Unraveling Medical Coding

Coding rules for Colonoscopies are complex, especially those relating to Screening Colonoscopies.  The Cologuard test is becoming more popular as a non-invasive colorectal cancer screening test.  On J...

The coding changes to Office / Outpatient Services implemented on January 1, 2021 and the complimentary changes to Hospital Services implemented on January 1, 2023 were designed to minimize documentat...

These are our 4 wishes to improve documentation, coding, and healthcare from our hosts Neal Sheth and Dr. Piyush Sheth. There is also a free gift for our listeners. Click the free link below to get y...

This episode discusses the clinical issues, proper coding (using CPT and modifiers), and current payment policies regarding colonoscopies. Unfortunately, because these three aspects are intimately ent...

2023 brings a host of changes to medical coding and billing. Dr. Piyush Sheth talks about ICD, CPT, and reimbursement changes including changes to RVU values. ...

Episode Summary: Medical Documentation has suffered a decline in integrity due to adoption of  Electronic Medical Records and an incomplete understanding of Documentation Guidelines. Hosts Neal S...

Episode Summary: RVU’s (Relative Value Units) are the currency of healthcare. Hosts and General Surgery Certified Coders Neal Sheth and Dr. Piyush Sheth explore the concept of RVU’s and Geographic Pra...

Episode Summary: Modifiers are two-digit codes that can be appended to a CPT code in special situations to justify payment for the service when payment otherwise would be denied. Understanding the pro...

Episode Summary: Modifiers are two-digit codes that can be appended to a CPT code in special situations to justify payment for the service when payment otherwise would be denied. Understanding the pro...

Episode Summary: CMS released their Calendar Year 2022 Medicare Physician Fee Schedule Final Rule on November 2nd. There are significant changes to the PFS conversion factor, billing for Shared/Split ...

Episode Summary: Our previous episode dealt with EMR issues relating to documentation quality and ease of use. In this follow-up episode, hosts Neal Sheth and Dr. Piyush Sheth explore concepts on crea...

Episode Summary: Electronic Medical Record software has  the potential to facilitate documentation and minimize errors. EPIC is the most widely used EMR in the United States. There are other EMR ...

Episode Summary: Critical Care coding is complicated. There are clearly defined requirements that must be adhered to in order to bill this time-based service. Hosts Neal Sheth and Dr. Piyush Sheth exp...

Episode Summary: Physician extenders (physician assistants, nurse practitioners, clinical nurse specialists, and certified nurse midwives) can ease the burden of the physician shortage. Coding an...

Episode Summary: Office consultation coding requires three documentation items in addition to fulfilling the standard evaluation and management services documentation of history and physical exam.&nbs...

Episode Summary: New medical documentation guidelines for Outpatient Office visits were implemented on January 1, 2021 as part of the “Patient’s over Paperwork” initiative by Medicare with input from ...

Episode Summary: Medical coding and billing is complex. The International Classifications of Diseases version 10 (ICD-10) and the Current Procedural Terminology (CPT®) code sets are expansive. Further...