Do I Have the Right Credential?
|
|
|
- Valentine Walsh
- 6 years ago
- Views:
Transcription
1 Do I Have the Right Credential? AAPC National Conference April 2013 Judy Wilson CPC,CPC-H,CPCO,CPC-P,CPPM,CPCI,CANPC,CMRS Jaci Johnson CPC,CPC-H,CPMA,CEMC,CPC-I
2 Disclaimer Information contained in this text is based on CPT, ICD-9-CM and HCPCS rules and regulations. However, application of the information in this text does not guarantee claims payment. Payers interpretation may vary from those found in this text. Please note that the law, applicable regulations, payer instructions, interpretations, enforcement, etc., may change at any time. Therefore, it is crucial to stay current with all local and national regulations and policies.
3 So Why Are We Here? What are the goals? From a work perspective Identify some basic differences in the CPC and CPC-H credential Identify some basic similarities
4 CPC-H Exam 150 questions 5 hours, 40 minutes Open Book CPT, ICD-9 (Volumes 1 and 2), HCPCS Level II Tests knowledge of coding for the outpatient hospital and ASC facilities, ICD-9-CM, revenue codes, and APCs.
5 CPC-H Exam Format Medical Terminology (10) Anatomy (10) Coding Concepts (10) Payment Methodologies (15) Compliance (5) ICD-9-CM (30) CPT Coding (20) HCPCS Level II (10) Surgery and Modifiers (40)
6 CPC-H Overview The CPC-H credential recognizes expertise in the area of outpatient hospital, hospital-based ambulatory surgical center coding, and independent ambulatory surgery centers (ASC). In most hospitals, coding is performed in several different areas including: Provider based clinics HIM department CPT, ICD-9-CM, HCPCS Level II surgical coding, etc. Ancillary clinical departments Through CDM
7 Overview The CPC-H credentialing examination will cover general billing questions for a facility as well as general code assignment for all areas of CPT, with emphasis on outpatient surgery coding and ICD-9-CM coding. Understanding the use of revenue codes along with the chargemaster is part of this examination, but memorizing the revenue codes and their assignment will not be necessary.
8 CPC Exam 150 questions 5 hours, 40 minutes Open Book CPT, ICD-9 (Volumes 1 and 2), HCPCS Level II The CPC examination consists of questions regarding the correct application of CPT, HCPCS Level II procedure and supply codes and ICD-9-CM diagnosis codes used for billing professional medical services to insurance companies.
9 CPC Exam Format Medical Terminology Anatomy Coding Concepts ICD-9-CM CPT Coding (all six sections and modifiers) HCPCS Level II
10 CPC Overview Expertise in reviewing and assigning accurate medical codes for diagnoses, procedures, and services performed by physicians and other qualified health care providers Proficiency across a wide range of services, including evaluation and management, anesthesia, surgical services, radiology, pathology and medicine A sound knowledge of medical coding rules and regulations including compliance and reimbursement allowing a CPC to better handle issues such as medical necessity, claims denials, bundling issues and charge capture
11 CPC Overview Knowing how to integrate medical coding and reimbursement rule changes into a practice's reimbursement processes Knowledge of anatomy, physiology and medical terminology necessary to correctly code provider diagnosis and services
12 How to Think Facility Differences The service The claim The payment structure
13 How to Think Facility Same CPT codes ICD-9 codes HCPCS codes Compliance and Documentation Standards
14 Lets Compare a Typical Surgical Intervention All names have been changed to protect everyone.
15 A typical day in surgery The day begins at Our Lady of a Better Day Hospital. Ms. Tan (Tough as Nails) has jut arrived to check in for her outpatient surgery. Ms. Tan will undergo a Lap Cholecystectomy possibly with grams under the competent hands of Dr. Gag (Good as Gold).
16 A typical day in surgery Ms. Tan is sedated, scrubbed and prepped and is now in the OR. Dr. Gag makes the incision and inserts the laparoscope. The gallbladder is not a pretty sight and it is thought best to have a look at the common bile duct as well and a cholangiography is performed.
17 A typical day in surgery CPC-H Coding Lap Chole with grams Status Indicator CPC Coding Lap Chole w grams RVU
18 A typical day in surgery Sadly Ms. Tan has had some issues in her past and it is showing up now. The damage to the bile duct as seen on the choliangiogram is caused from severe cirrhosis. Further inspection reveals a mass in the left lateral segment of the liver which requires resection.
19 Oh My!! Just as an incision is made to access the liver and begin the resection Ms. Tan becomes extremely hypotensive.
