March 27-30, 2022 HEALTHCON Schedule

Keynote

General Sessions

Conference Welcome

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E/M Panel

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During this session, an expert panel made up of a physician, coder, auditor, payer and representative from the AMA will answer audience questions regarding the 2021 E/M guidelines for office visits.

Keynote: Future of Medicare

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Gail R. Wilensky, Ph.D. is an economist and senior fellow at Project HOPE, an international health foundation. She also co-chairs the Bipartisan Policy Center’s initiative on the future of health care. She directed the Medicare and Medicaid programs, served in the White House as a senior adviser on health and welfare issues to President GHW Bush and was the first chair of the Medicare Payment Advisory Commission. Her expertise is on strategies to reform health care, Medicare, comparative effectiveness research and military healthcare

Legal Trends Panel

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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!

AAPC International and Review of Global Trends

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This session will provide an overview of AAPC’s international activities and discuss healthcare and medical coding trends from a global perspective. In addition, the session will highlight 2 case studies exploring the transformation of Saudi Arabia and Brazil’s healthcare systems which are currently undergoing sweeping changes and the journey of health information management and medical coding.

Telemedicine Panel

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During this session a panel of experts representing the provider, facility, and payer perspectives will be discussing best practices for navigating the ongoing changes with telemedicine and telehealth regulations. There are so many changes occurring it is difficult to keep up. The panel will answer questions from the audience.

2021 E/M Lessons Learned

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In preparation for the implementation of the new 2021 E/M guidelines for office visits, AAPC conducted many provider and coder trainings. In this session we will discuss comments questions and lessons learned along the way.

Session 1

Monday, March 28, 2022 | 10:45 - 12:00 PM

1A: Do You Really Understand the “With” Guideline?

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The ICD-10-CM Official Guidelines state that: The word “with” or “in” should be interpreted to mean “associated with” or “due to.” The classification presumes a causal relationship between two conditions linked by these terms in the index. Many coders do not understand the significance of this rule. This presentation covers the most common coding errors that overlook this guideline.

1B: Increase Revenue With Correct Cardiac Intervention Coding

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When your provider decides to perform another cardiac intervention after cardiac catheterization, it can be confusing trying to determine whether the catheterization can be billed together with the intervention. Mastering the hierarchy of the coronary interventions and add-on codes based on several coronary artery diseases can certainly add to revenue. Mastering the guidelines concerning when to report other coronary interventions can also add revenue that you do not want to miss. This presentation will address correct diagnosis reporting that links to correct procedural codes to help you avoid denials.

1C: A Deep Dive Into Shoulders

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Coding for surgical procedures performed on the shoulder is one of the most challenging areas for many orthopedic coders. In this presentation we will review the anatomy of the shoulder and put the pieces together to accurately code surgical procedures. We will incorporate both NCCI guidelines and CPT® changes, as well as discuss controversial procedures such as reverse total shoulder, remplissage procedure, and superior capsule reconstruction.

  • Presenter:
    Nate Felt, CPC
    • Time:
      03/28/22 10:45 - 12:00 PM, ET
    • Coding General
      CPC CIC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Compliance
      CPCO
    • Auditing
      CPMA
    • Coding Specialty
      CASCC COSC CPC-P CANPC

1D: How to Stay Ahead of Trends as Medicare Repeals the Market-based Inpatient Payment Methodology.

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CMS began collecting market-based (rather than charge-based) data in FY 2021 for use in the methodology for calculating inpatient hospital payments in 2024. Readiness and preparation are keys to mitigating the threat to provider revenues. This session will help you learn how to assess your facility’s current state and plan next steps in preparing for changes within your organization. It will include detailed illustrations of core concepts with examination of practical examples.

  • Presenter:
    Angie Audler
    • Time:
      03/28/22 10:45 - 12:00 PM, ET
    • Coding General
      CPC CIC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P

1E: Injection and Infusion Coding

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Come with me as we explore all that goes into correct injection and infusion coding. With their own hierarchy and set of rules, these ‘little’ services can add up to big money and big problems if not captured correctly!

1F: How to Negotiate Payer Contracts Like a Pro

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What are your peers doing with their payer contracts? In this session we will walk through numerous actual contract negotiations from real-life practice success stories and you will learn to advocate for your practice using proven techniques from a veteran contract negotiator. Most physician practices focus on cutting expenses instead of improving their revenue from non-governmental payers. A little focused effort on negotiating payer contracts can create much-needed money for your practice.

1G: Medical Necessity Denials – When and How to Appeal Them

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Medical necessity denials continue to increase in volume for both professional and hospital services, and it is estimated that only approximately 20 percent of claim denials are appealed. In this presentation you will learn how to address and appeal these denials successfully while improving your coding, A/R, and ROI. A multifaceted approach is required and involves evaluating opportunities to avoid denials upfront but also learning how to fight them when the denial is unavoidable.

  • Presenter:
    Holly Ridge, CPC, CPMA
    • Time:
      03/28/22 10:45 - 12:00 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P

1H: Auditing Behavior Health Notes – More Than Words on a Page

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This interactive auditing class will discuss the documentation requirements for psychology services, including the use of the crisis code. We will explore the CMS requirements for these services and look at some examples from recent TPEs. This is a great way to help your behavior health providers create better documentation that will support the CPT® and CMS guidelines.

