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.
Open discussion with industry leaders about what coding looks like around the world. Experts will explain their experience working with different countries and their coding initiatives. Audience will have opportunity to ask questions.
This panel discussion, led by AAPC’s Legal Advisory Committee, offers insights into today's – and tomorrow’s – most pressing legal concerns for medical practices and facilities facing increased financial scrutiny and regulation. Join us for this perennial favorite!
Monday, April 06, 2020 | 09:45 - 11:00 AM
Inpatient Pro-Fee services oftentimes collide with multiple providers and specialties caring for the same patient. Many times, we find hospital protocols are taking precedence over the need for medical necessity, and we all know that ALL services must be medically reasonable, indicated, and that we must prove each is medically necessary. During this session we will discuss complexities associated with a multiple provider approach to care, global bundling concerns, concurrent care, critical care, split-shared services, and of course discharges. Case studies will be presented for a hands-on learning opportunity.
The emergency department and all that takes place there is both challenging and intriguing for coders and revenue cycle professionals. By looking at both the professional and technical components of these interesting services, this presentation will discuss the types of emergency rooms and current payer trends in this area, the risks involved in split/shared visits with NPPs, and attendees will have the opportunity to learn about some of the more interesting ED procedural challenges including injections, infusions, diagnostics and trauma.
Querying is an important part of the coding and clinical documentation improvement process. A query may be necessary when there is incomplete, conflicting, and/or ambiguous information in the medical record. Coders should be able to identify when a query is appropriate and when it is not. In order to assign diagnosis and procedural codes to the highest degree of specificity, there must be supportin gdocumentation. Querying should occur only to improve documentation and never to increase revenue. A query should be non-leading and unbias. Did you know even your query template header may lead your provider in an unintended direction? Join this session an dlearn all about writing compliant provider queries.
During this session we will identify the many types of mental health services and work through the code categories to determine what services to bill in different scenarios. We will breakdown the documentation requirements and identify the provider type and/or employee that is allowed to render billable serivces.
So, you’ve built a compliance program. What now? Can you demonstrate its effectiveness? This session will focus on tools and measurements for demonstrating your compliance program is improving and is effective. From metrics to external expert assessments; learn what you need to do in order to confidently say your program is effective.
The rapid expansion of healthcare entities, constant efforts to remain financially stable and gain market share, has emphasized the need for flexibility and increased skills of their employees. Mergers, acquisitions, outsourcing and other actions have increased the likelihood that coders will need to gain additional operational knowledge. Although coding may not be a requirement for a position, coding knowledge can often enhance successful outcomes. Learn how you can add value to the bottom line.
Chronic Care Management has clearly but identified as a mechanism to achieve the Quadruple AIM of improving quality, lowering costs, improving patient satisfaction, AND improving the work life of physicians and staff. This session will review key program components and will highlight best practices and address common program pitfalls. Your team will be equipped with tools to integrate CCM as a care improvement strategy for your practice while expanded practice resources. Related coding rules and nuances will be reviewed.
Monday, April 06, 2020 | 11:15 - 12:30 PM
Definitions of medical necessity vary – depending on who you are – physician, coder, biller, payer. This session will explore and apply the definitions to the medical practice. From helping physicians document appropriately to supporting why they did what they did to assigning the right codes and modifiers to appealing to receive the payment deserved.
An in-depth look at surgeries of the hand and wrist including the pathophysiology of everything from carpal tunnel to trigger finger. What is done to treat these issues and how should you code for them? CPT and ICD -10 coding will be covered, and attendees will learn NCCI edits and tips for documentation requirements and pre-authorization. This course will help ensure that you are doing your part to get these services appropriately reimbursed.
To become a master of coding, you need to know more than just coding. It is vital to have a knowledge of the anatomy and physiology of the body in order to better understand surgical notes, medical necessity of treatments, and the degree of risk involved with treating certain illness/injuries. As part 1 of a 3 part series of presentations, this course will cover detailed and advanced anatomy and physiology for the digestive, biliary, and urinary systems in addition to common diseases, illnesses, treatments, and surgeries.