20 A typical day in surgery Alas, she stands by her name and Ms. Tan is stabilized and Dr. Gag requests a central line and arterial line placed.
21 A typical day in surgery CPC-H Coding Central Line CPC Coding Central Line Arterial Line Arterial Line
22 A typical day in surgery Dr. Gag decides based on the messy state of affairs that perhaps a roux en y bypass would be the best course of action for this patient.
23 A typical day in surgery CPC-H Coding Roux-en-Y CPC Coding Roux-en-Y 47740
24 A typical day in surgery Our patient is stable, closed, and is in recovery. When Ms. Tan awakes a tad later, she is feeling exceptionally well and feels strongly that she must go home totally disregarding Dr. Gag s pleas to have her committed oops admitted. Ms. Tan feels is most important to get on home and feed the cats.
25 So, then what happens? UB Our Lady of a Better Day Surgery which ones? Modifiers? Status Indicators? Anesthesia? CMS 1500 Dr. Gag Surgery which ones? Modifiers?
26 So, then what happens? UB Diagnosis Coding Our Lady of a Better Day Pre Operative Post -Operative CMS 1500 Diagnosis Coding Dr. Gag Pre Operative Post Operative
27 So. Most of the differences will be in understanding a payment methodology. Which CPT codes are allowed? Which modifiers should be used? How will payment determinations be made? A thorough understanding of correct CPT code application and diagnosis coding will be vital with either credential.
28 So what if? What if Dr. Gag and the anesthesia team were not able to stabilize Ms. Tan and the surgery did not continue? Modifier for Dr. Gag Modifier for Our Lady of Better Day
29 Thank you!!
2018 Biliary Reimbursement Coding Fact Sheet
The information contained in this document is provided for informational purposes only and represents no statement, promise, or guarantee by Cordis Corporation concerning levels of reimbursement, payment,
Outpatient Hospital Facilities
Outpatient Hospital Facilities Chapter 6 Chapter Outline Introduce students to 1. Different outpatient facilities 2. Different departments involved in the reimbursement process 3. The Chargemaster 4. Terminology
HC 1930 HC 1930 ICD-9-CM III/CPT Coding II
South Central College HC 1930 HC 1930 ICD-9-CM III/CPT Coding II Course Information Description Total Credits 4.00 Total Hours 80.00 Types of Instruction This course is a continuation of HC 1920, 1925,
LIFE SCIENCES CONTENT
Model Coding Curriculum Checklist Approved Coding Certificate Programs must be based on content appropriate to prepare students to perform the role and functions associated with clinical coders in healthcare
Appendix A WORK PROCESS SCHEDULE AND RELATED INSTRUCTION OUTLINE. Health Information Management (HIM) Professional Fee Coder Apprenticeship
Appendix A WORK PROCESS SCHEDULE AND RELATED INSTRUCTION OUTLINE Health Information Management (HIM) Professional Fee Coder Apprenticeship O*NET-SOC CODE: 29-2071.00 RAPIDS CODE: Type of Training: Competency-based
Observation Services Tool for Applying MCG Care Guidelines
In the event of a conflict between a Clinical Payment and Coding Policy and any plan document under which a member is entitled to Covered Services, the plan document will govern. Plan documents include
2006 Clinical Coding Workout 5/3/2006 MISSING QUESTIONS Chapter 5, Intermediate Ambulatory Page 1
Chapter 5, Intermediate Ambulatory Page 1 CPT Modifier Use 5.81. Dr. Raddy, staff radiologist, interprets a chest x-ray that was obtained in the hospital Radiology Department. Dr. Raddy is contracted with
Hospital-Based Ambulatory Care
C H A P T E R 2 Hospital-Based Ambulatory Care ANSWERS TO KNOWLEDGE-BASED QUESTIONS 1. What has been the trend in the utilization of hospital-based services? What factors help to account for this trend?