  • Presenter:
    Susan Marie Roelant, CPC, CPCO, CPMA, CEMC
    • Time:
      03/28/22 10:45 - 12:00 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Compliance
      CPCO
    • Auditing
      CPMA
    • Coding Specialty
      CEMC CDEI CDEO CPC-P

1I: Maintain Compliance During Physician Vacancies

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The COVID-19 pandemic taught us that even physicians get sick and have to take leaves of absence on occasion. This presentation will address how to handle physician vacancies while maintaining compliance with Medicare reassignment rules. You will learn the difference between locum tenens arrangements, reciprocal billing arrangements, and long-term leasing of employees from temporary agencies. The presentation will also cover proper billing and documentation, time limits, and the impact on patients.

1J: CMS 2022 Physician Fee Schedule Final Rule

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Each year, the healthcare industry awaits the CMS Physician Fee Schedule Final Rule to have a blueprint of what to expect in regulatory changes, reimbursement modifications, and coding guidance. 2022 will usher in new regulations for telehealth delivery and direction on pathways post-public health emergency. In this session you will analyze the key outcomes of the final rule to develop organizational strategies for incorporating these new findings into internal strategic plans.

  • Presenter:
    Kemberly J Tolliver, CPC
    • Time:
      03/28/22 10:45 - 12:00 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Compliance
      CPCO
    • Auditing
      CPMA
    • Coding Specialty
      CEMC CPC-P

Session 2

Monday, March 28, 2022 | 01:00 - 02:15 PM

2A: Which Cut is the Deepest?

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In this session we will discuss integumentary coding guidelines as they relate to lesion excision, debridement, and wound repair. We will cover the differences and the reimbursement issues faced. We will learn how to apply the proper modifiers and become familiar with the LCD policies for coverage by many insurance payers.

2B: Jumpstart Your Heart – The Electrophysiology of Your Heartbeat

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Discussion and analysis of the heartbeat, including anatomy, terminology, and pathophysiology, are the focus of this session. In addition to the electrical pathway of the heartbeat, we will examine normal and abnormal rhythm EKG strips to help explain these conditions. Heart disease, including women’s heart health, will also be presented.

2C: Orthopedic Procedure Coding in the Office

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This presentation will break down coding and documentation for office procedures commonly performed in the office setting. It will include discussion of when it is appropriate to bill an E/M service with modifier 25.

2D: The Ins and Outs of Inpatient Clinical Documentation Improvement

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This session will focus on understanding the inpatient clinical documentation improvement process. We will review common trouble areas, as well as discuss how to develop a good clinical documentation improvement team and workflow.

2E: Proper Coding and Billing for OT, PT, and SLP Services

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Therapy coding has experienced major changes over the past few years, and the changes continue to come. This session will review the proper selection and documentation of therapy evaluation codes. It will also discuss the new payment reductions for OTAs and PTAs in 2022 and the future of telehealth for therapy practitioners. In addition, we will review recent OIG and SMRC therapy audit findings.

  • Presenter:
    Monica Wright, CPC, CPCO, CPMA
    • Time:
      03/28/22 01:00 - 02:15 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Compliance
      CPCO
    • Coding Specialty
      CDEO CPC-P

2F: Conflict Resolution in the Workplace

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Conflict resolution strategies allow you to increase workplace productivity by mitigating conflict when it first occurs. They also help you to improve morale and teamwork within the workplace. In this session you will learn to develop the skills you need to master the process of resolving conflicts.

  • Presenter:
    MariaRita Genovese, CPC
    • Time:
      03/28/22 01:00 - 02:15 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P

2G: Turn Denials Into Dollars

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In a rapidly changing and unstable healthcare reimbursement environment, protecting insurance revenue has never been more vital or challenging! Claim submittals following proper billing guidelines do not always result in the claims payment expected. This session offers valuable resources and takeaways that help equip and empower revenue cycle and billing teams with practical ways to combat claim denials and offsets that do not align with applicable federal and state laws. This interactive session is designed to leave you inspired to address denial tactics.

  • Presenter:
    Karlene Dittrich, CPC, CPMA
    • Time:
      03/28/22 01:00 - 02:15 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P

2H: Lessons Learned From the Road – “Don't Make My Mistakes!”

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In this session we will discuss experiences from audits gone awry and look back to find a better way. This is an opportunity to note practices that make for complete, compliant audits with fewer problems and setbacks. We will also discuss when to say no to an audit.

2I: Understanding Release of Information – Mental Health and Substance Abuse

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In addition to HIPAA, Mental health and substance abuse services, and their related records, are subject to confidentiality and security requirements under 42 CFR Part 2, the 21st Century Cures Act, and state law. This session will help you understand the laws applicable to mental health and substance abuse services, where the uses and disclosure of this information may be more restricted than HIPAA, and how your organization can strengthen compliance of this information through segregation, policies, and documentation.

2J: We Are AAPC! A Reminder of Our Code of Ethics

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We will identify, review, and break down the AAPC Code of Ethics in this session, focusing on why the Code of Ethics is important and why we need to adhere to it both personally and professionally. We will discuss the importance of ethics in our billing and coding roles and define the difference between ethics and professionalism.