Outpatient/facility coding and physician coding are NOT the same. This session will cover the general principles of OP facility and physician coding as well as coding/reimbursement philosophies and how they differ. We will discuss certifications and knowledge needed to change from one field to the other.
This session will focus on emerging payment models in healthcare and their impact on hospital coding and billing. We will review value based care, population health, ACO's and quality metrics and trending. We will review the impact these have on RCM, CDI and compliance and how all these areas must work together for improved patient outcomes and appropriate reimbursement.
The audit has been completed and now it is time to relay the results. There are many ways to accomplish this task and the answer lies within the original scope. In this session we will look at a variety of templates that reflect audit findings and discuss what should be included in all written audit reports.
CMS promotes the TPE program as an educational tool for providers. The three rounds of audits are pre-payment so many providers take a laissez-faire attitude and ignore the high risk. Just because it has a catchy name does not mean you want to get caught in a TPE trap.
Whether you are a large organization or a small single provider practice, the number of denied claims can be overwhelming and cost a staggering amount of money. To manage this can be a scary prospect — but fear not, we are here to help. This presentation is designed to help you prevent denials as work those AR reports in an efficient manner. Sometimes small changes to your protocol can go a long way. Additionally, we will go over payer contracting, policies and editing tips and tricks and how you can make the most of your time.
All practices have had to work on re-designing work- flow for success under value based healthcare. The role of the practice manager/administrator is to direct that change and influence the attitudes and behaviors of staff to create a culture open to change. It begins with a strategy to motivate the TEAM of champions in every area of the office; front, nursing, providers, coding and billing to: T: Transform business operations E: Engage staff, providers, and patients A: Analytics to drive business decisions M: Monitor progress continually This session will provide tips for workflow re-design that includes creating a culture of accountability, lean processes, choosing quality measures that result in improved patient outcomes, clinical documentation improvement that demonstrates the complexity of your patient population and finding ways to use technology to improve overall performance. The successful practice is patient centered, patient facing, and will enrich the patients’ experience through “a thousand small gestures".
The field of Artificial Inelligence (AI) is facing various barriers for adoptions because people do not understand how the machine reached these conclusions. However, computational linguistics is a field that overcomes this black-box phenomenon, allowing for auditable results that can be used for the development of a truly trusted AI.
Monday, April 06, 2020 | 01:45 - 03:00 PM
If you need to find an extra day in the week to work on your daily to do list , attend this session to find it. We will help you identify your direct deposit of 86,400 and show you how to allocate it so you walk away happy. Being passionately productive is a mustas a busy HIM Professional because it will make you more efficient, calmer and allow you to achieve what you want to and need to faster.
This presentation will dive into common orthopedic coding concerns. This will include a review of CPT, NCCI and AAOS guidelines to help you more accurately code for orthopedic surgeries. This presentation will also give you a clinical perspective of orthopedic coding that will better prepare you for working with orthopedic surgeons.
Learn methods of exploring strategies for open communication and partnership between provider, coder and CDI specialist. Identify common diagnosis related denials for those specialties and how improved documentation can reduce those denials. Learn how to handle documentation conflicts between the inpatient and outpatient setting and explore ways to use SOI and ROM to validate the necessity of codumenting and coding to the highest degree of specificity and the relationships of comorbidities. Learn how to best navigate the clinical coding ambiguities surrounding "history of" versus "active" disease. Learn how documentation impacts research initiatives, reimbursement, readmission rates, quality measures, risk adjustment, and physician profiles. Review of the most common diagnosis queries and missed diagnoses in Oncology and Hematology.
This session features a discussion on the following: diagnostic test order requirements - who can order tests and when; common documentation issues - including 3D rendering, CTA, duplex exams; ICD-10-CM diagnosis coding - choosing the correct primary diagnosis code to support medical necessity; LCDs - more than just a list of "payable" diagnosis codes.
