Patient Driven Payment Model (PDPM) Overview

December 14, 2019
10:00 AM – 11:30 AM ET

On October 1, 2019 CMS shook up the skilled nursing world when they changed the payment methodology from the Resource Utilization Group, Version IV(RUG-IV) to the Patient Driven Payment Model (PDPM). This model places more emphasis on the characteristics of the resident and not the volume of therapy provided.

The PDPM model groups SNF residents into case-mix grouping based on diagnosis/PCS procedures when performed of approved non-orthopedic or orthopedic procedures.

The PDPM model is diagnosis/procedure driven and this increases the importance of accurate ICD-10-CM diagnoses coding and the ability to select the correct PCS procedure code when applicable.

This audio seminar will focus on the major changes taking place.

Our objectives for this seminar are:

  • Clinical make-up of the PDPM Model
  • ICD-10-CM to clinical Categories
  • Case-Mix model
  • MDS changes

Speaker: Mary Gregory, RHIT, CCS, CDIP, CRC, CPC, CCS-P, CPC

CMS.gov: A Guided Tour

October 16, 2019
12:00 PM – 1:00 PM CT

The Centers for Medicare and Medicaid Services’ (CMS) website, CMS.gov, is one of the largest and most comprehensive payor websites available to the public. Not only does it offer guidance and program information for Medicare and Medicaid beneficiaries, but buried in this website’s overwhelming amount of data and information is a treasure trove of guidance for coding, documentation improvement, and billing teams. Join us to discover how your organization can benefit from a guided tour of CMS.gov.

Objectives

At the completion of this webinar, participants will understand:

  • Important coding, billing and documentation guidelines provided by CMS
  • How and where to find links to CMS coverage guidelines (LCDs and NCDs)
  • How to interpret and apply CMS guidelines, policies and procedures to improve your organization’s coding, billing and documentation practices

Speakers: Melissa Cartier, RHIT, CCS-P and Katie O’Hearn, MS, RHIA, CCS-P, CRC

CPT 2020 Update/OPPS Update

December 18, 2019
11:00 AM – 1:00 PM ET

Are you ready for AMA CPT 2020 update? If not join us for a lunch and learn to learn about the new CPT updates. 2020 will see 394 code changes, including 248 new codes, 71 deleted codes, and 75 revisions. Most changes will be seen in the area of new technology. With the advances of new technology for e-visits and monitoring there is an explosion of new codes to help identify these services. We will discuss these changes. We will review the deletions and the revision and see how they will affect code assignment.

We will also review any OPPS final rules that will impact coding. CMS is proposing to add two new C-APCs and proposing to remove total hip replacement from the IP List only. As well as changes to the Ambulatory Surgery Center (ASC)

Come and join us for this informative session on the new updates for CPT and OPPS.

Agenda:

CPT Review

  • Review new codes
  • Review deleted codes
  • Review revised codes

OPPS Update

  • Inpatient only list
  • New comprehensive APC

Procedures added to Ambulatory Surgery Center

Speaker: Mary D. Gregory, RHIT, CCS, CDIP, CRC, CPC, CCS-P, Approved ICD-10-CM/PCS Trainer

PEPPER for the HIM Professional

October 30, 2019
3:00 PM – 4:00 PM CT

If you’ve heard of “PEPPER” but have never used this report, consider attending this session which will cover all the basics about the Program for Evaluating Payment Patterns Electronic Report (PEPPER). PEPPER is a free comparative data report that CMS contractor RELI group produces for CMS. PEPPER supports provider efforts related to correct coding/billing and adherence to Medicare payment policy by highlighting areas that may be at risk for improper Medicare payments. This session will focus on areas of interest to the HIM community.

Speaker: Kimberly Hrehor, MHA, RHIA, CHC, PMP