ILHIMA | Physician Coding Webinar Series

Overview

The Physician Auditor’s Toolbox: Auditing for Physician Practices is Different than Auditing for a Facility 

To be successful as a professional fee auditor, there are certain tools that are “must haves” for your toolbox.  In this presentation, the Medicare Physician Fee Schedule Database (MPFSD), National Correct Coding Initiative (NCCI) edits, CPT assistant, Coding Clinic, and encoders will be discussed.  We will walk through how each tool is important to a professional fee auditor, how they can be accessed, and how they should be used.  Tips on writing the audit report and giving the results to the physicians/other providers will also be covered.  A handout will also be available for attendees listing the tools and how to access them as a handy reference.

Learning objectives:

• After this presentation, attendees will be able to access the resources necessary to perform professional fee audits for practices.
• After this presentation, attendees will be able to demonstrate best practices to deliver audit results.
• After the presentation, attendees will be able to utilize the tools necessary to perform physician/other provider audits.

Misused Modifiers: Modifiers Help Tell the Story of What Happened During a Patient Encounter

They also indicate to a payor that something that may not normally be paid for, meets an exception for payment.  If used correctly, modifiers allow a practice to get paid properly; if not used correctly, modifiers may get a practice audited.  In this presentation, some of the most misused modifiers will be discussed, including modifiers 24 and 25 (and when they should be reported together), modifier 59, modifier 76, modifier 22, and modifiers 50 and 51.  Multiple examples will be used to ensure comprehension.

Learning objectives:

• After this presentation, attendees will be able to demonstrate understanding of the difference between modifiers.
• After this presentation, attendees will be able to better support appeals on modifier issues.
• After this presentation, attendees will be able to append the proper modifiers in the proper scenarios.

Medicare Physician Fee Schedule Database (MPFSD): Goldmine of Information

The Medicare Physician Fee Schedule Database (MPFSD) has a wealth of information contained in it.  The MPFSD will indicate what the relative value unit (RVU) breakdown of a code is if your physician is paid on an RVU basis.  It can indicate what modifiers may be appended to a particular code, Allowed amounts by locality for Facility and Non-Facility side, RVU breakdown, global days (if applicable), and if an assistant surgeon is payable (if applicable), among other things.  In this presentation, we will look through the MPFSD and uncover all it has to offer.

Learning objectives:

• After this presentation, attendees will be able to understand different ways to utilize the MPFSD.
• After this presentation, attendees will be able to search the MPFSD for the information on codes that they need.
• After this presentation, attendees will be able to demonstrate what the different columns in the MPFSD represent.

Date

Recorded: June 22, 2022
Recorded: July 20, 2022
Recorded: August 31, 2022

* These courses are available for on-demand purchase. 

Speaker

Betty A Hovey, BSHAM, CCS-P, CDIP, CPC, COC, CPMA, CPCD, CPB, CPC-I

Pricing

• ILHIMA Member: $20/per webinar
• Non-Member: $30/per webinar

• ILHIMA Member: $48
• Non-Member: $72

CE

# of CEs: Up to 3.0

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.

Instructions

Register

In order to access this course, you will need to click on the button labeled “Register for this Course“. Registration is available through 11:59 PM CT on April 1, 2023.

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

FAQs

• 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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