This 3 hour presentation is intended for coders.

Description:
How can a practice increase its revenue?  The easiest way is by collecting for services already performed, and the first step in that process is accurate CPT coding.  This fast-moving session will review CPT principles, the framework of the CPT book and code selection using the index and tabular listing.  How does a group know if two services can be billed together? The participant will learn how to check for bundled codes using the NCCI edits.  Using modifiers correctly is critical for both revenue and compliance; this presentation will describe the rules for the most common modifiers used by physician practices.  Attendees will learn the components of the global surgical package and what services may be billed outside of the global payment and what services are included and may not be separately reported.  Medical necessity is too often like beauty: in the eye of the beholder.  How does a practice know what Medicare and other payers consider to be medically necessary before the service is denied?  The participant will learn about local and national coverage policies and the compliant use of Advance Beneficiary Notices.

Learning Objectives:

• Review CPT principles and foundational components
• Understand and correctly apply bundled codes and modifiers
• Accurately bill for surgical procedures
• Determine Medical Necessity

CEUs:
3 AAPC credits for 2012

Practice administrators have a dual responsibility: ensure maximum revenue while complying with government regulations. This session provides a blueprint for compliance by focusing attention on analyzing data and governmental areas of interest. At the end of the session, the manager will develop a blueprint for compliance activities for the coming year.

Learning objectives:

• Evaluate coding risk for individual physicians and the group by analyzing claims data for level of service, use of modifiers and volume and comparing with normative data.
• Describe compliance areas of interest relevant to practice.
• List three key compliance activities for the upcoming year.

Medical practices must collect revenue quickly and at the lowest possible cost. Manual systems, collecting months after the date of service and submit and hope for the best result in lower payments and net revenues. From the first phone call or emergency visit to a zero balance, practices must use up-to-date technology and work processes to effectively collect patient and insurance due balances. For each step in the revenue cycle, this session will describe the optimal processes and technology to yield results.

Learning objectives:

• Assess the effectiveness of Revenue Cycle Management in their practice
• Identify one key process and one technology for improvement
• Measure current denial rate, define a strategy for decreasing and set a goal to re-measure quarterly