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

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

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

ICD-11: What HIM Professionals Can Expect

The World Health Organization adopted ICD-11 in May 2019, with the reporting standard to begin January 2022. Although the release does not have an immediate impact and the implementation timing in the United States remains uncertain, HIM professionals should be aware of ICD-11 developments. Knowledge and preparation are imperative to planning the approaching ICD-11 implementation.

Join HIM professionals to discover:

  • Why ICD-11 is being implemented so soon following ICD-10;
  • What are the differences and similarities between ICD-10 and ICD-11;
  • Who is involved in the planning;
  • When will implementation occur; and
  • Examples of ICD-11 will also be presented.

Speaker: Debra E. Martin, RHIT, CDIP, CCS

HIM and Risk Adjustment Methodologies

Understanding risk adjustment methodologies and industry-use is important as health care reinvents itself with shifting reimbursement models, care delivery changes and a population health focus. In this hour, attendees will gain basic knowledge on the different risk adjustment methodologies and be able to share this knowledge with their health care organization. This session will include pragmatic documentation examples to assure that population is accurately represented.

Upon completion of this webinar, attendees will:

  1. Gain an understanding of risk adjustment methodologies;
  2. Understand the potential for HIM to impact the external view of population health;
  3. Explain the ability to link documentation to risk adjustment strategies; and
  4. Provide concrete examples of risk adjustment strategies.

Speaker: Katherine Lusk, MHSM, RHIA, FAHIMA

Social Determinants of Health: Time to Initiate Data Capture with ICD-10-CM

Social determinants of health (SDOH) are the economic and social conditions that influence individual and group differences in health status. They are conditions in which people are born, grow, live, work and age and may impact a wide range of health, functioning, and quality-of-life outcomes and risks. More data is needed to assist in identifying these contributing factors; thus, health information professionals can assist by assigning ICD-10-CM codes.

With SDOH data, we can better understand the patient story, how and when to provide social services and other types of care and treatment. HIM professionals need to be aware of and help with the coding and reporting of these determinants. Now is the time to learn about SDOH and initiate ICD-10-CM code assignment by developing departmental policies.

This webinar will cover:

  • Overview of social determinants of health
  • ICD-10-CM Official Guidelines for Coding and Reporting
  • Actions to take through awareness and policy making
  • Case scenarios
  • Question/Answer

Speaker: Gloryanne Bryant, RHIA, CDIP, CCS, CCDS