Session 3

Monday, March 28, 2022 | 02:45 - 04:00 PM

3A: What Exactly Is a Significant and Separately Identifiable E/M?

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This session will help coders to determine when what has been performed and documented by a provider substantiates a significant and separately identifiable E/M. The National Correct Coding Initiative policy manual will be used as a reference to help make this determination without ambiguity. Not only will this content help coders appropriately review documentation already performed, but it will also help providers document properly proactively.

  • Presenter:
    Jeffrey Lehrman, CPC-A, CPMA
    • Time:
      03/28/22 02:45 - 04:00 PM, ET
    • Coding General
      CPC CIC COC CRC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Compliance
      CPCO
    • Auditing
      CPMA
    • Coding Specialty
      CGSC CPEDC CEMC CCPC CDEO CPCD CSFAC CGIC CPMS CENTC COPC COBGC CHONC CUC CRHC COSC CCC CANPC CEDC CCVTC CPC-P CFPC CIMC CDEI CASCC

3B: Coding for Spine Procedures

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This presentation will review spine anatomy and terminology as it relates to code selection. We will discuss the different fusion and laminectomy codes and when to use each, along with clarifying when to use excision vs. osteotomy vs. corpectomy codes. Practice examples will round out our session to solidify understanding throughout the presentation.

  • Presenter:
    Deni Adams, CPC, CPB, CPPM, CEMC
    • Time:
      03/28/22 02:45 - 04:00 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CGSC CPC-P

3C: Laboratory: Who Gets the Money?

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In this session we will go over general laboratory billing guidelines and discuss governmental regulatory guidance such as PAMA and how to handle billing on the UB-04 and CMS-1500 forms. We will also discuss some of the top questions concerning laboratory billing and compliance.

3D: Charting the Way – Improve Your Review of Inpatient Records

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This session is designed for inpatient coders as well as CDI professionals who want to increase their understanding of documentation review. Your ability to improve the quality of provider documentation begins with providing a quality review. Together, we will work through case scenarios and pinpoint areas to improve clinical documentation, identify query opportunities, and ultimately improve the accuracy of code assignment.

3E: ED Facility Leveling Explained

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Facility E/M leveling is very different from professional E/M leveling. This presentation will go over CMS and the 2009 OPPS Final Rule guidelines in developing your own leveling model. We will review the differences between professional and facility E/M leveling requirements, as well as review the different models used by various emergency departments, such as ACEP’s model, a points system, and developing your own model. You will experience coding scenarios and examples using these various models. We will then venture into the payer denial trends of facility E/M leveling and discuss recommendations to overcome these denials.

  • Presenter:
    Tammy M Vannatter-Berger, CPC
    • Time:
      03/28/22 02:45 - 04:00 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Compliance
      CPCO
    • Auditing
      CPMA
    • Coding Specialty
      CEMC CEDC CPC-P

3F: Achieving Operational Excellence

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3G: Breaking Down Billing for New Drugs

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Do you struggle with drug billing? Drug denials? Drug reimbursement? In this presentation I will break down the billing of novel therapies, unscramble the alphabet soup of acronyms, and provide you with a step-by-step process to ensure proper coding, billing, and reimbursement for drugs. I will include best practices, share reimbursement strategies specific to oncology drugs, and review prior authorization workflows that may work for you.

3H: Working with Legal Counsel to Prevent or Defend Audits

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This session will focus on how to prevent audits from federal and commercial payers, and if necessary, how to respond to records requests and various audits from them. Integral in this presentation will be best practices for working with legal counsel to create and manage this process internally and with the auditors.

  • Presenter:
    Courtney Tito
    • Time:
      03/28/22 02:45 - 04:00 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Compliance
      CPCO
    • Auditing
      CPMA
    • Coding Specialty
      CPC-P

3I: Potential Liability of Billers/Coders in Healthcare Fraud Prosecutions

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Law enforcement officials around the country are actively investigating and prosecuting allegations of healthcare fraud. Unfortunately, practice billers and coders are increasingly finding themselves under the government’s microscope. In this session we will discuss the current enforcement environment facing billers and coders. We will also discuss the steps you should take if you find yourself the focus of a government investigation.

  • Presenter:
    Robert Walton Liles, CPC
    • Time:
      03/28/22 02:45 - 04:00 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Compliance
      CPCO
    • Auditing
      CPMA
    • Coding Specialty
      CPC-P

3J: How to Get Hired – Job Searching Dos and Don’ts

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Session 4

Monday, March 28, 2022 | 04:15 - 05:30 PM

4A: Modifiers: A Risky Business

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To modify or not to modify, that is the question. Using modifiers inappropriately can create a huge compliance risk for providers. Unfortunately, when we learn to code, we are introduced to modifiers but not always taught their compliant use in depth. That all changes in this session! We will take a deep dive into some risky modifiers — the unbundling modifiers. At the end of this session, you will understand when E/M modifiers 25, 57, and 24 can correctly be reported. You will also learn the correct use of global surgery modifiers such as 58, 59, 78, 79, and more. Join in and let’s explore how to avoid the risky business of modifiers together.

