AUDIOCONFERENCE ON TAPE OR CD
Sponsored by JustCoding.com
presented on May 16, 2007
Do you know what OPPS guidelines are applicable to your critical access facility?
Unlike an acute-care hospital, a critical access hospital (CAH) does not receive reimbursement under the OPPS. Certain OPPS guidelines apply to CAHs, while others do not. Because of this, coders in CAHs often feel overwhelmed by which regulations apply to their setting, making coding and reimbursement a particularly challenging process.
Recognize and adhere to CAH regulations
Listen to this audioconference during which our experts discuss the similarities and the differences between OPPS and CAH billing. By identifying some of the unique billing considerations for CAHs, our experts hope to clear up the confusion that coders and billers experience.
AGENDA
- Method I vs. Method II: Key differences, including billing for physician services
- Medical necessity and Local Coverage Determinations (LCDs): Mammogram screenings, colonscopy screenings, etc.
- Software vs. manual
- Signed ABN
- Modifiers -GA and -GZ
- Importance of National Correct Coding Initiative (NCCI)/non-OPPS edits
- Proper use of HCPCS codes and their relevance to your facility
- C codes: Are they optional?
- G codes: Are you getting denials?
- Revenue codes
- Billing examples: CAH comparisons to OPPS hospitals
- 72-hour window
- ED coding
- Observation
- Proper registration of non-patients, e.g., lab-only patients (billing revenue codes 141 vs. 851)
- EMTALA
- Action points
- Cost-to-charge ratios
- Available resources
- Q&A
At the end of this audioconference you will be able to:
- Identify some of the unique billing considerations for a CAH, including the definitions of Method I and Method II
- Discuss the role of LCDs and medical necessity in a CAH setting
- Demonstrate the proper use of NCCI edits and HCPCS codes in a CAH
- Illustrate the similarities and differences between OPPS and CAH billing
- Explain the importance of using resources that are available to you and taking advantage of networking opportunities
BONUS MATERIALS INCLUDED IN YOUR PACKET!
In addition to the expertise and advice presented during this audioconference, you'll also receive
- Selected memorandums and transmittals that are relevant to CAHs
- List of available resources
These materials are provided with PDF links.
MEET THE SPEAKERS
Linda Coe, CCS, RN is director of coding and reimbursement services at QHR in Brentwood, TN where she assists healthcare organizations with improving and monitoring the quality of coding and documentation to secure appropriate reimbursement. She has extensive expertise in the areas of ICD-9-CM and CPT-4 coding as well as DRG/APC validation, coding accuracy, coding/physician education, and comprehensive chargemaster reviews. Ms. Coe has conducted seminars on transfer DRGs and numerous coding workshops for coders, physicians, nurses, and other clinicians.
Glenn Krauss, RHIA, CCS, CCS-P, is revenue systems coordinator at Mercy Health System in Janesville, WI. Mr. Krauss has more than 14 years of experience in the healthcare industry in numerous healthcare systems and in various staff positions such as coder, hospital management representative, and consultant. He also has extensive experience in teaching physiology, surgical procedures, the rationale of therapeutic treatments with ICD-9-CM and CPT coding, and complex medical and billing issues to help with both quality issues and reimbursement.
WHO SHOULD LISTEN?
HIM directors, managers, and coding staff; compliance officers; chargemaster coordinators; billing managers and staff; PFS managers and staff; operations managers and staff.
Purchase a tape or CD of the program and listen when you can. It's also a perfect training tool for new staff or as a refresher for veteran staff.
Save money when you purchase multiple copies! Ask your customer service representative about money-saving
discounts and bulk orders. Call toll free 800-650-6787 or e-mail
customerservice@hcpro.com.
