Terry A Fletcher (CodeCast #podcast 🎙)

Temporary provider. Important billing rules. Is your practice prepared? Planned leave, unexpected illness, and staffing gaps can leave practices scrambling for coverage. But bringing in a substitute physician or physical therapist takes more than filling the schedule. This week on CodeCast, Terry breaks down Medicare’s substitute provider billing arrangements, formerly known as locum tenens, and one of the most misunderstood details: the 60-day limitation.  Understanding the rules can help your practice maintain continuity of care and avoid claim denials, overpayments, and costly recoupments. Don’t let temporary coverage become a lasting compliance headache!  Tune in here: f.mtr.cool/3dzxt2fo6b #CodeCast #TerryTuesday

New codes. Updated guidelines. Is your team ready? The FY 2027 ICD-10-CM update took effect October 1, 2026, bringing changes that deserve attention from both providers and coders. In this week’s CodeCast Podcast, Terry takes a closer look at the new diagnosis codes and updated Official Guidelines for Coding and Reporting, with educational tips to help connect the dots from provider documentation to code selection and the final claim. Tune in here: f.mtr.cool/vn25w4xb9b #CodeCast #TerryTuesday #ICD10CM #MedicalCoding #ProviderEducation #CodingUpdates

“How can I get around that rule?” That’s one question guaranteed to get a reaction from Terry! When it comes to coding, billing, and compliance, finding loopholes is NOT the answer. In this week’s episode of CodeCast, Terry breaks down why understanding and following the rules matters more than simply getting a claim paid. Because compliance isn’t about shortcuts. It’s about accuracy, integrity, and doing things the right way. Tune in here: f.mtr.cool/ypkfmw67dn #CodeCast #TerryTuesday

Complex foot and ankle surgeries can come with complex coding questions. Are you getting the details right? This week, Terry breaks down podiatry procedural coding and shares why she cautions against adding CPT® or ICD-10-CM codes to operative reports, including the problems that can arise when those codes are incorrect or don’t accurately reflect the procedure performed. 🎧 Tune in here: f.mtr.cool/dsvx3m6mlc #Podiatry #MedicalCoding #SurgicalCoding #CPTCoding #ICD10CM #HealthcareCompliance

Obstetric coding changes are coming for 2027 and now is the time to start preparing. While coders may already be reporting E/M visits for newly pregnant patients, the full set of new and revised maternity care codes and guidelines won’t take effect until January 1, 2027. In this episode, Terry walks through recent questions and answers to help your team identify where additional research, education, or training may be needed before the changes officially roll out. Tune in here: f.mtr.cool/o3wprc7m2o #TerryTuesday #CodeCast #MedicalCoding #OBCoding #ObstetricCoding #ICD10CM #HealthcareCompliance

The care was provided, but does the documentation support the billing? Unclear documentation can lead to coding errors in Emergency Department and Critical Care services. This week, Terry breaks down the key elements of compliant ED documentation and what needs to be documented to support Critical Care billing. Tune in here: f.mtr.cool/paumg27yld #TerryTuesday #CodeCast

When the physician is at home… what counts as the practice location? CMS has made permanent the policy allowing practitioners to provide Medicare telehealth services from their homes, but that has raised some important questions about enrollment, practice location, and place of service. This week, Terry breaks down what should be listed as the physician’s practice location, the difference between Medicare enrollment and POS, and how the rules change for fully virtual practices and teleradiology. If your organization provides telehealth services, this is one you’ll want to hear. 🎧 Tune in here: f.mtr.cool/z684l8kj5j #TerryTuesday #CodeCast #Telehealth #Medicare #MedicalCoding #HealthcareCompliance #MedicalBilling

🚨 NEW ARTICLE JUST POSTED Working from home is not the same as having a medical practice and for telehealth providers, that distinction matters. If a practitioner has a legitimate physical practice location, CMS allows Medicare telehealth services to be furnished from home without generally requiring the home address to be enrolled as a practice location. But what happens when the provider is 100% virtual and their home is their only physical practice location? That’s where things change. This new article breaks down the Medicare enrollment requirements, privacy concerns, POS confusion, and some important questions providers should consider before giving up their brick-and-mortar location. Telehealth may be here to stay,  but should your home become your medical practice? Read the full article here: f.mtr.cool/0679w54bck #Telehealth #Medicare #CMS #HealthcareCompliance

Question: How does documentation specificity affect diabetes code assignment? Answer: 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. Tune in here: f.mtr.cool/zyvkjbu5ql #TerryTuesday #CodeCast

