Some orthopaedic coding issues cause persistent confusion, causing both revenue and compliance risks. But, the rules for these services can and must be mastered. These include providing an injection and an E/M service on the same day, pre-operative visits, reporting the services of mid- level providers to Medicare, documenting x-rays and medication units, and high level E / M services. Mastering the rules for these topics will increase coding accuracy and increase compliance.

Participants will leave with an audit tool for the use of Modifier 25 and injection services and for reporting services under the correct National Provider Identifier (NPI) number of the rendering provider.

After this session, attendees will:

• Understand how to apply the audit tool for assessing use of Modifier 25
• Recognize documentation needed for x-ray interpretation, medications and high level E/M visits
• Evaluate claims for correct NPI of rendering provider for Medicare

This one hour presentation is for clinicians, managers and coding and billing staff, and is presented in person or by audio feed.

Description:
Incident-to services appear on the OIG Work Plan year after year. The stakes are high for the practice in terms of revenue and compliance. Ask around the office, and there is often significant disagreement over the Medicare rules for these services, including in what setting each can be provided. This audio will provide definitive answers about billing for Non-Physician Practitioners incident-to or as shared services.

Agenda:

• Definition of Non-Physician Practitioners, incident to services and shared services
• Importance of place of service
• Nurse visits
• Special rules relating to consults, critical care and new patient visits
• Documentation requirements

Learning Objectives:

• Differentiate between when to bill for the NPPs services under the MD versus the NPP provider number
• Distinguish between incident to shared services rules

CEUs:
Can be applied for with 45 days notice

While practice administrators don’t need to be medical coders to ensure their practices’ success, they do need to understand the difference between medical coding rules and reimbursement policies, the source of authoritative citations, and rules to achieve maximum revenue while maintaining compliance. This session will provide answers to common medical coding questions applicable to a wide range of specialties, and help participants find answers to other questions when they return to their practices.

Learning objectives:

• Describe the difference between coding rules and reimbursement policies
• List three relevant coding concepts and identify the source documentation that explains each concept
• More effectively supervise coding staff along with coding systems and processes