CCO.us Podcast | Medical Coding, Billing, Auditing & Risk Adjustment

Does a dangerous medication automatically make an E/M encounter high risk? In this episode, Alicia Scott explains the two independent drug-related high-risk examples in the E/M risk column, the requirements for intensive toxicity monitoring, decisions involving parenteral controlled substances, and why IV administration alone doesn't establish high risk. You'll learn: ✔ Moderate vs. high-risk drug...

A diagnosis can be accurate—and still fail to support a claim if the documentation underneath it doesn't meet applicable requirements. In this episode, Alicia Scott examines retrospective HCC coding through the lens of a major settlement involving allegations about medical-record amendments and risk adjustment data. The discussion focuses on documentation provenance, amendment requirements, provid...

Trying to break into healthcare revenue cycle but don't know where to start? In this episode, Alicia Scott explains the five stages of revenue cycle, professional vs. institutional claims, common transaction numbers, rejected vs. denied claims, important KPIs, entry-level job opportunities, and credentials that can help you build your career. You'll learn: The five stages of revenue cycle Where be...

Z codes are everywhere—but knowing when to report them and where to sequence them can be surprisingly challenging. You'll learn: First-listed vs. secondary Z codes Status vs. history Screening vs. diagnostic Aftercare vs. follow-up SDOH documentation Common documentation traps FY 2026 Z code changes FY 2027 changes to watch This episode is from the CCO Club Q&A #1740 webinar. Watch the full vi...

Wound and ulcer care coding changed significantly in 2026. You'll learn: 2026 skin substitute payment changes Deleted and replacement application codes Applied vs. discarded product units MAC LCD considerations WISeR prior authorization Expanded ICD-10-CM ulcer coding Diabetic foot ulcer sequencing Podiatry CPT® updates Routine foot care requirements This episode is from the  CCO Community Q&A...

A patient is seen in the clinic in the morning and admitted to the hospital that afternoon. Same physician, same date, two encounters. Do you bill both? In this episode, learn how same-day outpatient-to-inpatient E/M billing works, including 99221–99223, bundling, cumulative time, modifier AI, concurrent care, payer differences, and documentation that supports a defensible claim. You'll learn: Whe...

FQHC billing changed significantly in 2026. In this episode, learn about the updated PPS base rate, retired G-codes, new APCM framework, behavioral health add-ons, RPM opportunities, and important telehealth billing changes affecting Federally Qualified Health Centers. You'll learn: 2026 FQHC payment updates Retired G0511, G0512 & G0071 Replacement care management codes APCM complexity tiers B...

Finding a diagnosis in ICD-10-CM is only the beginning. In this episode, learn how to navigate the ICD-10-CM Alphabetic Index correctly, understand key conventions like “With,” “See,” “See Also,” brackets, dashes, and non-essential modifiers, and use the Neoplasm and Drugs & Chemicals tables with confidence. This episode is from the CCO Club Q&A #1739 webinar. Watch the full video here: ht...

Critical care coding isn't about where the patient is—it's about condition, provider work, and time . In this episode, learn how to apply 99291 and +99292, meet the 30-minute requirement, count critical care time correctly, distinguish bundled from separately reportable services, handle split/shared care, and strengthen documentation for audit protection. This episode is from the CCO Club Q&A...

OB/GYN coding can get complicated fast. 🤰 Prenatal care 👶 Vaginal vs. C-section delivery 🔄 VBAC scenarios 👶👶 Twins 📋 Postpartum care 🏥 Hysterectomy coding In our latest episode, we're breaking down the coding logic behind the pregnancy continuum and common GYN surgical scenarios. This episode is from the CCO Community Q&A #1760 webinar. Watch the full video here: https://youtu.be/sNnZag...

Fertility and egg preservation coding changed in 2026. Learn the new Z31 codes, IVF and ART billing rules, cryopreservation, storage, modifier FP, and the documentation details that can prevent costly denials. This episode is from the CCO Community Q&A #1760 webinar. Watch the full video here: https://youtu.be/C-jMXYpy6Ig

Is CPT going away? CMS is questioning the current CPT structure—but the reality is much less dramatic than the headlines suggest. Learn what the 2027 RFI actually means, why HCPCS could become more important, and how coders can prepare for the future without panicking. This episode is from the CCO Podcast #1749 webinar. Watch the full video here: https://youtu.be/e060lJ2gSaY

