Join Bevan Erickson, AAPC’s CEO, for his State of AAPC address. He will cover exciting new and upcoming developments within your organization, why we’re moving in these directions, and how these evolutions will impact your daily life, both inside and outside of work.
Monday, March 29, 2021 | 09:45 - 11:00 AM
Hypertension is known as the "Silent Killer". This presentation will show the body's reaction to a hypertensive diagnosis. It goes through the diagnosis codes detailing the documentation requirements to meet medical necessity and selection of the accurate level of MDM.
This presentation will address 10 commonly questioned scenarios for general surgery coding using case examples. We will discuss several different questions that I have encountered during my career including: 1 - Liver Biopsies 2 - Complex abdominal repairs including component separation 3 - Hernia repairs, including hiatal hernias in conjunction with gastric restrictive procedures 4 - Incidental appendectomy
Coding, policies, guidelines, prior-authorization, medical necessity, and reimbursement constantly changes for the Orthopedic practice. This session will look at what's happening now in Orthopedics and will include a look at the affects of the E/M office visit guideline changes since January 2021.
The presentation will go over a brief introduction of what inpatient coding is, the ICD-10-CM/PCS guidelines, and quick understanding of PCS. This will cover the importance of proper selection of codes for both, diagnoses and procedures to show what positive and negative impacts it can have. Attendees will be exposed to DRG assignment and what can be done for proper physician education as well as internal education. Overall, the purpose will be to code to the highest specificity in the inpatient setting as well as providing the necessary education.
In this interactive presentation, the audience will be introduced to the new codes for ASC beginning 2020. This will include the addition of new guidelines, new CPT and HCPCS codes. At the end of the presentation, time will be alotted for Q/A with the speaker.
Improving practice management starting with the patient entering your office, proceeding through the visit, and discharge. Tracking the documentation, coding and billing through the revenue cycle management. How each staff member can impact the visit financially without even knowing it.
Discover missing revenue opportunities by conducting a charge capture audit. Departmental charge entry through the hospital's charge master requires understanding the reportable services, timely data entry, correct number of units and matching of services rendered. Although financial success is heavily dependent upon accurate and timely charge capture, providers may not fully realize the risks involved in not implementing charging controls. This session will focus on the risks and consequences of missed charges.
How does an auditor successfully reflect audit findings in a spreadsheet and how does that spreadsheet correlate to the final report? Please join us as we discuss these questions and step through the creation of both and discuss the importance of both.
In this session we will talk about how to develop, maintain and monitor compliance policies that are most beneficial to your practice. Hot spots, benefits and template use will allow attendees to have the skills to enact a diverse compliance program.
Interest in telemedicine has grown steadily over recent years, but the impact of COVID-19 has greatly accelerated the need to deliver remote care. As health care is provided on a virtual basis both today and in a post-COVID world what does this mean for your documentation, coding and billing processes?
Monday, March 29, 2021 | 11:15 - 12:30 PM
This presentation will discuss gray areas of documentation for scoring Evaluation and Management levels using the '95 and '97 guidelines by discussing the strictest interpretation of the guidelines. By educating your providers to document according to the strictest interpretation of the guidelines, you are helping set your provider up for success.
Under PAMA, CMS requires the professional ordering an Advanced Diagnostic Imaging (ADI) study to consult a qualified Clinical Decision Support Mechanism (CDSM). In 2020, 19 new G codes and 9 modifiers transitioned into a requirement on claims with ADI Services. ADI services are currently associated with MRI/MRA, CT, PET and Nuclear Medicine imaging codes. The revenue code assignment in the CDM drives the method for unit of service reporting on claims where multiple consultations of the same CDSM G-Code.
An in depth look at Plastics and Reconstructive Surgery coding with a focus on what needs to be included in documentation in order to meet the CPT requirements of services, and medical necessity. Look forward to an engaging presentation including information regarding CPT and ICD-10 coding associated with these codes.
This session will focus on compliance lessons learned during the recent COVID pandemic. We will talk about compliance changes during the PHE as well as the new normal after the pandemic. Attendees will learn about compliance concerns post-pandemic. We will also review telehealth compliance before, during and after the pandemic.