In the ever changing healthcare landscape, with more administrative burden being placed on physicians, it is even more important for coders to have a collaborative relationship with their clinical staff. Dr. Godsey will provide a physician's perspective on complete documentation and coding and tips on how to create that partnership.
Recognize when there is a need to consult with legal counsel before, during or after an audit. Discuss what is meant by attorney client privilege and understand when it is beneficial. Explain the regulations surrounding self-reporting and paybacks. Title is subject to change. This presentation is for the auditor.
oor ethical decisions plague our industry. This presentation will review ethics in the healthcare arena. We'll look at how ethics can play into our every day work lives. A quick look into how simple things like social media and conversations and their impact on our industry.
Revenue "Cycle of Life" - Attendees will learn to navigate the jungle through revenue cycle management. Learn to look for the quick sand traps that sink your revenue and the safety nets that can help save it! Don't let hidden threats pounce on your practice.
PCC's Lynne Gratton, CPPM, explores front desk best practices related to scheduling, patient check-in, insurance verification, copay and prior balance collection. Understand the importance of the front desk when it comes to your practice's workflow and collection process.
Gender Identify has existed since ancient civilization and yet healthcare continues to view patients as a binary value, male or female, despite the Affordable Care Act of 2010 which banned sex discrimination in healthcare settings. Lack of understanding Gender Identity can result in payer denials, awkward situations, and worse barriers for these patients to receive quality healthcare. As coders and auditors, we can be part the solution to tearing down these barriers. During this webinar we will explore the 5 steps to ensuring your organization is treating every patient with respect and documentation and payer requirements are met to ensure you are getting your gender identity claims paid.
Monday, April 06, 2020 | 03:45 - 05:00 PM
The presentation takes the coder on a journey of the impact of encounters after they have been coded. The attendee will be guided through the process of the impact of coding accuracy on the Medicare Advantage (CMS-HCC Model) when the coding is done to the highest level of specificity and when coding is not done optimally. In addition, the attendee will gain an understanding of the impact on the Medicare Advantage (CMS-HCC Model) of missed chronic conditions.
We will learn the basics of Ped coding and including NICU coding guidelines. Throughout the presentation we will review common coding denials and how to prevent them, how to improve documentation and how to discuss queries with physicians. As we examine real-life scenarios, we'll see the necessity of good documentation and identify instances where a follow-up query would help clarify.
Attendees will learn the impact on the in-room provider – AA, resident, CRNA, SRNA and the impact on concurrency. Risks areas will be covered as well as opportunities that are missed.
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.
Participants will learn how an effective outpatient CDI program will ensure complete and comprehensive coding and documentation at the point of care. Join us for an interactive discussion on how outpatient cdi can take your risk adjustment and quality efforts to the next level!
Every day attorneys are looking for Billing and Coding experts to give opinions about medical bills for lawsuits. Learn how to present yourself as an expert with the right resume/CV, how to let attorneys know you are available, how to review records and write an affidavit or an expert report. You may need to give your sworn testimony for deposition and possibly at trial and we will cover techniques for these areas. Learn how to turn your clinical expertise into a nice sideline to your job! Come learn from an expert on how to be an expert!
This program is appropriate for Practice Management professionals and anyone needing an update relative to HIPAA Privacy and Security requirements. We will review the basics of the Administrative Simplification Act to understand the basic concepts for protecting the privacy of PHI and ePHI. We will also outline the breach requirements under HITECH. With respect to the transactional component of HIPAA, we will review the 5010 standards as well as required identifiers. From a Security Rule perspective, we will review data security and computer networking issues as well as best practices for meeting the administrative, physical and technical safeguard requirements under the Rule.
The presentation will make administrators, compliance officers, medical coders and billers aware of the role they play in protecting personal health information. The auditing function will create a platform to monitor and track medical records and the cybersecurity component will provide governance, risk, and compliance of the policy and procedures associated with providing business continuity to the organization.
Tuesday, April 07, 2020 | 11:15 - 12:30 PM
This session will focus on new career areas for coders to explore. We will talk about new roles for coders to put their skills to use such as working as registry coders in a variety of areas. We will also explore other opportunities such as revenue integrity, CDI and quality metrics.
