HCM Marketplace

AUDIOCONFERENCE ON CD OR AUDIO ARCHIVE

Sponsored by APC Answer Letter

presented on October 23, 2007

Stay off the OIG's hit list-ensure appropriate use of modifier -59!
Over- and misuse of modifier -59 continually raises red flags with the Office of Inspector General (OIG), Medicare, and Medicaid. A frequent target for fraud and abuse investigations, modifier -59 has hospitals across the country sweating as pressure increases for clear record documentation at the point of care.

Get step-by-step advice to avoid noncompliance and protect your bottom line!
Modifier -59 is not a catch-all modifier-and the myth that it can be used to get any and all claims paid must be dismantled. During this program, our speakers will provide step-by-step strategies, tips, and advice to help you avoid compliance risks and develop a system of checks and balances before coders append modifier -59.

At the end of this program, you and your staff will be able to:

1. Identify the official guidelines for modifier -59
2. Describe how to appropriately and logically assign modifier -59
3. Name commonly miscoded and under-documented procedures associated with modifier -59
4. Illustrate process improvement ideas
5. Code complex cases involving modifier -59, and more

TAKE A LOOK AT OUR AGENDA

1. Understanding modifier -59 logic in your encoder
   1. What's included in procedures and what's not
   1. CCI edits
   2. Surgical packages
   2. Making decisions based on the documentation: Using decision trees and flow charts
   3. Case scenarios
2. Establishing a process for appending modifier -59
   1. Common documentation omissions
      1. Educating physicians
      2. Managing denials
   2. How the coding process should function at a facility
   3. Suggested best practices for HIM and compliance
   4. Case scenarios
3. Educating coding staff on modifier -59
   1. Where to find the most current information
   2. What to do when you find conflicting information
   3. Resource links
4. A question and answer sessions follows the presentation

NOTE: Purchasers will best benefit from this program if they have a basic understanding of the use for modifier -59.

FEATURED SPEAKERS

Susan Garrison, CPC, CHC, CPC-H, CCS-P, CPAR, is vice president of healthcare consulting services at Magnus Confidential in Atlanta. She has more than 25 years of experience in healthcare management, including the areas of documentation, coding, billing, and reimbursement for both outpatient hospital and physician services.

Caral Edelberg, CPC, CCS-P, CHC, is president, CEO, and founder of Medical Management Resources (MMR) in Jacksonville, FL, which helps both hospitals and emergency physicians control revenue loss, better manage the claims process and collect more of the money they're legitimately owed. Edelberg served three terms on the National Advisory Board for the AAPC, where she continues to serve on coding and billing faculty, and is also an active member of AHIMA and several other industry organizations.

CONTINUING EDUCATION CREDITS

This program has been approved for 2 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).

This program has prior approval of the American Academy of Professional Coders for 2.0 Continuing Education Units. Granting of this approval in no way constitutes endorsement by the Academy of the program, content or the program sponsor.

WHO SHOULD LISTEN?

• HIM directors
• Coding and billing managers and staff
• Compliance managers and staff
• Auditors
• Billing managers
• Business office personnel (including denials staff)
• Patient account representatives
• Accounts receivable managers
• Hospital administrators
• Clinicians
• Nurses
• Techs
• Providers

YOUR MATERIALS PACKET

In addition to the expertise and advice presented during this audioconference, you'll also receive a slide presentation of the program materials and take-home items including:

• Logic flowchart
• List of the 10 most common procedures billed with modifier -59-and how to address them in audits, such as outpatient surgical procedures and ED clinic cases
• And many more quick reference resources

These materials are provided with PDF links.

NEW PURCHASE OPTION: Audio Archive

In addition to the regular participation options for HCPro audioconferences, audio CD, we are pleased to offer a new option, an audio archive. An audio archive allows you to download the program and play it back at your convenience on your computer or MP3 player.

Purchase a 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.

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