Understanding the hierarchy of infusion, hydration & injection coding while following coding guidelines that appear to point you in another direction as you've just read an NCCI edit for a specific drug that required hydration pre/post for a chemo infusion that you thought you didn't code hydration. Let's dig into this together, but remember each MAC has their own specific guidance that must be researched well before you determine how to write a policy for your department and this is one of those areas that every organization should have one on file.
Skills and quality that will make you a successful Medical Practice Manager.
Delve into the world of denials, from the payer side vs the provider side. We will discuss denial management from what payers are looking for and what providers need to include in their appeals. Reviewing the appeals process, medical necessity and why it's important to develop a relationship with your provider representative. Stephanie Sjogren will be presenting from the payer side and Stephanie Thebarge will be presenting from the provider side.
Medical necessity is critical concept in coding. With the new Evaluation and Management changes in effect for office visit, medical necessity will be under specific scrutiny. As physicians, practice managers, administrators, coders and billers, are you frustrated with receiving denial based on “medical necessity” or “care is not reasonable and necessary” ? Are you asking yourself “What do they want to support medical necessity?” How well do you understand medical necessity? Those responsible for submitting claims as well as those providers of services need to have a thorough understanding of how payers make a medical necessity determination. This session will apply the general payer concept of medical necessity to the EM changes. Medical decision making is the area of the visit auditor evaluate as the primary determinant of the level of service. This session will review the areas of medical decision making focusing on how medical necessity is supported by the service(s) provided.
The updated 2020 DOJ Guidance has 245 questions/factors to evaluate a compliance program. This is about double the number of questions in the previous Guidance. These are not replacement questions but enhancements to what was already in place. The focus is on the evidence, credible proof, that your compliance program is effective. Industry experts estimate that less than 10% of all compliance programs could meet the standards for all the questions. How does your compliance program score? Learn what is required to meet the challenge of having a successful compliance program.
This fun and informative session will highlight cultural differences in general in healthcare and give you new insights to thinking globally. Topics include religion in healthcare, LGBTQ+ patients, cultural sensitivity and more.
Monday, March 29, 2021 | 01:45 - 03:00 PM
AAPC is always looking for individuals with a desire to share their experiences and knowledge. Fortunately, our membership is a great talent pool. AAPC and its members mutually benefit from members engaging in projects as Subject Matter Experts (SMEs). There are many SME volunteer and contract roles with AAPC and this session will provide clarity and insight on how to approach and take advantage of these opportunities
This presentation will compile the many sources that influence general surgery coding to provide the attendees a consolidated source of general surgery guidelines. We will cover the coding guidelines for breast surgeries, appendectomies, cholecystectomies, and intestinal and colon procedures. We will discuss the differences between the AMA, NCCI, ACS, and CMS guidleines for these procedures.
Understanding the basics of Cardiology Anatomy leading to simple diagnostics to Cardiac Cath and Interventional (PCI) procedural CPT and ICD-10-CM coding. Identify Cardiac Cath and/or PCI bundling issues and new billing opportunities for your cardiology practices, along with reviewing the language in a Cath Lab Procedure reports for the new and seasoned coder.
Have you heard the following from payers? That CC is not really a CC because the diagnosis could not be validated! Or, are you having trouble identifying those secondary diagnoses because of conflicting provider documentation? Many times, secondary conditions are overlooked because the entire medical record for the hospital stay is not being reviewed. Common example: Documentation by the ED physician preceding the admit order. It today’s healthcare reimbursement world
Modifiers are an additional complexity for coders to conquer and can have serious ramifications in the Revenue Cycle both for under use, causing organizations not to obtain appropriate reimbursement and over use, opening up organizations to risk and potential paybacks. Denials for hospital outpatient services can often be a result of improper or misuse of modifiers. The key concepts of when modifiers are needed, the types of modifiers that exists and the documentation that is required to support their use will be explored. A focus will be on those modifiers that most often result in facility denials and steps to resolution.