Have your TCM services been denied? Are your physicians leery to provide the service? This session will walk through a TCM self-audit using tools to identify documentation insufficiencies and other areas of risk. Those attending will gain knowledge on payor expectations to increase their TCM coding and billing compliance.
Obstetrical care covers services provided to a patient for an extended period of time. The global period for pregnancy is different from global surgery days. Understanding what is billable during this extended time can eliminate unnecessary denials or timely filing issues. We will also discuss the business side of obstetrics and necessary communication that should occur between the business office and the patient.
Radiation oncology is a unique sub-specialty and provides specific challenges. Because the EMR is image-based and not text-based, the coder/auditor must understand the process of care. Communication with clinical staff who provide/document services is critical. Payor guidance is not always jn agreement and the coder must determine which is relevant.
Ever wonder what Inpatient Coding is all about? Stop waiting and come join the Inpatient interactive presentation to obtain knowledge on what Inpatient coding consists of, the difference of using ICD-10-CM in the inpatient setting compared to outpatient, how ICD-10-PCS replaces CPT in inpatient, to consider becoming CIC certified and see what opportunities it can provide for you!
What does the constantly changing landscape of HIPAA compliance and cyber risk look like today and how do you stay protected. Cyber threats are evolving and becoming more difficult to detect and more dangerous, and healthcare organizations remain one of their top targets. At the same time, HIPAA enforcement is adapting, but are these new changes actually better for healthcare organizations? We'll explore what's new on the cyber-attack front and what organizations need to do to stay secure and HIPAA compliant.
Attendees will learn about how the OIG fits into the world of healthcare billing and coding. From a compliance, legal and practical perspective, attendees will hear about investigations where billing and coding were at the heart of fraud activities, and how billers and coders have a duty to ensure that their work is accurate and correct. An understanding of the lifecycle of a healthcare fraud investigation will be discussed, and attendees will gain insight into what triggers healthcare fraud investigations involving fraud, waste and abuse.
With more healthcare companies being fined for compliance concerns, it is even more important to ensure that you are compliantly documenting and coding these three major compliance areas: (1) misuse of modifiers 25 & 57, (2) incorrect reporting of shared and incident-to services with NPPs, and (3) inappropriate copy & paste "cloning" practices. This course will cover important coding guidelines, examples of incorrect use, relevant case studies, and risk mitigation strategies.
Running a practice in today's healthcare environment is messy at best. Most often we are stuck in the weeds just trying to make it through the day. By learning how use lean six sigma practices to best benchmark key deliverables in our practices we can begin to tie that into system reports to get the best gains and to show the value behind those gains in order to influence all stakeholders through data.
This presentation will analyze Medicare’s 2019 and 2020 Telehealth coverage expansion, examine the guidelines, and see where private payers stand on these services. The codes included will be G2010, G2012, 99446-99449, 99451, 99452, G0513-G0514, 99453-99454, 99457-99458, 99091, and G2086-G2088. I will also be addressing Medicare’s Telehealth coverage expansion for Home Dialysis Treatment, Telestroke, and Substance Abuse Treatment.
Tuesday, April 07, 2020 | 01:45 - 03:00 PM
Preventive care is often a confusing topic, and defining the differences between chronic disease management, wellness, IPPE, and AWV is often a confusing differentiation. Let’s also complicate that with a sick visit in conjunction with any of these preventive services- when is that reportable and what level of service can be billed with such a comprehensive encounter. During this session we will define each type of preventive encounter, the documentation expectations of each, as well as speaking to visits billable in addition to the preventive encounter. Attendees will leave with a checklist of documentation expectations, and modifier 25 considerations to ensure accurate documentation, billing, and reimbursement for services provided.
Peripheral coding is a comprehensive area based on proper catheter selection as well as knowledge to identify the hierarchies required for correct reimbursement. The coder must recognize when to use the endovascular revascularization codes for the procedures on the legs vs. identifying when vascular family order is appropriate along with supervision and interpretation codes. A thorough understanding of the CPT guidelines to ensure correct coding is required.