4B: Peripheral Vascular Procedures

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A look at peripheral revascularization, bypass and thrombolysis. This course will be an overview of codes and guidelines, as well as dissecting notes for documentation of these procedures.

4C: Sight Seeing in DC

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Teaching a session on the codes for ophthalmic services might pale in comparison to an E/M session — although they are essentially the bread and butter of an ophthalmology practice. Teaching when to use eye versus E/M codes can be tricky and a gray area topic to approach. There are variations and disagreements amongst the payers, so what do you do? In this session, we will explore best practices and how to create an optimum compliance path for your practice.

4D: Common Inpatient Audit Findings and How They Impact Your Facility

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This presentation will cover the most common audit findings and how they impact your facility. We will discuss findings related to principal diagnosis selection, CC/MCC selection, and how it impacts the DRG. Discharge patient status and how it impacts the payment to the facility is also covered, as are patient safety indicator findings and what that means for the facility and 30 days readmission/mortality measure opportunities.

  • Presenter:
    Brett Randolph
    • Time:
      03/28/22 04:15 - 05:30 PM, ET
    • Coding General
      CPC CIC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Compliance
      CPCO
    • Auditing
      CPMA
    • Coding Specialty
      CPC-P CDEI

4E: Overview of Outpatient Facility Coding and Overview of 2022 HOPPS Changes

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This session will cover a general overview of outpatient facility coding, as well as a deep dive into common conundrums with outpatient surgeries. A review of the new 2022 Hospital Outpatient Prospective Payment System (HOPPS) will also be included with a focused look at the impact of the rising number of procedures that have moved from inpatient to outpatient.

4F: Understanding Why Population Health is so Popular Now

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This session will focus on understanding the increase in popularity of population health programs and their place in value-based care and ACOs. The session will review the fundamentals of population health and the coding and billing implications.

4G: The Magical World of Oncology Billing

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Oncology billing can be challenging. This session will highlight common denials, authorization processes, place of service issues, and new chemotherapy medication procedures.

  • Presenter:
    MariaRita Genovese, CPC
    • Time:
      03/28/22 04:15 - 05:30 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P CANPC CHONC

4H: Compliance Audits vs. Forensic Audits – Understanding the Difference

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4I: Collection Issues: Best Practices, Tips, and Traps

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  • Presenter:
    Kelly McIntosh- Freeman
    • Time:
      03/28/22 04:15 - 05:30 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P

4J: APP Documentation and Billing

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Your practice is hiring a nurse practitioner, or perhaps a physician assistant. How can their services be coded? What can they do? How should they document? These and other questions will be answered in this informative and lively educational session. Don’t miss your chance to hear from one of our former national board members, Suzan Hauptman, as she speaks on one of her favorite topics.

  • Presenter:
    Suzan Berman Hauptman, CHC, CPC, CEDC, CEMC
    • Time:
      03/28/22 04:15 - 05:30 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Compliance
      CPCO
    • Auditing
      CPMA
    • Coding Specialty
      CPC-P CEMC CDEO CDEI

Session 5

Tuesday, March 29, 2022 | 12:45 - 02:00 PM

5A: Guidelines for Sequencing

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Sequencing ICD-10-CM codes has always been problematic for novice coders, but it must be mastered in order to understand its proper use in our everyday work. Many claim denials are due to improper sequencing, which leads to CPT® codes being linked to an incorrect diagnosis pointer. Even with electronic billing software, if the ICD-10-CM Alphabetic Index and Tabular List are not adhered to correctly, a clean claim will not be submitted, causing non-payment or improper payment rightfully due to the provider or facility. This presentation is designed to provide awareness of the guidelines and how the respective diagnosis code is impacted. Often the first code looked at is the only one used, which can lead to in-depth research, to ensure the claim submission is correct, not being completed. Most importantly, we, as coders, are responsible for reporting an accurate diagnosis for a patient and not reporting a diagnosis for them that they don’t actually have.

5B: Emergency Department Coding Complexities

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The emergency department (ED) is a unique practice environment where clinicians care for a wide variety of conditions with varying levels of severity. Coding these visits poses its own unique set of challenges. This session will cover the practical side of how to best code enigmatic situations. Attendees will leave with an understanding of ED evaluation and management (E/M), critical care, and observation codes; the documentation required when working with other clinicians; codes and vital documentation for common ED procedures; and how to resolve many coding conundrums.

  • Presenter:
    Hamilton Lempert, MD, FACEP, CEDC
    • Time:
      03/29/22 12:45 - 02:00 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CEDC CEMC CDEI CPC-P CDEO

5C: 2022 CPT® Updates for Everything Endovascular

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In this session we will review the 2022 updates for endovascular procedures, including new codes and changes in guidance from various societies over the past year.

5D: ICD-10-PCS in Pieces, Breaking Down Obstacles in Inpatient Coding

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The goal of this presentation is to help strengthen inpatient coders’ understanding of the difficult aspects of ICD-10-PCS coding, such as obtuse procedures or commonly misunderstood procedures, to bolster their coding abilities. By breaking down specific areas identified to cause trouble, coders can strengthen their ICD-10-PCS coding skills.

