Coding Roundtable – Behavioral Health and Substance Abuse Coding Best Practices Webinar

October 25, 2018
12:00 PM – 1:00 PM ET

Behavioral Health and Substance Abuse Coding Best Practices

This presentation is for those interested in learning more about coding this specialty to include mental health disorders, substance abuse, and procedures in behavioral health. We will review some best practices for coding appropriate specificity and medical necessity criteria in behavioral health.

Speaker: Erin Head, MBA, RHIA, CHDA, CHTS-TR

Coding Roundtable – Just in Time: FY 2019 ICD-10-CM/PCS and IPPS Changes

September 27, 2018
11:30 AM – 1:00 PM ET

Just in Time: FY 2019 ICD-10-CM/PCS and IPPS Changes

This 90-minute presentation will present the details of the significant changes to ICD-10 CM and PCS including changes to the guidelines and explain the logic of the PCS changes. Fiscal year 2019 IPPS changes related to ICD coding will be presented with explanations.

Speakers:

Barbara J. Flynn, RHIA, CCS, AHIMA Approved ICD-10-CM/PCS Trainer

Brandy Ziesemer, MA, RHIA, CCS, ICD-10-CM/PCS Trainer

HIM Roundtable: “Don’t Manage – Inspire. Leadership in a Changing HIM Environment”

June 15, 2018
12:00 PM – 1:00 PM ET

When employees are inspired, teams and organizations have higher productivity and better outcomes, even in times of tremendous change. Leadership is no longer about managing – it is about inspiring. In “Don’t Manage – Inspire. Leadership in a Changing HIM Environment”, leaders will explore best practices in leading through inspiration – a key leadership competency to motivate others in times of change.

Presenter: Allison Craft, PhD

Coding Roundtable: “Inpatient Rehabilitation Coding”

May 15, 2018
12:00 PM – 1:00 PM ET

This presentation will focus on the intricacies of inpatient rehabilitation facility coding. The differences between IRF prospective payment and inpatient hospital prospective payment. Strategies to prevent denials.

Objectives:

  • Inpatient Rehab Facility (IRF) Prospective Payment System (PPS) coding- what you need to know
  • Maximizing IRF reimbursement, IGCs and CMS 13
  • Common Rehab coding challenges
  • Ensuring proper coding acuity and avoiding RAC denials
  • Questions

Presenter: Erin Head, MBA, RHIA, CHDA, CHTS-TR

Physician Coding and Compliance

April 19, 2018
12:00 – 1:00 PM ET

This presentation shares insights as to how every physician’s office or outpatient facility can improve the efficiency and effectiveness of their reimbursement process – with coding and billing techniques that will ensure legal and ethical billing and optimize reimbursement.

Objectives:

  • Identify staff actions that do not comply with laws and regulations
  • Apply internal process adjustments to achieve legal, optimal reimbursement
  • Create an office culture of legal and ethical behaviors while maximizing revenue

Speaker: Shelley C. Safian, PhD, RHIA, HCISPP, CCS-P, COC

Clinical Coding Denial Prevention & Appeals Webinar

March 14, 2018
12:00 PM – 1:00 PM ET

Are coding denials by insurers such as Humana, Aetna, Blue Cross now taking over your time or the time of your denials management staff?

Clinical validation denials are now widespread and intrusive. Many of the targeted diagnoses have been documented clearly and consistently in the medical record but do not meet accepted published clinical indicators.

Official coding advice directs coders to code diagnoses that are documented by a physician as long as there is no conflicting documentation. Is the fact that the clinical “information” contained in the record does not “confirm” the diagnoses documented by the provider enough to remove the code(s) from the claim and pay the claim under a different DRG?

We have reviewed and appealed hundreds of such denials. We will share with clinical documentation improvement team the diagnoses receiving the most denials and clinical criteria used to make the denial. We will share our findings, successful appeals and those that were unsuccessful and why.

Concurrent clinical validation of the principal diagnosis, and CC/MCCs which determine the MS-DRG by CDI is necessary to ensure the documentation in the medical record supports the codes assigned thereby preventing future clinical validation denials. Learn how to compose physician queries that will obtain the clinical indicators to support or rule out a diagnosis that is not appropriate.

Program Objectives

• Understand difference between DRG validation and Clinical validation.
• Understand evidence-based clinical practice guidelines and how third party payers are using them to generate coding and/or DRG changes.
• Describe basic content of appeal letters and timely submission requirements.
• Develop internal tracking mechanisms to identify coding/DRG change denials and appeals.
• Discuss sample issues/cases involving coding/DRG changes due to clinical validation and/or documentation issues.

Speakers: Ms. Barbara Flynn, RHIA, CCS and Ms. Silvia G. Ortiz, MSHSA, RHIT, CMPSM