We will look into the role of the MFM in working with high risk pregnancies. We will examine how the OB/GYN and the MFM work together in high risk pregnancies. We will look at the tools an MFM uses in the evaluation of the fetus and managing any challenges. How the MFM uses other ancillary staff in the managment of that high risk pregnancy and the challenges in coding ang billing for the MFM services.
Modifiers for facility services can be pretty tricky. This session will introduce the most-used and most-abused modifiers in acute facilities, including tips on proper application/required documentation. We will discuss billing implications of incorrect modifier application, and tips on how to remain compliant with guidelines.
This presentation will cover the cognitive assessment CPT 99483 documentation requirements and patient’s that might benefit from this assessment. We will also cover the documentation guidelines for the new psychological/neuro psych testing codes (93160-96146) that were put into place Jan 2019. The focus will be on the CMS guidelines and documentation requirements.
The headlines of compliance settlements for physician practices seem to be more and more frequent. But when you look a little closer, the same themes seem to become apparent. This session will focus on cases of “compliance gone wrong” in physician practices. Learn what mistakes not to make.
This advanced interactive session will outline, through common examples, the more problematic elements of the CMS incident-to rule, which is applicable to outpatient services. This program will address the compliance risks associated with reporting services under this rule. Attendees will be asked to work through a number of common scenarios to “operationalize” their understanding of some of the more commonly problematic components of the rule, which include: • What it means to establish that care is “integral although incidental” to the physician’s professional service • How licensure issues impact compliance with the Incident-to rule under the auxiliary person definition. • How or if the rule applies to care supervised by non-physician practitioners.
If you are currently working from home or planning to work from home, then you would want to hear from to work-at-home dads as they discuss the good, the bad, and the ugly of working from home. This presentation will provide real stories to prove that working from is home is a dream for many, but will provide many challenges along the way including distractions, unexpected deadlines, being a parent, and being secluded from the outside world.
Wednesday, April 08, 2020 | 09:45 - 11:00 AM
Radiology coding is about more than counting number of views. This class will explain how to understand the most complex radiology studies from a clinic and coding perspective. We will also look at national coverage determinations and the reasons for the most difficult documentation and diagnosis requirements. Understanding the most common NCCI edits associated with Radiology coding will also be addressed.
Non-surgical sports medicine physicians are often innovative as they look for new ways to keep athletes healthy, so it is important for coders to stay on top of their game as well. We will look at common minor procedures in sports medicine including the new injection codes, PRP, Viscosupplementation Injections, Cryoanalgesia, and others. We will look at common coding concern and come away with a better understanding of these procedures as well.
Facility coding for Emergency Medicine services are often confused with professional coding. However, the two are quite different and often this confusion can create many billing conundrums for facilities. In addition, there are important distinguishers within the types of Emergency Medicine facilities. This presentation will cover the differences between the two with examples of common denial and audit trends based on current industry feedback and address any changes which impact the ED from the 2020 OPPS Final Rule.
You know you need to audit, but you want to make the most of your limited resources – how do you focus on what’s most important and structure your audits for the most impact? Why physician practices don’t audit, the benefits of an audit program, what areas should be audited, the benefits of an internal auditor versus and external auditor, the protection provided by attorney-client privilege and more. From timing of the audit to choosing the auditor and the audit sample to delivering the results and educating the physicians, this session walks you thorugh every aspect of the physician audit process.
Travel with me on a journey through the evolution of the medical record from the handwritten medical record through to today’s use of electronic medical records. We will look at how documentation and the coding of that documentation has been affected by regulation and the use of technology.
This course teaches managers how to apply the Five-Step Leadership System, which helps diagnose and correct employee concerns to achieve better performance. Attendees will also learn how to teach their staff the five corresponding steps of employee responsibility.