5E: Outpatient CDI

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5F: Benchmarking for Practice Success

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This presentation provides an introduction to benchmarking. Change is always occurring. Do we ignore it or use a thoughtful approach? In this session, we will define benchmarking and review warning signs of what is changing in healthcare and measures to consider for your practice.

5G: Bringing Consumerism to the Patient Financial Experience

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At the turn of the century, the banking and financial services sectors were finishing a monumental shift in their industry — consumerism. With the emergence of better-informed consumers that demanded transparency and a greater range of options, banks and financial institutions had to adapt or die. Thirty years and one pandemic later, consumerism is hitting healthcare. We are left with those same options: adapt or die. In this session, Wixom weaves history, analytics, and experiential frameworks together into an engaging and action-oriented presentation.

  • Presenter:
    Eric Wixom
    • Time:
      03/29/22 12:45 - 02:00 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P

5H: Using Regulatory Guidance to Support Audit Findings

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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. This session provides an overview of the most relevant and impactful regulatory guidance that can be used by auditors for both physician and facility-based audits. In addition to reviewing 42CFR, Medicare Manuals, CPT® guidance, AHA Coding Clinic, and Local and National Coverage Determinations, this presentation will provide attendees with real-life scenarios and explanations on how to appropriately cite these references in an executive summary.

  • Presenter:
    Pamela J Brooks, COC, CPC
    • Time:
      03/29/22 12:45 - 02:00 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Compliance
      CPCO
    • Auditing
      CPMA
    • Coding Specialty
      CPC-P

5I: Performing a Compliance Program Effectiveness Review

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Performing a Compliance Program Effectiveness Review - What are the key performance measures? - Where to start when overwhelmed

5J: Current State of Telehealth

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Most providers were reluctant to utilize telehealth services prior to COVID-19. But after the pandemic hit, many providers had no choice. What is the current state and what will the future bring? This session will cover the latest and greatest information available from both Medicare and Medicaid Services (CMS) related to telehealth services, and applicable guidelines at the national level. Learning Objectives: • Review most up-to-date CMS guidelines as of January 1, 2022 • Discuss which codes remain on the CMS Telehealth approved list and can continue to be billed via Telehealth • Highlight the documentation guidelines for the services which can be performed via Telehealth

Session 6

Tuesday, March 29, 2022 | 04:15 - 05:30 PM

6A: COVID Regulations Pre- and Post-pandemic

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This session will cover telehealth, facility and provider rules that will stick around post-pandemic, and some regulations that will be temporary for the next few years. We’ll focus on compliant billing for COVID tests, vaccines, monoclonal antibody infusions, labs (including CLIA certifications required), correct revenue codes, and types of bills for facilities. Note, this presentation will be fluid as the pandemic changes.

6B: Let's Talk About Feet

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Coding for procedures and services on the feet is one of the most challenging areas for many coders. It is a heavily regulated specialty that requires thorough understanding in order to bill appropriately. We will review the anatomy of the foot and ankle and discuss the coding guidelines for routine foot care and surgical procedures.

  • Presenter:
    Christopher Chandler, CPC, CGSC
    • Time:
      03/29/22 04:15 - 05:30 PM, ET
    • Coding General
      CPC CIC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CSFAC CANPC CPC-P CASCC

6C: Livin’ la Vida Gastro

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In this session, we will discuss advanced gastroenterology coding challenges, including procedures such as colonoscopy, endoscopic ultrasound (EUS), esophagogastroduodenoscopy (EGD), perioral endoscopic myotomy (POEM), and endoscopic retrograde cholangiopancreatography (ERCP). We will discuss payer issues, the documentation needed to support medical necessity, billing errors, CCI edits, proper use of modifiers, and Local and National Coverage Determinations applicable to this specialty. We’ll also talk about the issues with colonoscopy screenings and the pre-visit for screening. This presentation will cover both adult and pediatric conditions.

  • Presenter:
    Jessica Miller, CPC, CPC-P, CGIC
    • Time:
      03/29/22 04:15 - 05:30 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Compliance
      CPCO
    • Auditing
      CPMA
    • Coding Specialty
      CGIC CDEO CPC-P

6D: Root Operations for ICD-10-PCS

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What is the difference between excision and resection? What is included or should be considered for an incision and drainage (I&D) procedure? What qualifies for coding a device? Physicians generally do not document for the purpose of code assignment. This can be very problematic when clinical documentation and ICD-10-PCS coding guidelines do not match up. It is vital to establish the objective of the procedure when assigning codes; not doing this may lead to potential revenue loss for your facility. If you are new to inpatient coding or struggling with some of the procedural concepts, join us as we define some of the most challenging root operations.

6E: CPT® Coding for Electrophysiology Procedures

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Electrophysiology (EP) is a specialized area of cardiology. EP procedures include those that identify the source of cardiac arrhythmias and treat them using a variety of methods. It is also used to determine if a patient is at risk for sudden death, in which case, a defibrillator may be placed. Pacemaker and defibrillator implantation and many of the maintenance procedures for these devices are performed in the EP lab. While coding EP studies might appear daunting at first, understanding the key terms and what services are separately reportable makes the task easier.

  • Presenter:
    Sri Valli, CPC/ Leigh Poland
    • Time:
      03/29/22 04:15 - 05:30 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CANPC CPC-P CCVTC CCC

6F: Mental Health & the Opioid Crisis – What do we code?

