CodeCast | Medical Billing and Coding Insights

<p>Across the country, commercial payers are quietly down-coding E/M services without issuing ADRs and without providing notice. Office visit reimbursements are being arbitrarily reduced based on payer algorithms rather than a proper review of documentation for compliance. In today’s CodeCast episode, Terry sheds light on this growing problem and explains how to take proactive steps […]</p> <p>The post <a href="https://www.terryfletcher.net/podcast/2025/11/watch-for-payer-automatic-down-coding-without-notice/">Watch for Payer Automatic Down-Coding Without Notice</a> appeared first on <a href="https://www.terryfletcher.net">Terry Fletcher Consulting, Inc.</a>.</p>

<p>When auditing a medical record, a common mistake is viewing it solely from a coding perspective rather than an auditing perspective. True auditing requires examining not just the encounter itself, but also what occurred before, after, and around it. Focusing only on coding can result in missed compliance elements and insufficient support for what was—or […]</p> <p>The post <a href="https://www.terryfletcher.net/podcast/2025/11/auditing-a-record-isnt-the-same-as-coding-it/">Auditing a record isn’t the same as coding it</a> appeared first on <a href="https://www.terryfletcher.net">Terry Fletcher Consulting, Inc.</a>.</p>

<p>The September 2025 issue of CPT® Assistant raised important questions about how to appropriately level an evaluation and management (E/M) encounter when the presenting problem is an acute, uncomplicated illness or injury. A growing number of providers have been assigning Level 4 codes simply because an antibiotic was prescribed. However, this approach may not be […]</p> <p>The post <a href="https://www.terryfletcher.net/podcast/2025/11/leveling-a-visit-for-an-acute-uncomplicated-illness/">Leveling a Visit for an Acute Uncomplicated Illness</a> appeared first on <a href="https://www.terryfletcher.net">Terry Fletcher Consulting, Inc.</a>.</p>

<p>Medical billing and coding encompasses a wide range of responsibilities—from patient registration and claim reimbursement to final payment delivery to the provider. Navigating this process requires close collaboration among billers, coders, insurance companies, patients, and various healthcare professionals. Although often grouped together as a single discipline, billing and coding are distinct roles that work in […]</p> <p>The post <a href="https://www.terryfletcher.net/podcast/2025/11/claim-denials-coding-mistake-or-billing-oversight/">Claim Denials: Coding Mistake or Billing Oversight?</a> appeared first on <a href="https://www.terryfletcher.net">Terry Fletcher Consulting, Inc.</a>.</p>

<p>As more practices begin offering screening services, questions around billing for Medicare-specific G codes are becoming more common. In this episode, Terry breaks down when it’s appropriate to bill for preventive services, which providers are eligible, and what requirements must be met. To bill G codes, providers must be enrolled as Medicare suppliers and follow […]</p> <p>The post <a href="https://www.terryfletcher.net/podcast/2025/10/understanding-who-can-bill-preventive-g-codes/">Understanding Who Can Bill Preventive G Codes</a> appeared first on <a href="https://www.terryfletcher.net">Terry Fletcher Consulting, Inc.</a>.</p>