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Unique Challenges of Wound Care Coding - Presented on July 11, 2024 There has always been a challenge when it comes to Wound Care Coding. This session reviews the ins and outs from the Diagnosis(es) to the CPT code, as well as documentation requirements. Learn what the challenges are, and what they mean for your healthcare system. The Identification and Management of Sepsis - Presented on April 4, 2024
Sepsis has been used to deny payment by some payers. The remedy? Accurate Documentation. There has been many years of discussion on Sepsis, and the evidence based clinical definition to use Sep-2 vs. Sep-3. This presentation will shed some light on the identification of the management of Sepsis. The National Correct Coding Initiative (NCCI) Overview - Presented on January 4, 2024 This presentation focuses on NCCI edits and how to assign the appropriate modifier for correct coding and billing. It also defines and outlines the different CPT modifiers and global surgery rules. In discussing scenarios, this presentation will facilitate your understanding in resolving various edits as they apply to procedures. The content provides education that is extremely valuable to outpatient coders and auditors in the facility and physician arena; as the NCCI edits are very confusing, especially for surgery accounts, too. In doing so, this will save you substantial time and direction for all coding and billing questions that you have.
2024 I-10 CM & PCS, Guidelines and MCC/CC Updates - Presented on September 28, 2023 CMS has released the final FY 2024 I-10 code changes revealing 395 new CM diagnosis codes, 78 new PCS procedure codes and more than 97 diagnosis codes added to the CC/MCC lists. This session reviews the highlights of the significant CM and PCS changes, MCC/CC modifications and Guideline updates that affect you and your staff beginning October 1, 2023. Learn what the changes will be, and what they mean for your healthcare system.
Taking the Sting Out of Injection and Infusion Coding - Presented on July 6, 2023 CPT Coding the injections and infusions can be painful to comprehend, as they are complicated in nature and function. Coders need to understand WHY the service is taking place, WHAT was administered, HOW it was given, and HOW long it took. The hierarchy and timelines are challenging documentation components, and the coding process requires as much precision as the actual injection/infusion administration itself! In this session, learn definitions, time requirements, documentation rules, and drug details to eliminate the sting of injection/infusion coding. Coding Complications in I-10: It's Complicated - Presented on April 6, 2023The phrase, “…unless otherwise instructed by the classification,” was added to the Guidelines after ICD-10 was implemented. It doesn’t seem like a profound statement, but it has great implications when assigning ICD-10 diagnosis codes as well as influencing our query considerations and use. This session emphasizes the significant refinement and reorganizing of the complication codes within the ICD-10 system and instruct distinctions among those options for accurate code assignment. Don’t Let Fracture Care Coding Break Your Concentration - Presented on January 5, 2023Fractures are very common injuries but can be quite intimidating when coding depending on the type of treatment or the number physicians involved. To code correctly, documentation will need to support the type of treatment as well as unique tasks furnished by each physician. Packages usually result in smiles, but in fracture care, the global package can cause indigestion, so join this session to breakdown your fracture coding concerns and instill more confidence when coding for both the facility and professional components.
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2023 I-10 CM & PCS, Guidelines and MCC/CC Updates - Presented on September 22, 2022 CMS has released the final FY 2023 I-10 code changes revealing 1,179 new CM diagnosis codes, 340 new PCS procedure codes, and more than 150 diagnosis codes added to the CC/MCC lists. This session reviews the highlights of the significant CM and PCS changes, MCC/CC modifications, and Guideline updates that affect you and your staff beginning October 1, 2022. Learn what the changes will be and what they mean for your healthcare system. Successful Strategies for Coding Audits - Presented on July 7, 2022 Complex coding rules, federally mandated regulations, and contracted payer contracts not only cause headaches for today's health care administrators, but one missing or wrong CPT code can alone cause thousands of dollars in lost revenues. In today's climate of regulation oversight, decreased reimbursement, and increased denials, a chart audit will not only adhere to compliance regulations, but enable your team to identify possible revenue risks and maximize reimbursement potentials. You might want to grab a bottle of Ibuprofen while creating or maintaining your chart audit protocol, but your input and involvement can have a positive impact on the process as well as its outcome. Adequate compliance oversight can prevent your risks and headaches, so join us to build upon successful strategies for coding audits. Queries: Asking the Right Question - Presented on April 7, 2022
Since the implementation of I-10, there are more classifications, code choices, and external demands for specific/detailed clinical documentation. As healthcare reimbursement methodologies evolve, reliance on unspecified information may jeopardize provider payments and quality metric scores. Therefore, HIM and CDI teams need to employ documentation improvement strategies to ensure proper payments, minimize denials, better represent the patient's clinical conditions and treatments, and ensure publicly-reported quality scores are accurate.