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In this course we will look at Chapter five, concentrating specifically at the substance abuse categories. We will delve into documentation requirements of top diagnoses and how the coding guideline “with” can affect the Principal/first listed diagnosis. This class is for all levels of coders.

  • Presenter:
    Heather Greene, CPC, CIC, CPMA
    • Time:
      03/29/22 04:15 - 05:30 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P

6G: Coding and Billing for Psychiatry and Outpatient Mental Health Providers

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Mental health services bring with them distinct documentation and coding requirements to support accurate billing. This session will help attendees understand the codes and guidelines for psychiatric services, psychological testing, health behavior assessment and intervention, applied behavioral analysis, and Screening Brief Intervention & Referral to Treatment (SBIRT) codes. We’ll review key psychiatry evaluation and management coding concepts, including relevant add-on codes. Outcomes from recent Special Investigations Unit (SIU) psychiatry-specific commercial payer audit experiences will be incorporated to emphasize the importance of understanding coding guidelines and payer reimbursement policies.

  • Presenter:
    Laurie Bouzarelos, CPC
    • Time:
      03/29/22 04:15 - 05:30 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CEMC CPC-P CDEO

6H: Peer Review Audits and Escalation of Medical Necessity

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In this session, we will review the definition of medical necessity as it relates to Medicare, Medicaid, and commercial insurance carriers. The objective of this course is to "relearn" the meaning of medical necessity and how working with physicians promotes greater insight. During the presentation, we will discover resources for medical necessity guidance and regulations. We will also discuss peer review and how this relates to medical necessity within the healthcare field.

6I: Don't Be Scared of Shared Billing

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Medicare has covered shared billing between physicians and nonphysician practitioners for years. The Centers for Medicare & Medicaid Services temporarily removed the guidelines from the Medicare Claims Processing Manual and significantly changed the way shared services must now be performed, documented, and billed. Attendees will learn the new way to bill shared services and what needs to be documented to support a shared service, where a shared service may be performed, and under whose provider number the service may be billed.

  • Presenter:
    Maryann C Palmeter, CPC, CPCO, CPMA, CENTC
    • Time:
      03/29/22 04:15 - 05:30 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Compliance
      CPCO
    • Auditing
      CPMA
    • Coding Specialty
      CDEI CPC-P CEMC CDEO

6J: The Power of Networking

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This session will tell the story of two women who used networking to move themselves up in the healthcare field from medical assistant/receptionist to owners of their own consulting businesses. This presentation is meant to inspire attendees as well as give them the tools to assist in skyrocketing their careers to the next level and above. When exiting the session with a handful of contacts, they will be working towards the future.

Session 7

Wednesday, March 30, 2022 | 10:45 - 12:00 PM

7A: The Neoplasm Table - Six Columns of Confusion

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The six columns in the Neoplasm Table in ICD-10-CM coding are frequently misused and misunderstood. There is much confusion over how to use the unspecified and uncertain columns in particular. This session will cover the documentation needed, basic use of the table, and the tough question of when the table is no longer used and history codes are assigned. Anyone who codes will learn something in this fun and fast-paced lecture.

  • Presenter:
    Jill M Young, CPC, CEDC, CIMC
    • Time:
      03/30/22 10:45 - 12:00 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Compliance
      CPCO
    • Auditing
      CPMA
    • Coding Specialty
      CEMC CPCD CDEI CFPC CPC-P CHONC CIMC CDEO

7B: Coding for Plastic and Reconstructive Surgery - the Medically Necessary Stuff

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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. We will also discuss some of the high dollar procedures that can be reported to payers, (both government and private insurers) and in which situations. Look forward to an engaging presentation including information regarding CPT and ICD-10 coding associated with these codes. Attendees can expect to learn: 1. Icd-10 coding typically associate with cosmetic and medically necessary Plastic Surgery 2. Some relevant payer expectations regarding these codes (including some Pre-Authorization tips) 3. National coding guidelines that effect the way these codes can be reported 4. A greater understanding of these codes and the work they represent 5. Documentation recommendations for fulfilling medical necessity

  • Presenter:
    Tyler Griffeth, CPC, CPRC
    • Time:
      03/30/22 10:45 - 12:00 PM, ET
    • Coding General
      CPC CIC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CANPC CPC-P CASCC

7C: Coding for Dignity in Death

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When coding for hospice, choosing the code may seem rather obvious. However, the principal diagnosis can have a drastic impact on the patient's hospice experience, either granting or barring the treatments available. Just because someone is on hospice, it does not mean they are left to die, only that they forgo life-extending measures. Hospice patients still receive treatment, and depending on the code chosen, a patient might have access to dialysis or even physical therapy. These code choices can fundamentally change a person's last days and are arguably the most important codes used throughout the patient's lifetime.

  • Presenter:
    Margaret Wallace, CPC-A
    • Time:
      03/30/22 10:45 - 12:00 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P

7D: Keys to Creating an Empowered Team and Optimized Organization

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Being a healthcare leader is more challenging than ever. We believe you need an empowered team to help you find success as both an individual and an organization—all while managing issues that inevitably pop up along the way with clarity and confidence. This course will teach you how to build a culture that grows and retains high performers. You'll learn how to clarify your vision, foster your teams' confidence, build strategies so everyone is on the same page, and identify where people may be out of alignment so you can optimize your systems and processes for continuous growth.

