Condition Code 44 and the Utilization Review Committee

AUDIO CONFERENCE ON CD OR AUDIO ON-DEMAND

Sponsored by Case Management Monthly

Condition Code 44 clarified

This 90-minute audio conference helps clarify confusion about the proper use of Condition Code 44. Our speakers help you understand how to apply the code and ensure documentation compliance to receive appropriate reimbursement.

LEARNING OBJECTIVES

1. Determine the role of the case manager in assigning Condition Code 44
2. List Condition Code 44 requirements
3. Explain how to bill with Condition Code 44
4. Explain how to bill when Condition Code 44 criteria are not met

AGENDA

• Conditions of participation


1. Utilization review committee
2. Essential members
3. CMS clarification MLN SE0622
• Role of the case manager
• Requirements for use of Condition Code 44
1. When to use Condition Code 44
2. Who decides to change patient status
3. What information should be documented
4.  Correctly billing observation services
• Case study: How to bill with Condition Code 44
1. Counting hours of observation
• Case study: How to bill when Condition Code 44 criteria are not met
1. Prosthetic devices
• Case study: Example of inpatient order after surgery

A question and answer session follows the presentation.

WHO SHOULD LISTEN?

Case managers and directors, clinical documentation specialists, billing and revenue cycle staff,  hospital administrators, nursing administrators, physician advisors, quality professionals, social workers, hospitalists

MEET THE SPEAKERS

Kimberly Anderwood Hoy, JD, CPC, is the director of Medicare and compliance for HCPro, Inc. and is the lead instructor for HCPro's Medicare Boot Camp®—Hospital Version. She is a former compliance officer and in-house legal counsel for hospitals, and has expertise in conducting billing and compliance audits and internal investigations, risk assessment, program development, implementation of policies and procedures, and ongoing operations.

Sandra McCune, BSN, RN, is the utilization management specialist for Lakeland Regional Medical Center in St. Joseph, MI. In this leadership role, she is responsible for assuring compliance with Medicare & Medicaid regulations regarding billing status, medical necessity, readmission bundling, and IM letters. She has also implemented a system-wide process for compliance with Condition Code 44, ensuring effective communication to all impacted departments.

PROGRAM MATERIALS

Program materials are provided with PDF links. In addition to these materials, you will also receive:

1. Sample flow chart
2. List of billable services for Part B-only billing

AUDIO ON-DEMAND

In addition to the regular paurchase options for HCPro audio conferences, we are pleased to offer another option, 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.

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