Unless our educational specialty is in human resources, very few professionals have the opportunity to be trained on how to select and evaluate employees. Yet our employees are our most valuable assets - great employees help our practice shine, and bad employees can leave us with poor reputation. Government employment practices are often seen as rigid, but they provide a good frame work for private practices to improve hiring and elevation techniques. This session will discuss how government entities recruit, select and retain employees to give participants a frame work for their own human resources function.
Balance billing has received significant media coverage in 2020 due to the Covid-19 crisis. This presentation describes the practice of balance billing, details the state laws surrounding balance billing, and covers options for practices to avoid balance billing errors, the mitigating steps a practice is allowed to take, and why. We will go over EOBs to offer a real-life example, and discuss how the practice should handle the situation. We will also cover balance billing policies in a provider's office, and the perks vs drawbacks for and against balance billing.
You don’t have to be a grammar expert to write an effective audit report, nor do you have to attend weekly Toastmasters sessions to be an intriguing trainer, but what you do need to know how to best communicate your findings orally and written to truly make an impact in your career. Knowledge is power, but not if you cannot effectively communicate it.
The CMS TPE audit program is one where a small number of claims are evaluated and as a result, where errors are found, the amounts are usually not that large. As a result, providers often do not see the value in appealing these determinations, instead focusing on implementation of corrective action necessary to “pass” the second phase of the TPE audit cycle. Unfortunately, any adverse result cannot simply be paid and forgotten about. In this presentation, we will address the mandatory disclosure component of the False Claims Act, how this rule can be triggered by an adverse finding in a TPE audit, and the process for mitigating disclosure risk.
Let the Leader in You Shine - Have you always wanted to move into a leadership role in your local chapter, at the AAPC national level, in your job or community? Learn what it takes and how to achieve your goal by talking with those who have done it. The relaxed, informal round table atmosphere of this session will allow you to ask questions, get personal advice and learn how to obtain leadership roles to explore and grow your skills.
Monday, March 29, 2021 | 03:45 - 05:00 PM
To share high level information about risk adjustment coding and documentation principles and provide insight into how Virginia Mason has been able to successfully implement a risk adjustment coding program throughout their Primary Care departments. Provides pointers around implementation, execution and lessons learned. Tips and tricks around necessary program pieces, like building a coding support team, provider engagement, payer partnerships, provider education and creating organization-level awareness/urgency.
This presentation will review digestive system anatomy and a give a brief overview of the most common procedures that gastroenterologists perform: colonoscopy, EGD, and ERCP. We will discuss common billing errors, CCI edits and proper use of modifiers, along with LCD/NCDs applicable to this specialty. I will also explain why guidance from CMS can contradict specialty society recommendations regarding screening frequency and what to do about it.
Take some time to learn the science behind Molecular Pathology and Genetic Testing. Why is the relationship between 1 gene and 1 protein so important? Decide for yourself what PLA, MAA, BRC1, HUGO, and HLA represent. Are they medical acronyms or alphabet soup? This session will outline the Why, How and When behind molecular pathology services. Would you like to know why Medical Necessity is a big factor associated with these services? Would you like to learn the rules for billing and coding Proprietary Laboratory Analyses and Multianalyte Assays? Brush off your high school biology and come learn the answers to these questions and more.
The goal of this presentation is to help strengthen an Inpatient Coders understanding and ability to code difficult aspects of ICD-10-PCS coding. This can be obtuse procedures or commonly misunderstood aspects of ICD-10-PCS coding. By breaking down specific areas identified to cause trouble, coders can strengthen their ICD-10-PCS coding skills.
Effective communication between coders and providers is crucial to operations, quality care for patients, and success of the revenue cycle. Poor communication can lead to inefficiencies, lost revenue, and safety concerns. Communication involves speaking, active listening, body language, communication styles, and understanding personality types. This session is designed to help coders and physicians communicate more effectively with one another and to transfer those skills for effective communication with all staff and patients.
Collaboration is essential to any successful organization – but unfortunately how we individually perceive the world can sometimes cause miscommunication and conflicts that hinder effective teamwork. Based on two decades of brain-health research focusing on how people connect with one another, Dr. Salinas reveals how to improve our creative and empathetic skills to boost employee performance in project collaboration, value-creation and innovative design.