  • Presenter:
    Adrienne Lloyd, MHA, FACHE
    • Time:
      03/30/22 10:45 - 12:00 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P

7E: The ABC's of ASC's

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In this session, we will discuss the history of ambulatory surgery centers (ASCs). We will conquer the caveats of billing and coding in an ASC along with reimbursement guidelines. We will also delve into the nuances of Medicare, Medicaid, and commercial insurance payers' requirements and changes to the Medicare inpatient-only list for fiscal year 2022.

7F: Maximize Revenue Growth: Analyzing E/M Procedures

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Accurate reporting of evaluation and management (E/M) services drives reimbursement. However, coding these services is still a major cause of confusion for many provider types. In 2020, Medicare's projected total of improper payments for E/M codes was over $3.2 billion and accounted for 11.9 percent of all improper payments. This session will pinpoint the areas where administrators should focus internal process reviews to ensure compliance and, therefore, maximum reimbursement such as proper documentation, medical necessity requirements, and internal audits to prevent under- and over-coding errors.

  • Presenter:
    Jeffrey Stuart Newsome, CPCO
    • Time:
      03/30/22 10:45 - 12:00 PM, ET
    • Coding General
      CPC CIC COC CRC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Compliance
      CPCO
    • Auditing
      CPMA
    • Coding Specialty
      CSFAC CDEO CGIC CDEI CEMC CHONC COPC CIMC CUC CANPC CCVTC CGSC CPCD CFPC CEDC CPMS COSC CRHC CASCC CPEDC CPC-P CCPC CCC COBGC CENTC

7G: A/R Management

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7H: Counting of Data

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We are now more than one year into the new evaluation and management (E/M) guidelines for office and other outpatient services. Even with the time-lapse, there are still some pressing questions and remaining ambiguity around assigning data points for medical decision making (MDM). Join us as we discuss some of these pain points: Does my test include interpretation? When should I assign credit for a lab order or review? What happens if the review takes place on a different date from the encounter? How much weight should I give to the “Data” MDM element if my other two categories are minimal or low risk? Get answers to your questions by fully understanding all the definitions around data and how to communicate these definitions to providers.

7I: FBI Healthcare Fraud Program

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Provide an overview of the FBI's Health Care Fraud Program, including emerging threat trends, and a case study.

  • Presenter:
    Paul Baumrind/ Gregory Heeb
    • Time:
      03/30/22 10:45 - 12:00 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Compliance
      CPCO
    • Auditing
      CPMA
    • Coding Specialty
      CPC-P

7J: Eating Disorders

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Eating Disorders impact nearly 30 million men and women nationally. This presentation is designed to provide information about the symptoms, and treatment methods around a variety of eating disorders, and will also discuss the healthcare finance issues surrounding this devastating disease. Attendees will have the opportunity to take a direct look at one of the most challenging mental health conditions today in a straightforward and compassionate approach.

  • Presenter:
    Pamela J Brooks, COC, CPC
    • Time:
      03/30/22 10:45 - 12:00 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CFPC CEMC CIMC CPC-P

Session 8

Wednesday, March 30, 2022 | 12:30 - 01:45 PM

8A: CMS Changes to Reporting Shared Services

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CMS recently proposed important changes that will significantly impact billing shared services between physicians and nonphysician practitioners. These will be finalized by the time HEALTHCON commences and will be crucial updates that attendees need. In this session, we will review these changes including clarification on where shared services can be billed, requirements regarding who should bill for the shared services, and updates about what types of services can be billed as shared services.

  • Presenter:
    Christopher Chandler, CPC, CGSC
    • Time:
      03/30/22 12:30 - 01:45 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Compliance
      CPCO
    • Auditing
      CPMA
    • Coding Specialty
      CPC-P

8B: ENT Procedures, Surgeries, and Hot Topics

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This session will encompass a review of coding an office visit with a procedure on the same day and use of modifier 25. Then we will explore coding for surgical interventions using steroid implants and stents, nasal cryoablation, and nasal wall implants. In addition, we will tackle other hot topics such as diagnostic scopes, eustachian tube dilation, and hypoglossal nerve stimulation, followed by a look at the global surgical package in relation to functional endoscopic sinus surgery (FESS), septoplasty, and post-op debridement. Lastly, we’ll discuss cerumen removal and how documentation can make all the difference.

8C: Women's Health - Obstetrics and Gynecology

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This session will discuss services commonly performed in the practice of Obstetrics and Gynecology. The session will cover: • Preventive services for both Medicare and private payers. • Coding guidelines for CPT and CMS • Global care for obstetrics • Common surgical issues and denials.

8D: Pharmacy Coding and Charge Capture

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The Pharmacy session will address the many nuances of pharmacy coding and billing. We will look at the different methods of capturing medication charges, what is and isn’t billable, modifiers, dose calculations for correct charge capture, and drug taxonomies used for both pharmacy billing and in ICD 10 CM.

8E: Outpatient Coding Compliance Missteps to Avoid

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What modifiers are commonly misused resulting in enforcement and penalties? What are common medical necessity issues? 3. What steps are necessary when over payments are found?

