Live & Recorded Virtual Event
Overview
This presentation will review the legal description of medical necessity as it pertains to reimbursement for healthcare services. It will explore the role that ICD-10-CM diagnosis codes play in this aspect of the reimbursement process, including examples and case scenarios.
We will explain the impact of ICD-10-CM diagnosis coding on the reimbursement process – on whether a claim gets approved, denied, or reduced. We will discuss the steps beneficial to obtaining optimal reimbursement for procedures, services, and treatments provided.
Having a claim denied for lack of medical necessity when you are working for a legitimate, honest provider is something that should not go unchallenged. We must always ensure that the documentation, and the ICD-10-CM diagnosis codes reported are aligned with payer requirements.
We will discuss all the perspectives.
Learning Objectives:
- Build understanding of the role of diagnosis codes in reimbursement
- Examine physician documentation for rationales for ensuing procedures, services, and treatments
- Utilize resources to predict third-party requirements to prompt physician queries, as necessary
Course Info
Event Date
November 2024
Total CEs
1.0
Domain(s)
Data Structure, Content and Information Governance
Pricing
ILHIMA Member
$20.00
Non-Member
$30.00
ILHIMA Member – an AHIMA dues-paying member who has selected Illinois as their Component Association (CA)
Non-Member – includes AHIMA dues-paying members from other AHIMA Component Associations (CA) as well as AHIMA Credentialed Non-Members
Learn More
Speaker
Additional Information
AHIMA
This educational offering has been approved for continuing education credit for use in fulfilling the continued education requirements of the American Health Information Management Association (AHIMA).
AAPC
CEUs are accepted from programs sponsored by AHIMA national offices and the state or regional AHIMA branches. One hour of instruction is worth one CEU. A certificate of attendance or completion is necessary to show participation.
ACDIS
AHIMA CEUs that are CDI-related are accepted.
Register
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Already Purchased Course?
If you have already purchased this course, then you will need to sign in to access and then click on the session(s) listed under Course Content.
Access instructions for the course will be emailed to you within 2 business days following receipt of payment.
You will have 60 days to access the course after access has been granted.
How Do I Receive the CE?
You must click on the button labeled “Mark Complete” at the bottom of each course page before the CE will appear on the My Certificates page.
- For on-demand events, access instructions for the course will be emailed to you within 2 business days following receipt of payment.
- You will have 60 days to access the course. If your course has expired, and you need an extension, please contact us.
- You must click on the button labeled “Mark Complete” at the bottom of each course page before the CE will appear on the My Certificates page.
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Course Content
Course Includes
- 4 Lessons
- Course Certificate
