Joint Coding Roundtable

August 3, 2019
9:00 AM – 1:00 PM PT

Welcome CDI & Coding Specialists! 

Speakers:

Denise M. Johnson, RHIA, MS, CPHQ
Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, FCS, PCS, CCDS, C-CDI, C-DAM
Lee Anne Landon BSN, CCMC, CCDS
Betty Stump, MHA, RHIT, CPC, CCS-P, CPMA, CDIP, CCDS, CRC

 

Billing for Non Physician Practitioners: Incident To and Split Shared Services

Published June 11, 2019

Medicare reimbursement for nonphysician (“NPP”) and ancillary services may be captured at different percentages of the physician fee schedule (“PFS”) rate. When billing NPP’s services, Medicare’s “Incident To” and “Split/Shared” service provisions, depending on the setting, are also options to consider. These practices can result in rates that are equal to the reimbursement received as if the physician were rendering the services personally. While reimbursement might be more attractive for this practice, there are strict requirements that must be met to justify the additional payment amounts. For those considering ‘Incident To’ and ‘split/Shared’ billing practices, this presentation will provide the history of such concepts and how a hospital or physician office can structure the patient care workflow process to remain compliant with all Medicare requirements. The presentation will also address all too common weaknesses or misses in the industry that have been the focus of government investigations into non-compliant practices.

Speaker: Jodi Nayoski, CPC, CCS-P, CHC, CDIP

PDPM (Patient Driven Payment Model) and ICD10

Briefly summarize the course including how it relates to the business operations and/or the care of residents in the facility.

Effective October 1st, the new PDPM payment model will rely on very specific ICD-10 codes reported on the MDS to determine the resident’s “Clinical Category” payment rate. Many codes that have been previously been reported and accepted on claims will be rejected. Now is the time to prepare by studying CMS PDPM materials, assessing the current state of coding in each building, and ensuring that facility software will provide functionality that will enable a successful transition with minimal reimbursement delays.

Participants will understand:

  • Basic concepts of what the coding process with ICD-10 involves.
  • Impact of ICD-10 on PDPM and how it drives the 10 “Clinical Categories”.
  • Specific examples of the 27,854 codes that will be rejected October 1, 2019.
  • Specific examples of the 37,214 codes that will be accepted October 1, 2019.
  • Comorbidities and how they can affect the Comorbidity Score.
  • Specific examples where acceptable mappings conflict with coding guidelines.
  • Strategies for coding success under PDPM in their own facility.

Speaker: Bill Roush

Understanding HCC’s and the Importance Across All Care Settings

June 28, 2019
12:00 PM – 1:00 PM CT

At the completion of this educational activity, the learner will be able to:

  • Understand HCCs and the importance across all care settings
  • Understand Documentation and coding guidelines as it relates to HCCs
  • Learn suggested steps on developing an HCC program

Webinar Agenda/Highlights:

  • Introduction
  • What is Risk Adjustment?
  • What are HCCs?
  • Overview of the CMS-HCC Model
  • HCC documentation requirements for reporting/coding
  • Example HCC/RAF score scenario
  • Developing a program to improve HCC Capture Summary

Speaker: Lori Matherne, RHIA, CCS

RHIT/RHIA Online Certification Exam Prep: 12-week course

Start Date: June 24, 2019
End Date: September 22, 2019

These online workshops are designed to provide individuals in their FINAL stages of preparing to take either the RHIA or RHIT exam with the knowledge needed to better prepare for the examinations. These workshops are also designed to strengthen and reinforce competencies for ALL domains of the exam.