8F: Lessons in Leadership

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Let’s learn about growth plans and how they can help you fast forward your career. We will learn about the different personality types and how to effectively communicate with each member of your team helping you achieve the most productive use of your time. If you are already a leader in business this will help you grow your teams as well. Learn how to: Be consistent and motivated, maximize your growth strategies, increase your capacity and learn skills on how to grow to elevate your career.

8G: Clinical Denials: A Step-by-Step Approach

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Denials have increased significantly as the electronic billing and remittance process has become increasingly sophisticated. Claims have less human contact. Computer-based payment algorithms search for key information according to payer contract requirements. The average cost to rework a claim is $25 (Healthcare Financial Management Association), and failing to rework denials results in a loss of revenue that supports your MTF’s operation and maintenance budget. A 10-step process we share in this presentation will enable you to successfully appeal the most common types of denials that you see from your payers.

  • Presenter:
    Leigh Poland/ Sri Valli, CPC
    • Time:
      03/30/22 12:30 - 01:45 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P

8H: Let's Audit! From Sample to Report

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Attending a solid review of audit fundamentals is essential, whether one is new to auditing or a seasoned professional. In this session, we’ll discuss identifying who to audit, report analysis for sample identification, review of the notes, development and creation of reports, and effectively delivering the feedback.

8I: Human Trafficking - A Public Health & Legal Concern: It's Everywhere

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Presentation will cover common signs of victimization How are victims recruited? Do you have an internal policy if trafficking is suspected? Coding for Human Trafficking Patient victims may attempt to alert you to their situation Do you know your state requirements for reporting suspected victimization?

8J: Understanding Principle Care Management and Changes to the Care Management Code Family

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This session will introduce you to the newest code set to the Care Management code family. PCM facilitates non face-to-face care by the health care team for patients with at least one high risk condition. While PCM will typically be provided by subspecialists, the new codes may be used by any specialty. In addition to review of program requirements, we will review several case examples along with best practices for documentation and coding.

Exhibitor Schedule

Welcome Reception

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    • Time:
      03/27/22 04:30 - 06:30 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P
    • Time:
      03/28/22 08:00 - 09:00 AM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P
    • Time:
      03/28/22 10:15 - 10:45 AM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P
    • Time:
      03/28/22 12:00 - 01:00 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P
    • Time:
      03/28/22 02:15 - 02:45 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P
    • Time:
      03/28/22 04:00 - 04:15 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P
    • Time:
      03/29/22 08:00 - 09:00 AM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P
    • Time:
      03/29/22 10:15 - 10:30 AM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P
    • Time:
      03/29/22 11:45 - 12:45 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P
    • Time:
      03/29/22 02:00 - 02:30 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P
    • Time:
      03/29/22 03:45 - 04:15 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P

Networking Breakfast

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    • Time:
      03/30/22 08:00 - 09:00 AM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P
    • Time:
      03/30/22 10:15 - 10:45 AM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P

Box Lunch Break

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    • Time:
      03/30/22 12:00 - 12:30 PM, ET
    • Coding General
      CPC COC
    • Billing
      CPB
    • Practice Management
      CPPM
    • Coding Specialty
      CPC-P

Expos

Additional Events

Teach the Teacher

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$195 | This 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.

Register Here

  • Presenter:
    • Time:
      03/26/22 08:00 - 04:00 PM, ET
    • CEUs/CTUs: 8
    • Price: $195

AAPC Wants Thought Leaders – That Means You!

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Share your knowledge — learn how to become an AAPC content contributor from AAPC’s Head of Publishing, Leesa Israel. Healthcare is a vast and everchanging area, and we are all continually learning. The best way to learn is from each other! Each AAPC member has knowledge and experience from which other members can benefit – including you! If you have news or know-how that can benefit other healthcare business professionals, share it with AAPC’s 200,000 members by becoming an author for Healthcare Business Monthly or the AAPC Knowledge Center. Along with the satisfaction of helping your peers, authoring an article is a great way to raise your professional profile. And, it can earn you continuing education units (CEUs) to support your AAPC credentials. You don’t have to be an experienced writer: Our editors will work with you to translate your ideas to the page and screen. Leesa will tell you how! Join this pre-conference session to learn more and start your journey as an AAPC content contributor.

Register Here

  • Presenter:
    Leesa A Israel, CPC, CPPM, CEMC, CUC, Approved-Instructor
    • Time:
      03/27/22 11:30 - 12:30 PM, ET
    • Price:

HEALTHCON Rookies - Learn the Ropes

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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.

Register Here

  • Presenter:
    • Time:
      03/27/22 01:00 - 01:45 PM, ET
    • Price:

AAPC's Inaugural Ball

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The biggest, funniest, and loudest Inaugural Ball is on the way, as AAPC looks back at the past 30 years. The honor of your presence is requested for this black-tie event…make sure you come dressed to impress. We’ll have live music, prizes, dinner, and cocktails. Save the date and don’t be late because it’s ball time, Tuesday, March 29, 2022!

Register Here

  • Presenter:
    • Time:
      03/29/22 07:00 - 10:00 PM, ET
    • Price:
Register

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