HCM Marketplace

AUDIOCONFERENCE ON CD OR AUDIO ON-DEMAND

Sponsored by Briefings on APCs

presented on April 16

Billing for inpatient and outpatient implantable devices is complicated and dependent on understanding very specific Medicare reimbursement regulations. There are myriad questions about billing for full or partial credit devices, including the appropriate use of modifiers and condition codes. In addition, hospitals must determine whether to bill for the value of the item being replaced or the actual replacement item, how to handle discounts, and determine appropriate device charges.

Paramount in these scenarios is the need to document carefully and thoroughly so that appropriate costs and charges are accounted for, modifiers can be appended if necessary, and that payments and credits are applied properly to avoid compliance risk. Hospitals also must implement a method to ensure that materials management, HIM/coding, and financial services collaborate to create a compliant and effective charging, coding, and billing process.

This 90-minute audioconference features coding experts Hugh E. Aaron, MHA, JD, CPC, CPC-H, and Kimberly Anderwood Hoy, JD, CPC. They explain the regulatory guidance and complexities involved with getting the reimbursement you deserve, and, using case studies as teaching tools, provide hands-on strategies and coding guidance you can use to ensure your coding and billing is timely, accurate, and compliant.

NOTE: This is an intermediate-level program. Purchasers should have a general familiarity with CPT coding concepts and Medicare’s outpatient and inpatient payment systems.

TAKE A LOOK AT THE AGENDA:

1. Charging and payment for devices
1. Packaged v. separately payable devices
2. Pass through and non-pass through status indicators
3. Separate payments for new technology for inpatient devices
2. Revenue code requirements, including resources and where to find them
3. Full and partial credit:  Outpatient devices
1. Reasons behind CMS’ special payment rules
2. When the special billing rules apply
3. Billing for devices, including modifiers -FB, -FC and condition codes 49 and 50
4. Payment reductions
4. Full and partial credit:  Inpatient devices
1. When the special billing rules apply
2. Billing guidelines
3. Payment reductions
5. Full and partial credit:  Operational strategies
1. Identifying and communicating with staff devices subject to the payment reduction
2. Credit given subsequent to purchasing a replacement device
6. Device-dependent edits
1. Device to procedure
2. Procedure to device
7. Case studies

A question and answer sessions follows the presentation

LEARNING OBJECTIVES

At the conclusion of this audioconference, you will be able to:

• Recognize the ambiguities in CMS’ regulations and assess their guidance
• Appropriately report inpatient and outpatient devices on a claim
• Determine when a replacement device is subject to the special billing rules
• Report the correct modifier, condition code, and adjusted charge for devices
• Analyze if you are being paid properly for replacement devices
• Demonstrate how to appropriately document  the cost of replacement devices
• Develop a process to identify, track, and charge for devices subject to the payment reductions, including when credits are received subsequent to the purchase of a device

CONTINUING EDUCATION CREDITS

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.

MEET THE SPEAKERS

Hugh E. Aaron, MHA, JD, CPC, CPC-H, is a senior advisor for HCPro, Inc. His work focuses primarily on coding and billing accuracy with a particular emphasis on Medicare billing compliance. He formerly practiced health law and was the founder and president of HRAI Coding Specialists, LLC, a national training firm.

Kimberly Anderwood Hoy, JD, CPC, is the director of Medicare and compliance for HCPro, Inc. She is the lead instructor for HCPro's Medicare Boot Camp® - Hospital Version, and has experience as a compliance officer and in-house legal counsel for hospitals, and developed and implemented corporate-wide compliance programs for two hospitals.

BONUS MATERIAL INCLUDED 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 copies of CMS’ FAQs and other guidance relating to devices. These materials are provided with PDF links.

WHO SHOULD LISTEN?

HIM directors, managers, and staff; compliance managers and staff; finance managers and staff; chargemaster coordinators; revenue integrity managers; accounts payable managers and staff; materials managers; surgery department managers.

AUDIO ON-DEMAND

In addition to the regular purchase option for HCPro audioconferences; we are pleased to offer another option, an audio on-demand. Audio on-demand allows you to download the program and play it back at your convenience through your computer or MP3 player.Purchase a CD or audio on-demand 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.

• Audioconferences

• Other Health Information Management Products