Observation Services Tool for Applying MCG Care Guidelines Policy
In the event of conflict between a Clinical Payment and Coding Policy and any plan document under which a member is entitled to Covered Services, the plan document will govern. Plan documents include,
Compliant Documentation for Coding and Billing. Caren Swartz CPC,CPMA,CPC-H,CPC-I
Compliant Documentation for Coding and Billing Caren Swartz CPC,CPMA,CPC-H,CPC-I caren@practiceintegrity.com Disclaimer Information contained in this text is based on CPT, ICD-9-CM and HCPCS rules and
Grow Your Own Coders: Training Options for the Modern HIM World
Grow Your Own Coders: Training Options for the Modern HIM World Healthcon 2016 April Date 13, 2016 Presentation by Pamela Haney, MS, RHIA, CCS, CIC, COC Director of Presentation Training and byeducation
Audit Scope and Sampling. AAPC HealthCon 2017 Las Vegas Jaci J Kipreos CPC COC CPMA CEMC CPCI
Audit Scope and Sampling AAPC HealthCon 2017 Las Vegas Jaci J Kipreos CPC COC CPMA CEMC CPCI About the Presenter Jaci J Kipreos CPC, COC CPMA, CPC-I, CEMC Jaci has been working in the field of medical
PROFESSIONAL MEDICAL CODING AND BILLING WITH APPLIED PCS LEARNING OBJECTIVES
The Professional Medical Coding and Billing with Applied PCS classes have been designed by experts with decades of experience working in and teaching medical coding. This experience has led us to a 3-
Chapter 13 Section 2. Billing And Coding Of Services Under Ambulatory Payment Classifications (APC) Groups
Outpatient Prospective Payment System (OPPS)-Ambulatory Payment Classification (APC) Chapter 13 Section 2 Billing And Coding Of Services Under Ambulatory Payment Classifications (APC) Groups Issue Date:
2014 CODING & DOCUMENTATION UPDATE. Healthcare Services Group November 2013
2014 CODING & DOCUMENTATION UPDATE Healthcare Services Group November 2013 Overview of Topics ICD-10 Implementation 2013 OIG Work Plan Physician, ASC and Hospital 2014 CPT Code Changes 2 ICD-10-CM & ICD-10-PCS
Optima Health Provider Manual
Optima Health Provider Manual Supplemental Information For Ohio Facilities and Ancillaries This supplement of the Optima Health Ohio Provider Manual provides information of specific interest to Participating
Advanced Evaluation and. AAPC Regional Conference Chicago 10/27/12
Advanced Evaluation and Management AAPC Regional Conference Chicago 10/27/12 Jaci Johnson, CPC,CPMA,CEMC,CPC H,CPC I President, Practice Integrity, LLC jaci@practiceintegrity.com Disclaimer Information
ADVANCED MONITORING PARAMETERS 2017 QUICK GUIDE TO HOSPITAL CODING, COVERAGE AND PAYMENT
ADVANCED MONITORING PARAMETERS 2017 QUICK GUIDE TO HOSPITAL CODING, COVERAGE AND Overview: Coding and Payment Systems The procedures described are performed in the hospital setting, usually as an intraoperative
ATTENTION PROVIDERS. Billing & Reimbursement Requirements for Observation Services
EqualityCareNews November 2005 ATTENTION PROVIDERS Provider Bulletin 05-005 Billing & Reimbursement Requirements for Observation Services Effective October 1, 2005, under Outpatient Prospective Payment
LifeWise Reference Manual LifeWise Health Plan of Oregon
11 UB-04 Billing Description This chapter contains participation, claims and billing information for providers who bill on a UB-04 (CMS 1450) claim form. This chapter supplements information contained
Health Informatics. Health Informatics professionals treat technology as a tool that helps patients and healthcare professionals.
Health Informatics Health Informatics professionals treat technology as a tool that helps patients and healthcare professionals. 3.02 Understand health informatics 2 Health Informatics A career area that
Billing & Reimbursement Presentation. November 28, 2007
Billing & Reimbursement Presentation November 28, 2007 Billing & Reimbursement for Joslin Affiliates Introduce yourself - front end clinic & operations staff need to meet hospital chargemaster, coding
Transitioning to ICD-10: An Action Plan for Practices
Transitioning to ICD-10: An Action Plan for Practices By Nancy M Enos, FACMPE, CPMA, CPC-I, CEMC 1 viterahealthcare.com/icd10 The Four T s of Transition to ICD-10: Timing, Training, Testing and Technology
Jaci Johnson, CPC,CPMA,CEMC,CPC H,CPC I President, Practice Integrity, LLC Disclaimer
Advanced Evaluation and Management More than a roll of the dice? History Exam Medical Decision Making Jaci Johnson, CPC,CPMA,CEMC,CPC H,CPC I President, Practice Integrity, LLC jaci@practieintegrity.com
Presented by: Jodie Edmonds VP Medicaid Revenue Consultant Passport Health Communications
Presented by: Jodie Edmonds VP Medicaid Revenue Consultant Passport Health Communications Complete and correct coding of claims will become more important, and will have an effect on claim payment. The