Discuss billing modifiers and how they effect the billing process. Discuss difference between CMS & AMA guidelines. Show samples of how to use the most common modifiers for Global period and surgery. We will discuss modifiers that are used for evaluation and management only and surgery only.
New E/M guidance has been published and coders and auditors are working through the revised rules to understand and apply the guidance. Unfortunately, careful review of these new rules for selecting the level of an outpatient E/M service reveals a number of significant problems; specifically, areas where the guidance relative to time or medical decision-making is ambiguous. These issues will be a source of continuing frustration to coders and auditors alike. To ease the potential for such frustration, these issues will be highlighted and attendees will be provided with documentation tips and/or recommendations for implementation of internal policies that will be necessary to support code selection pending clarification from payers.
In today's healthcare landscape there are many different types of healthcare fraud schemes. Although traditional (and persistent) schemes are still around, they have evolved, becoming more complex and difficult to identify. Through examples of cases in the healthcare industry that were successfully investigated and prosecuted along with current trends being seen across the country, this presentation hopes to provide the audience with an understanding of the new challenges that are facing law enforcement.
Healthcare organizations like Medicare Advantage Organizations depend on proper medical record documentation to validate their enrollee’s risk adjustment scores. When documentation lacks the necessary requirements, the MAO and provider both could miss out on revenue needed to care for the enrollee. In this session we will discuss the necessary documentation required for risk adjustment submission as well as dive into the differences between documentation of specific conditions.
Tuesday, March 30, 2021 | 11:15 - 12:30 PM
2021 has launched E&M coders and auditors into a new work world with variations in scoring E&M services by location. There are significant differences between E&M guidelines now, but also many synergies that exist. It is important that day-to-day operations blend the differences and merge the synergies to ensure accuracy, proficiency, and compliance.
This session will review the CPT and HCPCS II updates over the past year related to interventional radiology and interventional cardiology. This session will also include a review of complex structural heart interventions.
This course will cover psychological and neuropsychological testing codes which were new in 2019 as well as the Health Behavior Assessment/Intervention codes which were new in 2020. I will explain the difference between "administration and scoring" codes and "evaluation services" codes. We will discuss time statements, commonly used tests, clinical processes, CCI edits, and appropriate diagnosis coding. We will also review HBAI codes and underutilization of these services.
In this session we will cover the pulmonary complications associated with COVID 19. A review of normal pulmonary physiology followed by restrictive pulmonary pathologies associated with COVID 19, including pneumonitis, pneumonias, ventilator acquired pneumonia, and Adult Respiratory Distress Syndrome. A review of basic ventilator functions as they relate to ventilator modes, ventilator settings, positive pressure, and enhanced oxygenation modalities, followed by the challenges posed by restrictive disease and how those challenges are met through management of the airway and the ventilator.
We can all become better coders as we gain a better understanding of the nuances of the common orthopedic surgeries. This presentation will break down common orthopedic surgeries and help paint the picture for these surgeries by reviewing operative notes as well. We will learn more about common knee, hip, and shoulder surgeries, so that attendees are better able to communicate with orthopedic surgeons about coding concerns.
The importance of analytics for decision support in market share, RVU allocation , yearly budgeting , quality scoring as well measuring revenue. It increases the visibility of daily or monthly operations. Analytics provides a snapshot in real time to guage industry performance.
The appeal's coder wears multiple hats day to day. This individual has a stressful, and critical role within the organization. From the day to day hustle and bustle, the appeal's coder is responsible to catch trends, communicate, fix, adjust, alert, and much more! How does this individual master successfully keeping it all together? Being successful and being the jack of all trades within the organization can be done!
Discuss the intricate details of modifiers 25 and 59.
You don't want to "compliance" - you want to "do it right", but with limited resources, small physician practices make some common mistakes as identified by health care attorneys and compliance professionals. This session explores common mistakes and how to prevent them - including not auditing, auditing with the wrong focus, not checking the exclusions lists, not conducting exit interviews, not monitoring relationships and more. Whether you are a hospital system acquiring physician practices or a physician-owned practice coping with compliance on your own. This session will provide the basics.