Not every interaction supports an E/M service and knowing the difference matters. This week, Terry walks through real-world scenarios where the work doesn’t rise to the level of a separate E/M service or can’t be counted toward E/M, and explains why. She also looks at similar situations where reporting or counting an E/M service may be appropriate. With fraud, waste, and abuse (FWA) concerns continuing to put practices under the microscope, understanding these distinctions is critical. Tune in this week and make sure your E/M reporting can stand up to scrutiny. Tune in here: f.mtr.cool/rmrzie0r8z #TerryTuesday #CodeCast #MedicalCoding #EMCoding #HealthcareCompliance #FraudWasteAbuse #MedicalBilling

What really determines risk in an E/M service? 👀 The AMA is clear: risk is based on the patient-management decisions made by the physician or QHP reporting the E/M service, and when it comes to surgical risk, the individual patient’s circumstances and risk factors matter. This week, Terry breaks down what that means for “pre-op clearance” visits, how to determine the appropriate level of risk, and tackles the ongoing 76937 billing controversy.  Tune in here: f.mtr.cool/vn5e7cxb2o #TerryTuesday #CodeCast #MedicalCoding #EMCoding #PreOp #CodingCompliance #MedicalBilling

It’s time for the Top 10 Coding Corner Membership Questions of the Quarter! Terry is answering the questions members are asking most, including telehealth, the reality behind voice recognition transcription disclaimers, and new CMS proposals slated for 2027. Tune in for the rundown! Tune in here: f.mtr.cool/6xa2dqo27p #TerryTuesday #CodeCast

Today on the CodeCast Podcast, Terry tackles a common auditing debate: Does an auditor need to specialize in a specific specialty to effectively audit its E/M services? Specialty knowledge can absolutely help, but can it also create bias and lead us to assume what should be documented instead of auditing what actually is? Let’s talk about it on today’s CodeCast! Tune in here: f.mtr.cool/irdbjutmsl #TerryTuesday #CodeCast

Finally

What’s ahead for the 2027 Medicare Physician Fee Schedule (MPFS)? This week, Terry breaks down what we’re anticipating for 2027, what the proposed changes could mean for providers, and why the comment period matters right now. He also shares what we can do before the comment period closes and what needs to happen to better support and strengthen private practices moving forward. Listen in and get up to speed on what’s coming. Tune in here:f.mtr.cool/bwhumsmmia #TerryTuesday #CodeCast

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. Tune in here: f.mtr.cool/yzbcqsyrgd #TerryTuesday #CodeCast

With more patients turning to large-language models such as ChatGPT, Gemini, Claude and others to answer their questions about symptoms, medical conditions and more, the American Medical Association (AMA) is offering some go-to advice that will help patients get more out of their experience with AI chatbots while staying safe. The key to effectively using AI chatbots, is to understand they are not a replacement for a physician. Terry discusses the AMA 5 steps to AI ChatBot safety and what physician practices need to do to protect patients in this uncertain and sometimes, unchecked reality.  AI chatbots are not as a substitute for the evidence-based, personalized guidance of an actual doctor. Tune in here: f.mtr.cool/jjakaimgfa #TerryTuesday #CodeCast

In today's episode of the CodeCast podcast, we're breaking down why E/M time belongs to the physician or qualified healthcare professional performing the service, why time from other team members cannot be combined to support the E/M level (in the office setting), and an important Medicare reminder: shared visits do not apply in the office or other outpatient setting. Let's dive into the rules so you can code with confidence and avoid a common compliance pitfall. Tune in here: f.mtr.cool/nyjefeslgs #TerryTuesday #CodeCast

Terry tackles a growing compliance issue in telehealth: where the patient is located at the time of the visit. While physicians generally must be licensed or otherwise authorized to practice in the state where the patient is physically located, evolving payer policies and Medicare rules have added new layers of complexity. From commercial insurance requirements to CMS guidance on services provided outside the United States, Terry explains what providers need to know to remain compliant and avoid costly reimbursement pitfalls. Tune in here: f.mtr.cool/bxadixicwv #TerryTuesday #codecast

Terry tackles a growing compliance issue in telehealth: where the patient is located at the time of the visit. While physicians generally must be licensed or otherwise authorized to practice in the state where the patient is physically located, evolving payer policies and Medicare rules have added new layers of complexity. From commercial insurance requirements to CMS guidance on services provided outside the United States, Terry explains what providers need to know to remain compliant and avoid costly reimbursement pitfalls. Tune in here: f.mtr.cool/bxadixicwv #TerryTuesday #codecast