3F Auditing Outpatient Surgical Services. Disclaimer. Agenda. 3F Auditing Outpatient Surgical Services November 2013
3F Auditing Outpatient Surgical Services 2013 Regional Conference Baltimore, MD November 18, 2013 presented by Sarah L. Goodman, MBA, CHCAF, CPC H, CCP, FCS All Rights Reserved Disclaimer Every reasonable
Minimizing the Financial Impact of ICD 10 to Budgets, Productivity Forecasts and Reimbursement
Minimizing the Financial Impact of ICD 10 to Budgets, Productivity Forecasts and Reimbursement National Rural Health Resource Center Rural Hospital Performance Improvement (RHPI) Project December 19, 2012
Your Student s Head Start on Career Goals and College Aspirations
Your Student s Head Start on Career Goals and College Aspirations HEALTH SCIENCE THERAPEUTIC SERVICES PATHWAY NURSING The Destinations Therapeutic Services Pathway prepares students for careers in medical
Emergency Department Facility Coding and Billing
Emergency Department Facility Coding and Billing The Basics of Facility Coding A Historical View of Hospital Coding and Reimbursement for ED Services E/M Visit Level Coding ED Procedure Coding Payment
Chargemaster Coding Updates and Implementation for 2015 Hospital Coding & Billing Updates Effective January 1, 2015
Chargemaster Coding Updates and Implementation for 2015 Hospital Coding & Billing Updates Effective January 1, 2015 Who should attend? This seminar is targeted to individuals responsible for APCs, Billing,
Chapter 9 Section 1. Ambulatory Surgical Center (ASC) Reimbursement
Ambulatory Surgery Centers (ASCs) Chapter 9 Section 1 Issue Date: August 26, 1985 Authority: 32 CFR 199.14(d) Copyright: CPT only 2006 American Medical Association (or such other date of publication of
Archived SECTION 19 - PROCEDURE CODES. Section 19 - Procedure Codes
SECTION 19 - PROCEDURE CODES 19.1 CPT CODES...2 19.2 PROCEDURE CODES...2 19.3 PROCEDURES REQUIRING A COPAY (TEXT DEL. PRIOR TO 7/08)...3 19.4 COVERED AMBULATORY SURGICAL CENTER PROCEDURE CODES...3 Ambulatory
Archived SECTION 19 - PROCEDURE CODES. Section 19 - Procedure Codes
SECTION 19 - PROCEDURE CODES 19.1 CPT CODES...2 19.2 PROCEDURE CODES...2 19.3 PROCEDURES REQUIRING A COPAY (TEXT DEL. PRIOR TO 7/08)...3 19.4 COVERED AMBULATORY SURGICAL CENTER PROCEDURE CODES...3 Ambulatory
Coding Analysis Related to Commercialization of the XPANSION Skin Grafting Instruments Provided by The Institute for Quality Resource Management
The codes provided would be recognized as active payable codes by The Centers for Medicare and Medicaid Services (CMS) and private insurance as well. The payment amounts will vary for private insurance
Optima Health Provider Manual
Optima Health Provider Manual Supplemental Information For Facilities and Ancillaries This supplement of the Optima Health Provider Manual provides information of specific interest to Optima Health contracted
Benefit Criteria for Outpatient Observation Services to Change for Texas Medicaid
Benefit Criteria for Outpatient Observation Services to Change for Texas Medicaid Information posted on October 8, 2010 Effective for dates of service on or after December 1, 2010, the benefit criteria
Chapter 13 Section 2. Billing And Coding Of Services Under Ambulatory Payment Classifications (APC) Groups
Outpatient Prospective Payment System (OPPS)-Ambulatory Payment Classification (APC) Chapter 13 Section 2 Billing And Coding Of Services Under Ambulatory Payment Classifications (APC) Groups Issue Date:
Cigna Medical Coverage Policy
Cigna Medical Coverage Policy Subject Observation Care Table of Contents Coverage Policy... 1 General Background... 2 Coding/Billing Information... 4 References... 5 Effective Date... 10/15/2014 Next Review
Chapter 9 Section 1. Ambulatory Surgical Center (ASC) Reimbursement
Ambulatory Surgery Centers (ASCs) Chapter 9 Section 1 Issue Date: August 26, 1985 Authority: 32 CFR 199.14(d) Copyright: CPT only 2006 American Medical Association (or such other date of publication of
ADDENDUM SOUTHWEST SKILL CENTER TRAINING PROGRAMS
ADDENDUM 2017-2018 SOUTHWEST SKILL CENTER TRAINING PROGRAMS The SouthWest Skill Center offers a variety of programs in healthcare to help you build skills for the career of your dreams. These hands-on
OBSERVATION CARE EVALUATION AND MANAGEMENT CODES POLICY
OBSERVATION CARE EVALUATION AND MANAGEMENT CODES POLICY UnitedHealthcare Oxford Reimbursement Policy Policy Number: ADMINISTRATIVE 232.10 T0 Effective Date: March 1, 2017 Table of Contents Page INSTRUCTIONS
a. 95 guidelines are based on body systems 97 systems based on bullet points.