Using my experience as a consultant who gets to observe a lot of providers, I see providers and staff overwhelmed with the barrage of conflicting information about Risk Adjustment. It shouldn't be that hard. In this presentation, I will demonstrate that Risk Adjustment is correct coding. I will explain how to communicate and message this effectively so that coders can go back to their clinics armed with the tools for success. They will learn about pre-visit planning and post-visit workflows as well as how to shadow their providers and provide valuable feedback.
Tuesday, March 30, 2021 | 03:45 - 05:00 PM
This session will focus on regulatory requirements for clinical trials and research coding and billing. It is imperative to operate within the regulatory walls to remain compliant in research. We will examine the clinical trials process from beginning to end - so if you are new this area of coding and billing this session is for you. If you are looking for a new area of coding and have thought about getting into clinical trials this will give a good background in the flow and regulatory requirements so you can really understand the process. If you currently work in this field, this session will be a good review to ensure you remain in compliance.
This presentation will cover common coding guidelines to apply for spine and pain stimulator procedures. Topics will include common diagnosis codes and their impact on the LCD. Common spine approaches and techniques will be covered to assist coders in proper CPT selection with an additional focus on updated AMA guidance and new procedures.
This session is an indepth look at all the unique services that Maternal Fetal Medicine providers have to offer, from Obstetrical Ultrasound Coding (76801 – 76828) - to external cephalic version. In this session we will focus on what needs to be included in documentation in order to meet the CPT requirements of services, and medical necessity. Look forward to an engaging presentation including information regarding CPT and ICD-10 coding associated with MFM coding. Attendees can expect to learn: 1. Icd-10 coding typically associate with OB Ultrasound 2. Some relevant payer expectations regarding these codes 3. National coding guidelines that effect the way these codes can/should be reported 4. A greater understanding of these codes and the work they represent 5. Documentation recommendations for fulfilling medical necessity
These days, one way or another, risk adjustment affects every venue. Knowing the objectives of others when they code a chart can help us understand what is important when we are auditing for risk adjustment. For example, inpatient coders are focused on MS-DRGs, CCs and MCCs, but not usually on HCCs. What does that mean to the risk score for that patient, and is there any coding intervention warranted? Similarly, what do pro-fee or inpatient coders need to know? We will review perspectives of pro-fee and impatient coders, risk adjustment coders, payers, and Medicare so that we can improve our approach for HCC capture.
Emergency Medicine physicians were provided a survey of 10 hypothetical patients each with common discharge diagnosis. The physicians were asked to provide a patient E/M coding level for each scenario based on this diagnosis. Variability in patient coding levels occurred in 90 percent of the sample patients. Review of this study illustrates the potential financial impact on an Emergency Department, demonstrates the need for continued coding education and offers strategies for improving physician documentation and coding.
The Centers for Medicare and Medicaid Services (CMS) created the Comparative Billing Report (CBR) program to support data evaluation and provider education, and raise awareness of peer claim submission patterns. This session discusses the history of the program and the protection of the Medicare Trust Fund from possible improper payments. The session will detail the CBR topic selection process, and outline past and future topics. Attendees will observe a review of a CBR to appreciate the data provided within each report.
Coder and Billers will learn the new updates and how they pertain to the prosthetics and orthotics coding world. We will review documentation improvements and billing issues. While discussing real world coding scenarios we will review billing issues and how to improve coding skills. Attendees will learn proper coding techinques for prosthetics and orthotics coding.
The program integrity unit serves to detect and prevent Fraud, Waste and Abuse (FWA). It is the responsibility delegated to the Special Investigation Unit (SIU) to review provider activities, issue audit requests, identify overpayments and educate providers. In recent years with mandates to proactively detect FWA these audits are increasing. This session will delve into data analytics used to identify and trigger an audit request, how to respond to the request, and implement post audit findings in the provider office.
Medicare Advantage Organizations and Commercial Payers alike rely heavily on medical record documentation to validate their submitted risk adjustment categories. Poor documentation could account for the loss of a higher revenue HCC even if the patient actively has a more complicated condition. This session will provider coders and auditors the tools necessary to identify gaps in medical record documentation, as well as provide tips on educating providers. When providers document correctly, we decrease gaps and increase the overall revenue for HCC’s.
