Data Structure, Content and Information Governance (Coding)
This presentation will give an overview of the different types of vascular access devices, pertinent anatomy, and documentation requirements and offer tips and tricks for accurate coding in both coding systems.
Discover the top opportunities for improving inpatient coding accuracy on secondary diagnoses. This presentation reveals one health system’s findings from internal audits, and gives strategies for improving coding quality.
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.
This seminar will introduce coding professionals to the “World of HCC Coding”. Information will be dispersed regarding the CMS Risk Adjustment Program, including but not limited to guidelines, categories, documentation needs, and a high level explanation of the program.
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.
RAC audits include new DRGs for complex review. This presentation will cover CC and MCCs as they relate to: Anemia, Bone Mass Index, Chest Pain, Debridement, Decubitus Ulcers, Respiratory Diagnoses, Sepsis, Altered Mental Status & Encephalopathy, Lysis of adhesions, and Post-acute care transfers. Applications and scenarios for reporting the new codes, as well as reimbursement potentials, from a Centers for Medicare and Medicaid Services perspective, will be addressed.
This presentation will include arterial and venous procedures, specifically arteriovenous anastomosis creation, dialysis circuit interventions, and lower extremity revascularization. We will also cover the new 2017 dialysis circuit intervention codes: 36901-36909. Applications and scenarios for reporting the new codes, as well as reimbursement potentials, from a Centers for Medicare and Medicaid Services perspective, will be addressed.
This presentation will cover documentation elements needed to establish appropriate severity and DRGs. Applications and scenarios for reporting the new codes, as well as reimbursement potentials, from a Centers for Medicare and Medicaid Services perspective, will be addressed.
This is an article from the AHIMA bok that has some wonderful information for long term care coders, and how to apply the guidelines for ICD-10cm correctly. In addition to the LTC guidelines, there is hands on 25 quiz after the article to work on skill building.
This presentation will deliver information from an auditor’s perspective in order to enhance the audience’s understanding of compliant coding. Tips on avoiding documentation traps will also be covered and the audience will be given a sneak preview into 2021 E/M changes.
It has been found that almost 100% of the prior authorization levels given by the Medicare Advantage Plans do not match the PDPM score calculated by the facility MDS. In many cases the difference is $200-$500 per day in reimbursement. NaviHealth is the approved vendor who authorizes SNF stays for Humana and Security Health Plan. In this session we will discuss the request for recalculation process and the financial ramifications.
SNF PDPM has been in effect for over 2 months, we have learned many lessons as well as identified coding practices which result in reduced reimbursement to the SNF. In this session, we will use case studies to review the impact of diagnosis coding on reimbursement.
Advanced Care Planning is a commonly performed service, but one that is often lacking compliant documentation. Learn how to properly capture Advanced Care Planning services and other time based evaluation and management visits.
The health care industry is currently undergoing monumental changes in the U.S. Transition from utilization-based to outcomes-based payment structures has resulted in declining net revenue for many healthcare organizations.