Interview questions for freshers Medical Coding Interview Questions 1) What is the basic difference between 95 and 97 guidelines? a. 95 guidelines are based on body systems 97 systems based on bullet points.
Review Process. Introduction. Reference materials. InterQual Procedures Criteria
InterQual Procedures Criteria Review Process Introduction As part of the InterQual Care Planning family of products, InterQual Procedures Criteria provide healthcare organizations with evidence-based clinical
Sample page. Orthopaedics: Hips & Below. A comprehensive illustrated guide to coding and reimbursement CODING COMPANION
CODING COMPANION 2018 Orthopaedics: Hips & Below A comprehensive illustrated guide to coding and reimbursement POWER UP YOUR CODING with Optum360, your trusted coding partner for 32 years. Visit optum360coding.com.
Coding, Corroboration, and Compliance How to assure the 3 C s are met
Coding, Corroboration, and Compliance How to assure the 3 C s are met Sue Roehl, RHIT, CCS sroehl@eidebailly.com 701-476-8770 OIG 1996 - $23.2 Billion errors Figure 1 Insufficient/No documentation 46.76%
Modifiers 54 and 55 Split Surgical Care
Manual: Policy Title: Reimbursement Policy Modifiers 54 and 55 Split Surgical Care Section: Modifiers Subsection: None Date of Origin: 7/28/2004 Policy Number: RPM030 Last Updated: 7/3/2017 Last Reviewed:
Observation Care Evaluation and Management Codes Policy
Policy Number Observation Care Evaluation and Management Codes Policy 2017R0115A Annual Approval Date 3/8/2017 Approved By Reimbursement Policy Oversight Committee IMPORTANT NOTE ABOUT THIS You are responsible
HEALTH INFORMATION TECHNOLOGY (HIT) COURSES
HEALTH INFORMATION TECHNOLOGY (HIT) COURSES HIT 110 - Medical Terminology This course is an introduction to the language of medicine. Course emphasis is on terminology related to disease and treatment
NIM-ECLIPSE. Spinal System. Reimbursement Brief
NIM-ECLIPSE Spinal System Reimbursement Brief 1 NIM-ECLIPSE Spinal System Reimbursement brief NIM-ECLIPSE Spinal System The NIM-ECLIPSE Spinal System is a surgeon-directed and neurophysiologist-supported
National Fee Analyzer. Charge data for evaluating fees nationally
National Fee Analyzer Charge data for evaluating fees nationally 2013 Contents Introduction...1 Key to Proper Reimbursement... 1 The Medical Coding System... 1 What This Book Has to Offer... 2 A Coding
Procedural andpr Diagnostic Coding. Copyright 2012 Delmar, Cengage Learning. All rights reserved.
Procedural andpr Diagnostic Coding What is Coding? Converting descriptions of disease, injury, procedures, and services into numeric or alphanumeric descriptors Accurate coding maximizes reimbursement
Important Billing Guidelines
Important Billing Guidelines The guidelines contained herein are meant to assist GHP Family Participating Providers in billing appropriately for medically necessary services rendered to GHP Family Members.
