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Join AAHIM for an informative webinar and hear about clinical validation that will: Define clinical validation; Explain the distinction between coding regulations and CMS billing regulations and applicable statutes; Articulate solutions to these conflicting imperatives.
During this session, we will review the definition of “Medical Necessity” as it relates to Medicare, Medicaid, and Commercial insurance carriers. The objective of this course is to “relearn” the meaning of medical necessity and how working with physicians promotes greater insight.
Presentation will address the FY 2022 updates to the ICD-10-CM and ICD-10-PCS Code Sets and Official Coding Guidelines with an emphasis on their impact in the acute care setting. Revisions to the FY 2022 MS-DRG Grouper logic will also be reviewed.
Sessions include: 1) Strategies for Dealing with Payer Denials; 2) CDI – The First 48 hours – CDI Query Response Time; 3) Does the Documentation Tell the Story; 4) Coding Updates Plus Reimbursement Impact & Documentation; Requirements for Surgeries Eliminated from the Inpatient Only List; 5) Coding Productivity; and 6) Charge Analysis
Objectives include: 1) Review best practices related to telehealth coding; 2) Identify documentation requirements for use of the telehealth codes; 3) Review of 2021 E/M Coding Changes & Medicare Telemedicine Updates, and 4) Review best practices for auditing and monitoring telemedicine coding and documentation.
Sessions include: 1) How Successful Coders can Develop an Auditor’s Mindset; 2) Code it Right!; 3) Social Determinants of Health and ICD-10-CM Coding; 4) Understanding the Revenue Cycle Plus the Impacts of the New Physician E&M Coding Changes; 5) Diabetes Coding Back to the Basics; and 6) Hospital Re-Admissions
With medical decision making (MDM) as the key element for the new E/M services guidelines, documenting the medical necessity is more important than ever. This session will walk through the key revisions to the E/M guidelines and discuss ways in which basic documentation principles will ensure that the medical record documentation paints a complete picture of the services rendered, and support the medical necessity of code selection for each level.
This presentation will: Provide and explain the CPT E/M office or other outpatient service revisions and when those changes will take effect Identify why CPT E/M revisions are needed and the benefits provided Describe how the foundational changes will impact your work
With the challenges during the COVID-19 pandemic, hear from experts in the industry on how they managed through the challenges within revenue cycle and health information management functions to maintain and improve, outcomes, and financial performance.
By attending this highly informative and thought-provoking session, participants will gain the practical mindset to recognize the strategies and tactics necessary to begin playing the same “game” and with the same rules being used by the payers, better insuring the survival of their facilities, their jobs, and sometimes even the lives of their patients.
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