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AUDIOCONFERENCE ON CD OR AUDIO ARCHIVE

Sponsored by Briefings on APCs

presented on March 18, 2008

Evaluation and management (E/M) coding in the emergency department setting can be a constant and costly problem for facilities. When clinicians do not provide the appropriate documentation for all patient visits and  procedures, the result can be under coding/over coding or compliance errors. This then results in reimbursement errors. In addition, for 2008 CMS issued additional guidance for hospitals to use when developing their E/M assignment tools. This adds a new layer of complexity and opens up the potential for government audits.

Take a proactive approach with E/M coding and billing

Don’t miss HCPro’s 90-minute audioconference, Facility E/M Update: Meet CMS’ latest coding and documentation requirements, where our expert speakers explain the 11 new and existing E/M guidelines. After you and your staff learn the changes, speakers William L. Malm, MD, RN, and Shelia R. Gunn, CPC, CCS-P, CMBS-I, detail how to build a documentation team at your facility to educate staff, ensure compliance, and prevent lost reimbursement. You’ll also learn how to conduct self-audits and understand when to use modifier -25.

TAKE A LOOK AT THE AGENDA

1. 2008 OPPS guidance: CMS’ 11 criteria for level assignment
   1. Services to include in your leveling system
   2. What you should not include
   3. Audit warnings from CMS
2. Documentation for compliance/reimbursement
   1. Relevant documentation requirements for procedures and visits
3. Critical care documentation and CMS FAQ specifying included services
4. Modifier -25
5. Importance of documentation improvement approach
   1. Educating nursing and/or clinical staff on documentation requirements
   2. Creating a documentation team
6. Case studies
   1. Coding common ED encounters
   2. Creating an E/M documentation/level assignment template
7.  Auditing yourself
   1. Federal Register
   2. Modifier -25

A question and answer session follows the program

Note: Participants should have a basic understanding of OPPS, CPT and HCPCS coding, ICD-9 diagnosis coding, and modifier requirements. This is an intermediate level program.

LEARNING OBJECTIVES

By the end of the program you’ll be able to:

1. Identify CMS’ 11 new/existing E/M principles for 2008
2. Implement a documentation team
3. Explain the importance of documentation to other members of the team
4. Take proactive compliance measures in event of an audit

BONUS TOOLS IN 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

1. Audit resources
2. Related article from HCPro’s newsletter Briefing on APCS

These materials are provided with PDF links.

MEET THE SPEAKERS

William L. Malm, MD, RN, is the practice director for Revenue Cycle Management Consulting and the Center for Revenue Cycle Excellence within the consulting division at HCPro, Inc. He has more than 20 years of experience in a combination of clinical and financial healthcare, including as a compliance officer, revenue cycle specialist, and chargemaster specialist. Having performed over 100 chargemaster analysis engagements, his specialty is in the resulting operations, including education, audit, and post-implementation reviews. He continues to be a prcticing ED and trauma clinician.

Shelia R. Gunn, CPC, CCS-P, CMBS-I, is an adjunct regulatory specialist. She has extensive experience with coding for both physician and hospital services.  She has worked in various capacities in which her duties included serving as an Instructor for Coding and Reimbursement training and certification programs. She is a Certified Professional Coder by The American Academy of Professional Coders and a Certified Coding Specialist — Physician by the American Health Information Management Association. 

EARN CONTINUING EDUCATION CREDITS

AHIMA
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).

AAPC
This program has prior approval of the American Academy of Professional Coders for 1.5 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, outpatient coding/billing staff, ED directors, emergency nursing staff, compliance staff, nursing staff, reimbursement analysts, and chargemasters analysis.

Purchase a CD or audio archive 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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