TRICARE Reimbursement Manual M, February 1, 2008 Ambulatory Surgery Centers (ASCs) Chapter 9 Section 1
Ambulatory Surgery Centers (ASCs) Chapter 9 Section 1 Ambulatory Surgical Center (ASC) Reimbursement Prior To Implementation Of Outpatient Prospective Payment (OPPS), And Thereafter, Freestanding ASCs,
today! Visit or call 800/
The bestselling Certified Coder Boot Camp is now available online! Register today! Visit www.hcprobootcamps.com or call 800/750-0584. Register 30 days in advance and save $200! Call HCPro at 800/750-0584
A Revenue Cycle Process Approach
A Revenue Cycle Process Approach VALERIUS BAYES NEWBY Education BLOCHOWIAK Preface x Parti Chapter1 WORKING WITH MEDICAL INSURANCE AND BILLING Chapter 3 Introduction to the Revenue Cycle 2 1.1 Working
OUTPATIENT DOCUMENTATION IMPROVEMENT
OUTPATIENT DOCUMENTATION IMPROVEMENT Pam Brooks, MHA, COC, PCS, CPC Coding Manager Wentworth-Douglass Hospital Dover NH Disclaimer This presentation is for general education purposes only. The information
JEFFERSON COLLEGE COURSE SYLLABUS HIT 250. Healthcare Billing and Reimbursement. 3 Credit Hours
JEFFERSON COLLEGE COURSE SYLLABUS HIT 250 Healthcare Billing and Reimbursement 3 Credit Hours Prepared by: Niki Vogelsang, MBA, RHIA Health Information Technology Program Director Created on Date: 10-11-11
Anesthesia Payment & Billing Information
Anesthesia Payment & Billing Information Time and Points Eligible Anesthesia Procedures Defined Blue Cross and Blue Shield of Texas has determined that certain anesthesia procedures will be reimbursed
Anesthesia Services Policy
Anesthesia Services Policy Policy Number Annual Approval Date 3/14/2018 Approved By Oversight Committee IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY This policy is applicable to UnitedHealthcare Medicare
Exploratory Study of Radiology Coding in Health Information Management Practice
Exploratory Study of Radiology Coding in Health Information Management Practice 1 Exploratory Study of Radiology Coding in Health Information Management Practice by Melanie Brodnik, PhD, RHIA Abstract
Chapter 02 Hospital Based Care
Chapter 02 Hospital Based Care MULTICHOICE 1. The physician sends the patient to the hospital for a radiological examination. The patient returns to the physician's office for follow-up of test results.
Surgical Assistant DESCRIPTION:
Private Property of Florida Blue This payment policy is Copyright 2017, Florida Blue. All Rights Reserved. You may not copy or use this document or disclose its contents w ithout the express w ritten permission
A McKesson Perspective: ICD-10-CM/PCS
A McKesson Perspective: ICD-10-CM/PCS Its Far-Reaching Effect on the Healthcare Industry Executive Overview While many healthcare organizations are focused on qualifying for American Recovery & Reinvestment
CDERC, CCS-P Vice President Strategic Development American Academy of Professional Coders
ICD-10-CM Implementation Part 3 Deborah Grider, CPC, CPC-I, CPC-H, CPC-P, P COBGC, CEMC, CDERC, CCS-P Vice President Strategic Development American Academy of Professional Coders Goal This Webinar conference
Facility-Based Behavioral Health Program Professional Fees Reimbursement Policy Annual Approval Date. Approved By
Policy Number 2016RP505A Facility-Based Behavioral Health Program Professional Fees Reimbursement Policy Annual Approval Date 09/30/2016 Approved By Optum Behavioral Reimbursement Committee IMPORTANT NOTE
Modifier 53 Discontinued Procedure
Manual: Policy Title: Reimbursement Policy Modifier 53 Discontinued Procedure Section: Modifiers Subsection: none Date of Origin: 9/13/2007 Policy Number: RPM018 Last Updated: 5/8/2017 Last Reviewed: 5/12/2017
Global Period for Surgery. Is it billable?
Global Period for Surgery. Is it billable? August 10, 2017 Question: My patient presented to the ED with an infection at the incision site from a surgery that I did 4 weeks ago. It has a 90 day global.
