Who Should Attend This Course
Practice Executives, Administrators, and Practice Managers
You are the chief compliance officer in most private practices. In order to supervise the economic engine of the practice you must understand the business office operations.
Coders and Billers
If you’re responsible for entering data, working denials, applying modifiers, posting payments, and filing appeals, your expertise in surgical and office coding must be exacting in its execution!
Hospital or MSO Executives Running General Surgery Practices
Maximize your profits! Understand what is special and unique about billing for the general surgery service line, and keep your surgeons happy and bonus-able. (Not to mention reduce compliance headaches.) Learn the rules and avoid using incorrect and expensive assumptions that result in fiscal disaster.
Team Attendance Produces The Best Results!
Getting paid is a team effort—and surgeons lead the team. If the doctors don’t understand what’s needed in an operative report from a coding and reimbursement point of view (something they don’t teach in residency) they are short changing themselves.
As a result of this course participants will be able to:
- Select the right type of code and level of service in all situations
- Identify evaluation and management (E/M) services that are part of the global payment and those that may be separately billed
- Describe top three key activities in order to transition to ICD-10
What’s on the Agenda
Selecting the Correct Type of E/M Service and E/M Modifier
- Global surgical package
- E/M modifiers
- Increased risk from misuse of modifier 25
- What to bill? Selecting the correct category of code
Selecting the right level of E/M service and avoiding audit risk
- Level of E/M service
- Electronic health records and templates—reduce your risk and create useful notes
- Avoiding cloning and overdocumentation, as defined by the OIG
- Selecting a level of service based on medical necessity and complexity
- Critical care
- Screening colonoscopy
- Last call: ICD-10 readiness
- How non-specific ICD-9 codes will hinder the transition to ICD-10
- Critical documentation changes
- Mapping program dos and don’ts
- Diagnosis coding and risk based contracts
- Key performance financial indicators
- Detailed appeal strategy
- Who is responsible for coding?