Sherry Marchand, CPMA – 2018 Coding and Billing

Get the latest and Correct coding techniques and documentation tips and Complete definitions are required to ensure prompt response and Future insurance claims require optimal payments

Sherry Marchand, CPMA – 2018 Coding and Billing

CPT/HCPCS PROCEDURE CODES and COMPLIANCE WITH DOCUMENTATION STANDARDS

• Credentialing resources
• Explore the Revenue Cycle
• Evaluations and Re-Evaluations for Occupational Therapy and Physical Therapy and Speech Services. (Include tools to modify criteria.
• Orders
• Plan of care, Certification/Re-certification Rules Checklist
• Therapy using CPT Procedure codes and Rehab
  • Evaluations, re-evaluations, and Assessments
  • Modalities that are supervised
  • Guidelines for billing therapy
  • Constant attendance modalities
  • Orthotic changes can be included in therapeutic procedures and Prosthetic management and Training and Cognitive skills development
  • Speech Pathology Services
  • Neuromuscular procedures
  • Debridement, strapping, splints or casts
  • HCPCS Level II codes are used for DME
  • Hospitals charge for orthotics and Other providers
  • Lymphedema Service
  • Woundcare
  • Physical Performance Testing
• Daily Session Notification Checklist
• Discharge Checklist
• NCCI Edits
• Modifiers
• HCPCS II Procedure codes in Therapy and Rehab
• Functional Limitation Requirements-Codes for functional limitations and severity modifiers – required for outpatient   claims filed to Medicare
• Place of Service Codes

DIAGNOSTIC CODING

• ICD Preparation: New Tools-10-CM – Bring your WI-Device with FI capability
• Discuss the chapters that have an effect on Therapy and Rehab
• Requirements for documentation regarding laterality

FEDERAL REGULATIONS MEDICARE’S BILLING RULES and Special Payer News

• Medicare Therapy Cap
• Documentation for Medical Necessity in Therapy and Rehab
• Changes in Congress: Understand them and Their impact on Therapy and Rehab
• Understanding Value-Issues relating to based payments: (i.e. MACRA, MIPS and APM)
• Check out these resources about CMS MAC, RAC and ZIP. and Guidelines for the CERT Program
• OIG audit focuses on behavioral health services
• Medicare’s “incident to” Guidelines and definitions “incident to” Services vs. Payer Supervision
• Overview of Commercial Plans and Therapy coverage
• Common types of fraud in health care and Missbrauch

COMPLIANCE

• Effective compliance plans include the following components
• Understanding the most recent reports from CMS MAC and RAC, OIG and GAO reduces error rates in documentation

UNDERSTANDING REIMBURSEMENT PROCESS

• Understanding the claim contents 837p and 837i resources
• Check out common revenue codes for the 837i claim formats
• Learn more about Medicare Learning Network

THE APPEAL SYSTEM

• Understanding reasons for denials
• Steps to respond to appeals
• Formats of appeal letters

Would you like to be contacted? Sherry Marchand, CPMA – 2018 Coding and Billing ?

Description:

2018 Coding and Billing Therapy and Rehab

Stay up to date with ICD, CPT-10-CM, and HCPCS Level II codes

Learn what is required to comply with coding regulations and Documentation standards 

• Master modifications to the Medicare Therapy Cap-Exception process and how it will effect patient’s out of pocket expenses.
• Learn more about orthotics and Prosthetic management and Training services that distinguish between initial and continuing training and subsequent encounters.
• A new CMS code is available to help develop cognitive skills for improving attention and memory. and Problem solving
• Master documentation elements, CPT coding and Expected payment changes for Evaluations and Re-Physical evaluation codes and Occupational Therapy and Speech and Language Services
• Prepare for complex MACRA law: Physical Therapists and Occupational Therapists and Speech and New reporting requirements are in place for 2019 Language Pathologists at MIPS and APM bundle payments Find out what the next steps are for your organization.

Find the latest and Correct coding techniques and documentation tips and Complete definitions are required to ensure prompt response and Future insurance claims require optimal payments

This course will prepare Therapy and A rehab provider who is familiar with the industry coding will be able to provide rehabilitation services. and Changes in billing are necessary to survive in the changing healthcare environment.

These subjects include 2018 CPT and HCPCS and ICD-10-Updates in CM Coding: Effective Billing, Revenue and documentation techniques and best practices. Guidelines for Claims Processing: 837p and 837i claim format. Prevent denials, delays and Learn how to overcome rejections with effective appeals Strategies to maximize Medicare and managed care reimbursement and Insurance companies

Denials, delays, and “more information required” These are becoming increasingly popular treatments and Rehab insurance and Medicare claims. Medicare claims. and The claims process for physical ailments has been further complicated by changes to reimbursement policies and Occupational therapists and Facility-Providers of rehabilitation services that are community-based. Effective Medicare and Insurance billing requires an in-depth understanding of coding and documentation and Procedures for billing. Combining all the new requirements with the existing coding guidelines and This seminar aims to help you implement proven billing methods. The most recent billing techniques will be taught to you. and Accurate coding and documentation tips and New definitions are added to ensure prompt delivery and Maximum reimbursement for future claims