Top Audit Finding: Discrepancies in Secondary Diagnosis Assignment on Outpatient and Pro-Fee Claims
March 8, 2018 Top Audit Finding: Discrepancies in Secondary Diagnosis Assignment on Outpatient and Pro-Fee Claims By Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-approved ICD-10- CM/PCS trainer There is
Alabama Primary Health Care Association October 4, Separating Clinical Documentation, Professional Coding, and Billing: A Workflow Analysis
Alabama Primary Health Care Association October 4, 2017 Separating Clinical Documentation, Professional Coding, and Billing: A Workflow Analysis Presented by: Gary Lucas, M.Sc., CPC, CPC-I, AHIMA ICD-10
Department of Defense INSTRUCTION
Department of Defense INSTRUCTION NUMBER 6025.8 September 23, 1996 ASD(HA) SUBJECT: Ambulatory Procedure Visit (APV) References: (a) DoD Instruction 6025.8, "Same Day Surgery," July 21, 1986 (hereby canceled)
Chapter 13 Section 2. Billing And Coding Of Services Under Ambulatory Payment Classifications (APC) Groups
Outpatient Prospective Payment System (OPPS)-Ambulatory Payment Classification (APC) Chapter 13 Section 2 Billing And Coding Of Services Under Ambulatory Payment Classifications (APC) Groups Issue Date:
Program Selection Criteria: Bariatric Surgery
Program Selection Criteria: Bariatric Surgery Released June 2017 Blue Cross Blue Shield Association is an association of independent Blue Cross and Blue Shield companies. 2013 Benefit Design Capabilities
Chapter 1 Section 16
General Chapter 1 Section 16 Issue Date: August 26, 1985 Authority: 32 CFR 199.4(c)(2)(i), (c)(2)(ii), (c)(3)(i), (c)(3)(iii), and (c)(3)(iv) 1.0 APPLICABILITY Paragraphs 3.1 through 3.7 apply to reimbursement
IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY
Global Surgery Policy Number GLS03272013RP Approved By UnitedHealthcare Medicare Committee Current Approval Date 04/09/2014 IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY This policy is applicable to UnitedHealthcare
VIRGINIA WORKERS COMPENSATION MEDICAL FEE SCHEDULES GROUND RULES JUNE 5, 2017
VIRGINIA WORKERS COMPENSATION MEDICAL FEE SCHEDULES GROUND RULES JUNE 5, 2017 Contents Introduction... 3 Definitions... 4 General Information... 11 Application of the Medical Fee Schedules... 11 Exclusions
For Vanderbilt Medical Center Carolyn Buppert, NP, JD Law Office of Carolyn Buppert
For Vanderbilt Medical Center Carolyn Buppert, NP, JD Law Office of Carolyn Buppert www.buppert.com Describe the services in critical care that nurse practitioners perform that are billable Discuss what
Charge Integrity of Surgical Services
Charge Integrity of Surgical Services Crowe Healthcare Webinar Series Audit Tax Advisory Risk Performance 2015 Crowe Horwath LLP Agenda 1. Objectives 2. Surgical Services Charge Structures 3. Accounting
The new semester for this Certificate will begin Fall 2018
Great Basin College Professional Medical Coding and Billing Program Certificate of Achievement The new semester for this Certificate will begin Fall 2018 For more information, Contact: Gaye Terras 775-753-2241
Payment Policy: Visits On Same Day As Surgery Reference Number: CC.PP.040 Product Types: ALL Effective Date: 03/01/2018
Payment Policy: Visits On Same Day As Surgery Reference Number: CC.PP.040 Product Types: ALL Effective Date: 03/01/2018 Revision Log See Important Reminder at the end of this policy for important regulatory
Effective Date. N/A Medicare Indicator Status B Services Reimbursement Policy Anesthesia Modifiers
Payment Policy Title Number Last Approval Date Replaces Cross Reference Anesthesia Guidelines CP.PP.017.v2.9 02/27/18 Original 09/01/00 Effective Date N/A Medicare Indicator Status B Services Reimbursement
Master complex Medicare regulations and prepare for government audits.
2011 Summer/Fall Classes Master complex Medicare regulations and prepare for government audits. Seattle, WA August 1 5 Cincinnati,OH September 12 16 Dallas,TX October 17 21 San Diego, CA Oct. 31 Nov. 4
Non-Chemotherapy Injection and Infusion Services Policy, Professional
Non-Chemotherapy Injection and Infusion Services Policy, Professional Policy Number Annual Approval Date 3/14/2018 Approved By Oversight Committee IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY This policy
Modifiers 80, 81, 82, and AS - Assistant At Surgery
Manual: Policy Title: Reimbursement Policy Modifiers 80, 81, 82, and AS - Assistant At Surgery Section: Modifiers Subsection: None Date of Origin: 1/1/2000 Policy Number: RPM013 Last Updated: 7/11/2017
