses the protections of a disclaimer and w…
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In this episode of the CodeCast podcast, Terry discusses the frequent urgent care center encounters that elevate to the patient going to the ER. Is this considered automatically high risk? So many providers want level 5, but what if it’s to get testing or services unavailable at the UC? Terry discusses the complexities and compliance issues with th…
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Top 10 Tuesday Q&A – Coding, Billing, and Compliance Questions
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This week’s CodeCast Podcast is all about coding and billing. Join Terry for a full deck of important information on Coding, Billing, and Compliance. Get answers to our top ten questions including eVisit POS, LE Thombectomy services, SDoH assessment codes, Data Point E/M clarifications, and more. Subscribe and Listen You can subscribe to our podcas…
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This week on the CodeCast Podcast Terry dives into the new rules for hernia repair codes. Terry discusses when the 0-global-days and 90-day-global-days services are billed on the same date. What applies? What about co-surgery? What about follow-up visits, or add-on codes for staple/suture removal? Tune in to find out details about these topics and …
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What does “separate procedure” mean in CPT?
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Some procedures in the CPT book are listed as “separate procedures” meaning they are commonly carried out as an integral component of a total service or procedure that has already been identified. In this episode, Terry discusses if, and when, you can report these with a code for the total procedure if modifiers will help, and what details to pay a…
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TPE audits from Medicare, along with private and commercial payer audits are on the rise. It is more important than ever to monitor physician records and make sure that when they submit any level of E/M. (Especially level 4’s and level 5’s.) In this episode, Terry reinforces making sure the visit not only meets the level of service billed, but also…
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There will be more over-coding and overreaching with the additional codes Medicare provides to capture services. This episode explains the distinction for code G0136 and why it isn’t a “screening” service (as per CMS) but an assessment. Terry discusses the new SDoH assessment code and when it should and shouldn’t be billed. We previously discussed …
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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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Compliance Issues With MD/QHP Collaboration Agreements
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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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