Why do Cardiology, Orthopedics & Interventional Radiology feel so difficult to code? We're breaking down the anatomy, modifiers, global periods, vascular families, bundling rules and 2026 coding changes that make these specialties challenging. This episode is from the CCO Podcast #1749 webinar. Watch the full video here: https://youtu.be/N40H5keImdA

One missing modifier... One missed NCCI edit... One incorrect diagnosis... That's all it takes for a claim denial. Learn the 6-step error-proofing workflow every coder should use before submitting claims. This episode is from the CCO Club Q&A #1738 webinar. Watch the full video here:  https://youtu.be/zMM_TS6Uknk

CKD coding can have a huge impact on documentation, HCC capture, and reimbursement. Learn the documentation elements, staging rules, ICD-10-CM guidelines, and coding strategies every medical coder should know. This episode is from the CCO Club Q&A #1738 webinar. Watch the full video here: https://youtu.be/d52QSvkhrXs

Substance Use Disorder documentation requires far more than identifying whether a patient uses alcohol or drugs. Proper coding depends on accurate provider documentation of severity, remission status, withdrawal, intoxication, substance-induced conditions, and associated comorbidities. In this episode, we discuss the CDI essentials for behavioral health documentation and how accurate coding suppor...

Substance Use Disorder coding depends on accurate documentation—not assumptions. In this episode, Laureen Jandroep explains ICD-10-CM coding for substance use disorders, remission status, withdrawal, intoxication, CDI best practices, and the documentation details that improve coding accuracy and patient care. This episode is from the  CCO Community Q&A #1754 webinar. Watch the full video here:...

Fraud, Waste, and Abuse can affect every healthcare organization—and every medical coder. In this episode, Laureen Jandroep explains the seven federal FWA laws, common coding red flags, OIG audit targets, False Claims Act risks, and practical compliance strategies to help coders protect themselves and their organizations. This episode is from the CCO Community Q&A #1759 webinar. Watch the full...

Major Depressive Disorder, Dysthymia, and Adjustment Disorder are frequently confused in coding, but each diagnosis has unique documentation, coding, and risk adjustment requirements. In this episode, Laureen Jandroep explains severity levels, HCC 59 implications, documentation standards, common coding errors, and how to accurately code mood disorders. This episode is from the CCO Club Q&A #17...

Medical coding audits can significantly impact reimbursement and compliance. In this episode, Alicia Scott explains the seven major audit programs, documentation requirements, Medicare appeals, audit triggers, and practical strategies every medical coder should use to prepare before an audit occurs. This episode is from the CCO Community Q&A #1759 webinar. Watch the full video here: https://yo...

Modifiers are only two characters long—but they can determine whether a claim gets paid or denied. In this episode, Laureen Jandroep explains CPT®, HCPCS Level II, and ICD-10-CM coding conventions, common modifier mistakes, audit risks, and practical strategies to improve coding accuracy and reimbursement. This episode is from the CCO Club Q&A #1737 webinar. Watch the full video here: https://...

The new telehealth CPT® codes 98000–98007 were designed to simplify telemedicine coding—but Medicare isn't paying them. In this episode, Alicia Scott explains the AMA vs CMS conflict, modifier 93 and 95 usage, payer-specific requirements, virtual check-in updates, and common telehealth coding mistakes every medical coder should know.  This episode is from the CCO Community Q&A #1757 webinar. W...

Struggling with integumentary surgery coding? In this episode, Laureen Jandroep reviews the most commonly tested CPC exam concepts, including biopsies, excisions, repairs, debridement, skin grafts, Mohs surgery, breast procedures, coding guidelines, and exam-day strategies to help improve coding accuracy and confidence. This episode is from the CCO Community Q&A #1757 webinar. Watch the full v...

AI is reshaping medical coding workflows, but not in the way many people fear. In this episode, Laureen Jandroep explains the difference between AI hype and real-world adoption in healthcare, including coding automation, NLP tools, agentic AI, 2026 CPT changes, compliance risks, and why human coders remain essential in the AI era. Watch the full video here https://youtu.be/2VcIZrp_u8w

Choosing between the CPC and CCS can shape your entire medical coding career. In this episode, Alicia Scott and Laureen Jandroep explain the differences between AAPC and AHIMA certifications, including outpatient vs inpatient coding, exam difficulty, career growth, specialization paths, remote work opportunities, and which certification may help you get hired faster. Whether you are brand new to c...