Wednesday, April 08, 2020 | 11:15 - 12:30 PM
You know how to code accurately... but do you know how to spot errors on the CMS 1500? Your contracted insurance rates are very good- but how do you know if your provider is billing in the range of other other providers in your geographical area? Put on your Sherlock Holmes hat to join me in this session where we will combine Compliance (Healthcare Fraud Prevention) for internal claim review and Reimbursement to look at where you are leaving money on the table as we learn more about Usual-Customary- Reasonable definitions and tools!
This presentation will cover acute and chronic Pediatric HCCs. It will cover the age breakdown for the various conditions and tiers. By the end of the presentation you will know why it is important for a practice to monitor Pediatric HCCs, watch for acute vs chronic, and understand chronic conditions.
It is critical for health information professionals to educate clinicians on complete and accurate documentation requirements for Post-Traumatic Stress Disorder (PTSD) and Alcohol Use Disorder (AUD). Health information coding professional ethics are needed now more than ever to ensure the clinical data integrity conversation begins between the provider and patient; and the health record is documented to the fullest on behalf of the veteran.
We will review some of the potential concerns for hospital coders. Topics will include: Validation audits, DRG accuracy, Risk Adjustment, PSIs, and Sepsis.
Medical necessity is one of the most common reasons for denial of physician services. There is escalating physician frustration regarding how their services are defined as “medically necessary”. The session will explore different perspectives of what defines “medical necessity” from the physician, coder and payer vantagepoint. This presentation will help you to understand what medical necessity is, how to document it and how it factors into choosing a level of service.
Coders, billers and office managers are increasingly finding their personal actions "under the microscope" of prosecutors and regulators when an associated physician or practice is investigated by the government. Are your actions placing you at risk? Join us as we discuss the types of conduct that have resulted in the prosecution of administrative staff members AND steps that you can take to reduce your level of risk.
We become better coders when we understand the entire process of managing a claim. I will explain the difference between an EOB and remittance advice, as well as CARC and RARC codes and what goes on behind the scenes at the insurance company. I will advise on how to know when to call the insurance and which questions to ask. I will also teach how to research payer policies.
Risk adjusted reimbursement continues to expand into almost every practice. The problems with transition parallels DRG challenges. The best practice for transition pararells that of DRGs. Actual improvement examples and data will be delivered. This is revenue cycle improvement in value bvased reimbursement.
Take this chance to stop by the exhibit hall, visit the exhibitors, network with peers and have lunch
Take this chance to stop by the exhibit hall, visit the exhibitors, network with peers and have lunch
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.
Learn more about a dynamic and progressive business at our AAPC Facility Expo. See the future and learn from the best of the present. You might learn the latest in documentation, coding, billing, electronic medical records, compensation, and many other things. Whether you are a facility veteran or an interested observer, so much is happening, you will be enthralled. The Facility Expo promises a mix of new information and fun.
$195 | This 2020 workshop provides certified instructors with tools to improve their teaching and communication skills. This is also a great opportunity to network with other instructors. Earn 8 CTUs or 8 CEUs for participation in this workshop.
Cost Varies | AAPC certifications are the gold standard for the business of healthcare and are held by more than 96,000 professionals. Those who obtain these credentials are critical to compliant and profitable medical practices/facilities. These credentialed individuals also typically earn 20% more than non-certified employees. AAPC credentials increase your chances of being hired and retained in a competitive job market
No Cost | All officers and prospective officers are invited to meet with members of the AAPC Chapter Association on Saturday, April 4 from 5:30 pm to 8:30 pm. It's a great way to kick off HEALTHCON 2020 and we will have all of the information you need to govern your chapter successfully in 2020. This is a chance to meet with other officers just like you, ask lots of questions and compare the way that you get things done... what works and what might be better. Take home ideas for presentations, find ways to identify the best speakers for your meetings and join in a great opportunity for networking with your peers. HEALTHCON is a great place to meet people, and officers can be some of your best networkers. Bring your ideas to share and plan to soak up information while you are in the happiest place on earth! Hope to see you there.
No Cost | 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.