Supply Policy. 11/15/2017 Approved By Reimbursement Policy Oversight Committee
Supply Policy Policy Number 2018R0006A Annual Approval Date 11/15/2017 Approved By Reimbursement Policy Oversight Committee IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY You are responsible for submission
Postoperative Sinus Endoscopy and/or Debridement Procedures
Manual: Policy Title: Reimbursement Policy Postoperative Sinus Endoscopy and/or Debridement Procedures Section: Surgery Subsection: None Date of Origin: 10/1/2009 Policy Number: RPM009 Last Updated: 7/3/2017
Appendix A WORK PROCESS SCHEDULE AND RELATED INSTRUCTION OUTLINE. Clinical Documentation Improvement Specialist Apprenticeship
Appendix A WORK PROCESS SCHEDULE AND RELATED INSTRUCTION OUTLINE Clinical Documentation Improvement Specialist Apprenticeship O*NET-SOC CODE: 29-2071.00 RAPIDS CODE: 2026CB Type of Training: Competency-based
Focus On Observation
Focus On Observation Introduction CPT and CMS Requirements CPT Codes Documentation Requirements Observation Coding: Facility Considerations 2 LogixHealth s unsurpassed service stems from the fact that
Empire BlueCross BlueShield Professional Commercial Reimbursement Policy
Subject: Place of Service NY Policy: 0018 Effective: 12/01/2015 02/21/2016 Coverage is subject to the terms, conditions, and limitations of an individual member s programs or products and policy criteria
Healthcare Common Prodecure Coding System
G0278 ILIAC AND/OR FEMORAL ARTERY ANGIOGRAPHY, NON-SELECTIVE, BILATERAL OR IPSILATERAL TO CATHETER INSERTION, PERFORMED AT THE SAME TIME AS CARDIAC CATHETERIZATION AND/OR CORONARY ANGIOGRAPHY, INCLUDES
Global Surgery Package for Professional Claims
Manual: Policy Title: Reimbursement Policy Global Surgery Package for Professional Claims Section: Administrative Subsection: None Policy Number: RPM011 Date of Origin: 1/1/2000 Last Updated: 3/6/2017
ICD-10 Frequently Asked Questions - SurgiSource
ICD-10 Frequently Asked Questions - SurgiSource What Version of SurgiSource is ICD-10 Compliant? Version 6.0 Where can I find ICD-10 Training Materials for SurgiSource? 1. Visit our Client Portal (portal.sourcemed.net)
9 TIPS FOR SURVIVING AFTER THE ICD-10 GRACE PERIOD ENDS. By Aine Cryts
9 TIPS FOR SURVIVING AFTER THE ICD-10 GRACE PERIOD ENDS By Aine Cryts BE SPECIFIC IN YOUR CODING "Specificity in documentation and diagnosis coding since the ICD-10 implementation is to be encouraged.
OFFICIAL NOTICE DMS-2003-A-2 DMS-2003-II-6 DMS-2003-SS-2 DMS-2003-R-12 DMS-2003-O-7 DMS-2003-L-8 DMS-2003-KK-9 DMS-2003-OO-7
Arkansas Department of Human Services Division of Medical Services Donaghey Plaza South PO Box 1437 Little Rock, Arkansas 72203-1437 Internet Website: www.medicaid.state.ar.us Telephone: (501) 682-8292
Research to Another Level: Medical Coding and the Life Care Planning Process: Part I
Journal of Life Care Planning, Vol. 7, No. 2, (61-72) Printed in U.S.A. All rights reserved 2008 Elliott & Fitzpatrick, Inc. Research to Another Level: Medical Coding and the Life Care Planning Process:
Independent RHC Billing Introduction Session 3 Spring, 2018
Independent RHC Billing Introduction Session 3 Spring, 2018 Contact Information Mark Lynn, CPA (Inactive) RHC Consultant Healthcare Business Specialists Suite 214, 502 Shadow Parkway Chattanooga, Tennessee
Reimbursement Information for Contrast Enhanced Spectral Mammography (CESM) Services 1
GE Healthcare Reimbursement Information for Contrast Enhanced Spectral Mammography (CESM) Services 1 May 2018 www.gehealthcare.com/reimbursement This advisory addresses Medicare coding, coverage and payment
Paraoptometriic Codiing Certiifiicatiion
Paraoptometriic Codiing Certiifiicatiion Study Map Preparing for the Certified Paraoptometric Coding (CPOC) examination will be a breeze with the many resources available through the AOA and other internet
ALASKA. Official MEDICAL FEE SCHEDULE WORKERS' COMPENSATION
Official ALASKA WORKERS' COMPENSATION MEDICAL FEE SCHEDULE Effective, 201 STATE OF ALASKA DISCLAIMER This document establishes professional medical fee reimbursement amounts for covered services rendered
SURGICAL ONCOLOGY MCVH
SURGICAL ONCOLOGY MCVH PGY-4 and PGY-5 Medical Knowledge: Demonstrates knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences;
Appendix A WORK PROCESS SCHEDULE AND RELATED INSTRUCTION OUTLINE
Appendix A WORK PROCESS SCHEDULE AND RELATED INSTRUCTION OUTLINE Health Information Management (HIM) Hospital Coder/Coding Professional Apprenticeship O*NET-SOC CODE: 29-2071.00 RAPIDS CODE: 2029CB Type