Never fall behind on coding again!
Reduce undercoding, decrease denials, comply with Medicare’s regulations, and get the reimbursement your rehab facility deserves with Coding and Billing for Outpatient Rehab Made Easy.
Written by renowned speaker and consultant Rick Gawenda, PT, this book can be used as a quick reference guide for experienced coders or as a training tool for those unfamiliar with coding. This comprehensive resource provides:
- Clear descriptions of commonly used CPT codes, ICD-9 codes, and modifiers, including modifier -59
- Billing scenarios and tips on how to avoid common coding problems
- A test for each section that ensures you understand the billing and coding instructions
- A chart of the CCI edits rehab providers must follow
- A breakdown of how ICD-9 codes affect rehab providers
- A step-by-step guide on how to fill out forms CMS-1500 and CMS-1450
Bonus materials!
With Coding and Billing for Outpatient Rehab Made Easy, you’ll also receive a bonus CD-ROM containing easy-to-print forms and a list of important codes, plus a quarterly e-mail alert with the latest changes in CPT codes, ICD-9 codes, and CCI edits.
Take a look at the table of contents:
- Chapter 1: CPT codes
- What are CPT codes?
- Timed vs. Untimed
- HCPCS codes
- Commonly used rehab codes
- Evaluation and reevaluation codes
- Speech central nervous system and
psychological assessments/tests
- Common speech-language treatment
codes
- Modalities
- Supervised modalities
- Constant attendance modalities
- Therapeutic procedures
- Wound care
- Tests and measurements
- Orthotic management and prosthetic
management
- Biofeedback
- Muscle and range of motion testing
- Education and training
- Splints and strapping
- Frequently asked CPT and HCPCS
questions
- References
- Chapter 2: Modifiers
- What’s a modifier?
- Provider-type modifiers
- ABN notification
- Four common modifiers
- National Correct Coding Initiatives
- CCI edit tables
- Mutually exclusive edits
- Column 1/Column 2 edits
- Using the CCI edit chart
- Figure 2.1: The CCI edit chart
- Documenting the need for a modifier
- Education
- Billing with the KX modifier
- Frequently asked modifier questions
- References
- Chapter 3: ICD-9 codes
- Making a diagnosis
- Putting ICD-9 codes to use
- Local coverage determinations
- Finding the correct ICD-9 code
- Figure 3.1: ICD-9 codes
commonly used by therapists
- The therapy caps
- Figure 3.2: A list of automatic
exception ICD-9 codes
- Frequently asked ICD-9 questions
- References
- Chapter 4: Billing for your time
- The only way to get paid
- Insurance
- CPT code documentation
- Timed CPT codes
- Figure 4.1: The eight-minute rule
- More billing examples
- Final reminders
- Billing test
- Billing test solutions
- References
- Chapter 5: Filling out the claim forms
- Introduction
- Figure 5.1: Form CMS-1500
- Form CMS-1500
- Figure 5.2: Form CMS-1450
- Form CMS-1450 (UB-92)
- References
Coding and Billing for Outpatient Rehab Made Easy will take the confusion out of coding and billing for outpatient rehab and ensure accurate reimbursement for the services you provide.
About the author
Rick Gawenda, PT, is the director of physical medicine and rehabilitation at Detroit Receiving Hospital and the owner of Gawenda Seminars. Mr. Gawenda has worked in all areas of therapy within the hospital and home healthcare setting. He has provided valuable education and consulting to hospitals, rehabilitation agencies, private practices, and his peers in the areas of CPT and ICD-9 coding, billing, documentation, reimbursement as it pertains to outpatient therapy services, and the appeals process for Medicare denied claims. He is the current President of the Michigan Association of Medical Program Rehabilitation Administrators, member of the APTA, and actively involved in the Health Policy & Administration section of the APTA.
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