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

Description:
CMS has specific, detailed rules about billing for a service provided jointly by a resident and an attending physician, under the attending physician’s provider number. This conference will delineate how the attending needs to participate in the care and what the attending needs to document for E/M services, services based on time, minor procedures, endoscopies and major surgeries.

Don’t use these rules? Do you have NP or PA students in your office? This session will also clarify the regulations related to students.

Agenda:

• Review of GME program requirements
• Rules related to E/M services, psychiatry, minor procedures, endoscopy and surgery
• Codes determined by time
• Medical students, Nurse Practitioner students and Physician Assistant students
• Minimally acceptable documentation
• Use of modifiers

Learning Objectives:

• Describe the documentation requirements for each type of surgical and E/M service
• Assess if the documentation is adequate to meet the program requirements for billing under the attending physician’s provider number

CEUs:
Can be applied for with 45 days notice.

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.