Presentations

With new payment models, diagnosis coding for physician services takes on added importance. Accurate and complete diagnosis coding will affect incentive payments and negative payment adjustments along with utilization, quality measures and patient satisfaction.

CCM and TCM are complex services, which may be a reason why practices that could benefit from them don’t try. A 2015 survey found only 22% of practices had a CCM program, and...

Evaluation and Management (E/M) services account for 30% of the revenue paid by Medicare for all physician services. For many specialties, E/M codes account for 60-70% of total revenue. Maximum reimbursement depends on understanding the rules related to these services. The goal of this one day seminar is to teach these rules with the goal of revenue enhancement and compliance.These presentations are interactive, hands-on practical sessions: bring your toughest "what if's" and your most confusing E/M scenarios! All specialties that bill E/M services will find this helpful. The final session of the day is a bonus session for primary care practices on E/M services.

Are you missing modifiers? Misplacing modifiers? If so, you’re losing money and wasting time working denials. Slapping a modifier on “just to be safe” (modifier 59 users, this one’s for you) can result in payment when none was due or denials. Coding denials due to incorrect or missing modifiers can cost a practice money.

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.

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.

Some orthopaedic coding issues cause persistent confusion, causing both revenue and compliance risks. But, the rules for these services can and must be mastered.

Surgical procedures are paid under the global surgical services rules, which include pre-operative, intra-operative, and post-operative services in a single payment. This session describes the CPT and CMS rules for the global package. There are some instances in which the physician can be paid for E/M or surgical services within the global period: this session will identify those circumstances and how to submit claims for the service.

Medical practices can decrease denials and accelerate payments, by setting up work processes that use advance functions in their software systems to identify, quantify and categorize denials. The purpose is to...

Timely and practical education on the most important financial management and payer contracting topics that impact today’s medical practices.

As of January 1, medical practices can bill for discussing advanced directives and end of life planning with patients using existing CPT™ codes. Although CMS describes this service as a support to primary care...

The OIG, CMS and private payers have warned clinicians against producing identical notes using their EHRs. And yet, we want physicians to use the features of these programs to more easily document their services. Often the results are lowered productivity and clinical notes that don’t provide meaningful clinical data and look identical to one another. Medical practices need policies to guide clinicians and auditors with the Documentation Guidelines and guidance from payers in mind.

Claims for all services performed on or after October 1, 2015 must use ICD-10 diagnosis codes. This three-hour session will introduce the important principles of ICD-10. The session will cover general guidelines and the chapter specific principles that set the rules for code selection and sequencing. The participant will learn how to select a diagnosis code by understanding the framework of the system and the correct procedure for using the index and tabular list to find a diagnosis.

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.

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.

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.

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.

There are black, white, and grey areas in E/M auditing. This session focuses on the grey areas with suggestions about setting policies that are consistent, safe, and reasonable.

Hospital services have higher error and denial rates than office services. Many physicians who are confident about coding in the office express confusion about their charges in the hospital. They find the charge slips confusing. They make mistakes in the category of service and date of service. This conference ends that confusion.

Have you ever felt confused when reviewing subsequent hospital services? Wondered if the note should count at all? Worried about legibility? This audio conference will discuss the good and the bad, the grey and the black and white of auditing subsequent hospital visits and nursing home services. We'll review sample notes for each type of service and discuss the use of time in selecting these codes.