Wednesday, March 31, 2021 | 09:45 - 11:00 AM
In this presentation, we will review and discuss the clinical indicators support the diagnosis of Sepsis 2 or Sepsis 3. We will evaluate documentation and discuss query options for clarification.
Victoria and Aisha will present a clinicial and coding overview of the cardiac anatomy and how it is effected by common cardiac devices including pacemakers, defibrillators, stents, and leads. The presentation will include clinical and coding scenarios of patients presenting with symptoms, receiving a diagnosis, and having cardiac corrective devices placed.
What is bundled and what can be coded? What are common denials practices may be seeing? What are the procedures that seem to confuse us the most? What did the provider do? What did the provider document/what the note indicates? What did the coder interpret the note to state? What was billed and denied and why? What to consider in follow-up of denied claims.
Evidence-based guidelines summarize current knowledge about how, best, to evaluate and manage patient conditions. Each guideline constitutes a benchmark against which clinical excellence and value may be assessed. Such assessments, in turn, rest upon appropriate documentation and accurate coding. Thereby, documentation and coding create the information platform, upon which we communicate, evaluate, understand, improve, and fund all clinical activities. This presentation “connects the dots” and surfaces the requirements for each element of this information platform, so that we – together – can assure the ever-improving clinical excellence and value of American healthcare!
This session tackles medical necessity confusion by covering: 1. Medical necessity documentation guidelines and how they may have changed in ICD-10 2. How the definition of medical necessity has changed 3. Keys for using the medical necessity modifiers -GA, -GY, -GZ 4. Not medically necessary vs. not covered - what's the difference 5. Use of the Advanced Beneficiary Notification - for Medicare and other payers 6. Accessing Medical necessity quidelines in ICD-10
One of the most common reasons employees leave organizations is a feeling of workload imbalance or unfairness in their work unit. Without consistent accountability, organizations are at risk for both inefficient flow and losing their high-performing staff, creating a detrimental impact on their entire practice. By establishing a system with clear expectations and measures for individual and team performance, you can increase engagement, teamwork and productivity - laying the basis for optimal clinical flow. This session will help attendees will learn key strategies to hard-wire and improve processes and build an engaged team-based culture, while reducing the frequency of workload imbalance and intensity of training new staff.
Mental health services bring with them distinct documentation and coding requirements to support correct billing for services. This presentation will focus on coding updates, documentation requirements, evaluation and management coding for psychiatry and incident-to in the mental health treatment setting. Presentation will conclude with specific recommendations for attendees to set up their own internal compliance review to verify the documentation, coding and billing in their practice setting meets or exceeds industry expectations.
One of the most challenging and critical components of an effective healthcare audit is the ability to provide regulatory guidance references to support audit findings. An overview of the most relevant and impactful regulatory guidance that can be used by auditors for both physician and facility-based audits is provided. Review of 42CFR, Medicare Manuals, CPT (AMA), the AHA Coding Clinic and Local and National Coverage determinations will provide attendees with real-life scenarios and how to appropriately cite findings in the executive summary.
This presentation will review how to perform internal billing audits regularly to ensure compliance throughout your practice. We will start with coding compliance and review of EHR/charting rules and best practices to follow for coders to get charges our correctly the first time. We will then move to reviewing what to audit during the posting process, both patient and insurance. There are many things we can see quickly to identify trends and use them to improve processes. A/R work and follow up is another very important aspect that will be covered. This will surely be a very useful session that will likely improve communication and collaboration in your revenue cycle team.
Wednesday, March 31, 2021 | 11:15 - 12:30 PM
Primary Care providers have a lot on their plate. This presentation will dive into the common procedures seen in a primary care setting. This includes fracture care, injections, lesion removal, repairs, and others. We will review these procedures from a clinical perspective in order to help us better understand the coding. This presentation will give you the tools needed to code correctly for these minor procedure and give you confidence discussing coding concerned with physicians.