This session will briefly review the query expectations, but will mainly serve as your query coach. You will learn how to transpose your weak queries into high functioning questions that not only respond to guidelines, but allow physicians to better understand the query process and have great potential to increase query response rates.
Join us to learn more about the essential query components as well as improve your query writing techniques. Z Codes: Factors Influencing Health Status and Contact with Health Services (Z00-Z99) -
Presented Jan 12, 2022
CM Z codes provide additional information about a patient encounter, and most have sequencing instructions. Confusion often occurs about if or when to report as well as its designated sequencing intent. Social Determinants of Health (SDoH) fall in Chapter 21, so this session speaks to the significance of SDoH, as well as other circumstances that can influence your patient’s health status. To strengthen the Coder’s knowledge as well as to ensure appropriate reporting, this session emphasizes all Z code categories, their definitions, sequencing expectations, as well as their use in various settings.
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2022 CM and PCS Updates -
Presented on September 22, 2021
CMS has released the final FY 2022 I-10 code changes, revealing a total of 159 new, 20 revised, and 32 deleted CM codes. This session reviews the highlights of the significant CM and PCS changes, as well as MCC/CC and Guideline changes affecting you and your staff effective October 1, 2021.
Risk Adjusted Coding and Hierarchical Condition Categories (HCC) -
Presented on July 7, 2021
When Medicare Advantage (MA) Plans were developed, so too was a process to determine or predict healthcare needs based on the MA enrollee’s health. Hierarchical Condition Categories (HCC) are defined as a risk adjusted reporting model to calculate risk scores that can in turn, predict future health care costs. MA plans are paid by CMS through a risk adjusted formula, so there are incentives for the health care provider (hospital/clinic/physician) to be reimbursed on a risk adjusted model as well. This session provides the HCC background, demonstrates HCC impact, and assists your team to determine if HCC coding is in your future.
Clinical Documentation Integrity (CDI) in a Rural Setting -
Presented on April 7, 2021
Code assignments are assigned based on the level of Medical Record Documentation, and often these code assignments trigger hospital and physician reimbursements...but these days, more than reimbursement is at stake for all health care settings. This session emphasizes the significance CDI and explains how your setting can benefit when adopting the CDI culture as a key strategy. You will learn essential CDI definitions, its benefits, and typical objectives; the key elements of a vital CDI program; and obtain direction and tools to jump start your CDI culture.
CPT Genitourinary Coding
- Presented on January 6, 2021
There are various items to consider when coding genitourinary procedures in CPT, so this session will walk through the GU anatomy as well as highlight the basic terms that are essential to understand and assign appropriate CPT codes. After this foundation is established, more advanced concepts and hands-on examples will be shared to secure a better understanding of GU related procedures.
2021 CM and PCS Updates
(57 min)
– Presented on September 23, 2020
CMS has released the final FY 2021 I-
10 code changes, revealing a total of 490 new, 47 revised, and 58 deleted CM codes. This session will review the highlights of the significant CM and PCS changes, as well as MCC/CC and Guideline changes affecting you and your staff effective October 1, 2020.
2021 Evaluation and Management Updates
(124 min) -
Presented on July 1, 2020
Major changes are coming to EM services provided in any physician practice. January 1, 2021 seems to be in the far future, but given the magnitude of changes and staff involved, your team needs to be ready and prepared to adjust to the revised system. There’s no time like the present to inform your clinic staff of the 2021 Guidelines and changes. Please invite your teams to learn about the new definitions, expected outcomes, and implementation recommendations. |