Chargemaster Essentials 2019

The heart of chargemaster, also known as charge description master (CDM), is translating the care provided to the patient into a language that payers understand. Pricing transparency regulations can be a pitfall or a prize. Understanding how to present the health care organization’s prices to the public is another important factor to consider.

This presentation will address the common elements of any CDM and how they impact compliance and reimbursement. The new pricing transparency regulations will be addressed, and strategies on how to meet the regulations while making the facility appealing to the public will be provided.

Attendees will be able to understand the following at the conclusion of the presentation:

  1. The common elements of the chargemaster;
  2. Terminology related to the chargemaster and billing;
  3. Pricing transparency regulations; and
  4. Steps to take to make the pricing marketable.

Speaker: Kathy Heckman, RN, CPC and Rick Louie

Diaries of a Professional Fee Coding Compliance Auditor

In a textbook environment, everything comes through easy and perfect for professional fee reimbursement – but that is not the real-world experience! Over the past decade, health information professionals have seen many changes to the documentation and coding world. With the implementation of electronic medical records, there have been many compliance risks in professional fee coding and reimbursement.

This presentation will provide an in-depth look at the most common issues seen during compliance audits for professional fee reimbursement and provide helpful tips in identifying those risks and how to avoid them. Documentation issues, templates, cloned notes, modifier usage, physician’s as the coding professional, nonphysician practitioner issues (incident to/split shared guidelines), teaching physician guidelines, critical care, and more will be explored.

Speaker: Jacquelyn Craver, RHIA, CCS, CCS-P

Coding For COVID-19 Part I: Guidelines, New Codes and Resources

2019 novel coronavirus disease (COVID-19) has brought an influx of patients being admitted to the health care system. While diagnoses and treat of these patients is important, the ability to accurately capture this data by health information professionals is also vital.

This webinar will address the differences between COVID-19 and Coronavirus and will provide a comprehensive look at COVID-19 ICD-10-CM and CPT codes. Coding guidelines will be discussed as they apply to both hospital and coding professional scenarios, including telehealth services. Examples of pro-fee encounters at one health care organization will also be shared.

In addition, available resources for HIM professionals will be highlighted. View recent news updates and helpful resources here.

Speakers: Deanna Klure, RHIT, CDIP, CCS and Carol Yarbrough, MBA, CHC, CPC, CCA, OCS

Operationalizing Information Governance: Beyond the Definition

Information is an organization’s most valuable strategic asset. Every decision that is made at a health care organization, from patient care decisions to hiring decisions to the supplies to be ordered to acquisitions, are based on information. A health care organization cannot assume that its information is accurate and meaningful. Information must be managed in a thoughtful, standardized and holistic way, and it must be managed across the entire organization. This webinar will review the complexity of the lifecycle of information and the challenges that can cause an organization to go “off course,” creating risks, increasing costs, and affecting all business decisions, including patient care.

This presentation will reinforce the importance of information governance (IG) for health care organizations and will take the discussion beyond the definition of IG by providing examples of how HIM professionals can demonstrate the need for IG by showing operational significance across the entire organization. The lifecycle of information will be the focal point for discussions around the operational challenges and return on investment for IG practices. Participants will leave with tools and resources for building an IG program using information management practices, and will gain:

  1. An understanding of IG, what it is and why it’s important;
  2. Insight into the complex components of the lifecycle of information, including the challenges health care organizations face;
  3. An understanding of how IG concepts can be used to address these challenges; and
  4. Checklists that can be used to assess its areas of risk and actionable items.

Speaker: Ann Meehan, RHIA

The Next Generation in Quality Improvement: eCQMs

The days of manually reporting quality measures are over. Knowing how to use electronic clinical quality measures (eCQMs) and interpret what they tell about organizational and provider performance is essential. This session will review eCQMs, the quality data model, value sets, and more. Several widely used eCQMs will be deconstructed and discussed in detail for a more in-depth
understanding.

By the end of this webinar, attendees will:

  1. Define an eCQM;
  2. Understand the components and related standards;
  3. Explore the data quality model; and
  4. Explain the requirements for eCQM implementation.

Speaker: Susan Fenton, PhD, RHIA, CPHI, FAHIMA

Surgical Complication, or Not, That is the Question

Identifying whether a condition, that occurred in the operative suite or in the post-operative period, is a surgical or post-operative complication can be challenging, even for the most seasoned professionals. Dr. Adriane Martin, a board-certified general surgeon, will cover common intra-operative complications and post-operative conditions. She will provide participants with a clear understanding of these events/conditions. The impact of these conditions upon the Centers for Medicare & Medicaid Services (CMS) quality measures will also be examined.

A clear understanding of intra-operative and post-operative complications is critical in health care’s quality driven environment. At the conclusion of this presentation, participants will be able to:

  1. Define a “cause and effect” relationship;
  2. Identify situations in which diagnosis/conditions are potentially “inherent and/or unavoidable”;
  3. Describe common diagnoses which are potential “surgical complications”; and
  4. Identify CMS quality measures impacted by “complications”

By gaining a clear understanding of operative and post-operative complications participants will ensure that patient care is being accurately reported. In turn, reimbursement and quality scores will be reflective of the care delivered.

Speaker: Adriane Martin, DO, FACOS, CCDS