This session will be a comprehensive review of both new changes in otolaryngology coding as well as a review of hot topics and current areas of coding confusion in otolaryngology. Topics will include nasal valve correction, swell body reduction, eustachian tube dilation, DISE, hypoglossal nerve stimulation, endoscopic sinus surgery, sinus ostial dilation, bone anchored hearing aid placement, and more. Specific case examples will be provided with key words and guidance on how to most accurate interpret and code operative reports.
This session is designed for Inpatient Coders looking to transition to CDI or for those who are wanting to increase their understanding of both modalities. Often the roles of CDI personnel and Inpatient Coders overlap. In order to do either job optimally you need knowledge of both. This aspect alone is why Inpatient Coders make excellent CDI professionals. The world is full of opportunities and the goal of this session is to pave the road for transition by providing the means to elevate attendees from novice to expert. After all CDI and Inpatient Coding are a match made in heaven.
Have you wondered what how treating cancer affects chronic conditions and how to get your provider to document like a pro? Driving into a pothole can be quite a surprise to the vehicle and the body system. When the dents in the road are not repaired timely, they mature and become more hazardous each day. The medical field has its own depressions. One of the toughest potholes for coders and auditors is oncology. We sometimes hit a thunderbolt when reviewing the medical documentation and trying to figure out which cancer is malignant or benig
Healthcare organizations consistently struggle to optimize their space, equipment, and other resources. The pandemic has further complicated those efforts as practices try to maximize their patient access and volumes while adhering to social distancing and enhanced cleaning procedures. As such, it is more important than ever to understand how space and resources are utilized across the entire practice. This session will demonstrate how to use the principles of 5S spaghetti mapping, waste walks and standard work to optimize your space. Six Sigma Methodology provides the framework to build a practice that delivers a consistent experience for patients, maximizes space and fixed resources utilization and quickly adapts processes to the ever-changing environments. By implementing these strategies, practices can not only improve their current operations and flow but identify key areas for standardization and margin improvements well into the future.
Presentation will discuss the 5 stage Medicare appeal process with discussions and tips for possible success at each level. Will also discuss current 4 year delay at the 3rd stage and how to attempt to speed up process. Will also discuss appeals procedures and tips with various insurance carriers.
This is a unique presentation brought to you by a long time coder turned healthcare reimbursement lawyer. This is not another run-of-the-mill audit session to show how to respond to an audit. This is a whole lot more! This presentation will teach how not to fall into the trap of responding in a transaction fashion without knowing the details. The details are not just the codes or billing for a service or procedure. You need to know the details which the auditor or payer relied on to determine their findings.
On March 30, 2020 the DOJ initiated a lawsuit against Anthem for allegedly submitting inaccurate Medicare Advantage chart reviews to CMS for risk adjustment, stating that “Anthem knowingly disregarded its duty to ensure the accuracy of the risk adjustment diagnosis data that it submitted to [CMS] for hundreds of thousands of Medicare beneficiaries." This presentation provides participants with up-to-date useful information and practical insights into the Anthem/DOJ dispute, with tools that they can use to improve RA coding for their clients and practices.
Medical coding for the Department of Defense and Department of Veterans Affairs hospitals and clinics is truly unique. The patient population, type of services provided, and reimbursement varies greatly from what we are accustomed to in the private sector. Inaccurate coding affects not only health data collection and reimbursement, but also oftentimes affects eligibility for continued care. Understanding the uniqueness of these services is vital to improving the quality of clinical documentation and accuracy of the coded data.
Celebrate the wonders of human anatomy at our very popular AAPC Anatomy Expo. This fast-paced event offers an in-depth look into the complex machine we call the human body. Physicians and Clinical Experts from a variety of specialties will use anatomical models, devices, and videos to provide an insider’s look at the anatomic and physiologic nuances of the body. Novice and expert alike will find this session fun, informative, and exhilarating.
The AAPCCA Board of Directors will be holding a leadership meeting exclusively for all officers. Please plan on coming a little early for some great tips on serving as a local chapter officer and networking with like-minded individuals!
Is this your first HEALTHCON? Then this is the session for you! This session will be as informative as it is interactive. Learn about using our app, logging CEU codes correctly, networking best practices and other information that will help you get the most out of your HEALTHCON experience.