Coding Track Day 1 – Thursday, Sept. 30, 2004

7:00 a.m. – 8:00 a.m. – Registration and Continental Breakfast

8:00 a.m. – 9:15 a.m. – General Session: Keynote speaker Theodore R. Marmor on Medicare Reform, History and Politics: Why Almost Everything You’ve Heard, Read or Seen Probably Isn’t True (click here to return to General Session agenda descriptions)

9:30 a.m. - 10:45 a.m.
In-Office Procedures – Overlooked Coding Opportunities
Robin Linker, CPC, CPC-H, CCS-P, MCS-P, president, Robin Linker & Associates, Inc., Aurora, Colo.

Don’t underestimate your billing opportunities for minor surgery/procedures as well as E/M services in your office. For instance, take the surgical clearance exam a primary care provider might offer: Follow the 3 Rs and you can bill a consult instead of a lower-paying follow-up visit. But, for surgery practices, beware of conveniently billing out that H&P as a consult. Robin Linker guides you through the wilds of correctly coding office-based services and procedures. Unravel strapping and splinting – whether to go the global or E/M route – but don’t forget to bill supplies! You also get a detailed explanation of coding minor procedures, such as benign lesion removal vs. paring procedures (you’ll see a reimbursement penalty for using the wrong code) and destruction of lesions. She tackles preventive medicine vs. E/M services – how to differentiate between a sick visit and annual check up – with specific examples, such as when a hypertension follow-up is a sick visit vs. an annual checkup. You take home 5 examples of office visits that could be legitimately coded out to levels 4 or 5, but are habitually undercoded (read “underpaid”). Plus, Robin shares a handy tip sheet on consults and an E/M audit tool for all levels.

11:00 a.m. - 12:15 p.m.
Suffering from Modifier Mania? Try This Rx to Help!
Karen Hurley, CMM, CPC, President, Hurley Practice Management Services, Inc., Waldorf, Md.

You know by now to always use modifier -25 on your E/M to show it is a separately identifiable service with a minor surgery. But not so fast -- when you perform an injection procedure and an E/M service on the same day, 90782 is always bundled into the E/M and -25 does not apply. At this session on correct modifier use, Karen Hurley sorts out dilemmas like this, and others. Example: Multiple joint injections on the same day (20600-20612) require a -51, but watch out: if the service changes to I&D of an abscess (10060), you need the -59 instead. Find out when to use modifiers for complications, which modifier to use to bill an E/M during an unrelated global period (and some tips on what’s really “unrelated” and what’s still part of the global), get a handle on ABN modifiers (eg, how you use -GZ for a patient-requested colonoscopy or breast/pelvic exams outside of LCD coverage frequencies) and much more. Karen discusses the most important CPT modifiers with specific examples of when – and perhaps more importantly, when not – to use them. She also spotlights common HCPCS modifiers that affect day-to-day medical practice.

1:30 p.m. - 2:45 p.m.
Coding Medical Necessity
Jo Ann Steigerwald, RHIT, ACS, Medical Business Specialists, Baraboo, Wis.

This session was standing room only last year! Get here early to guarantee your seat.
No matter how razor sharp your CPT coding, if you don’t know the principles of medical necessity, you won’t get paid. Veteran coder Jo Ann Steigerwald takes you on a tour of medical necessity coding. Take unspecified codes – a prime example is 682.9 (unspecified) for incision and drainage – if you find this code on your standard encounter sheet, you are most certainly losing money. Steigerwald shows you how to avoid the dangers in “unspecified coding” as well as 9 other medical necessity coding taboos. Don’t let anyone tell you to just pick a code to get paid – make sure it’s the right code!

3:00 p.m. - 4:15 p.m.
Teaching Physician Coding and Documentation under Revised Rules
Myra Wiles, President, Physician Compliance Solutions, Oklahoma City, Okla.

Keeping your teaching physician documentation in line is a tall order – for instance what signatures do you need? Can you have other physicians sign off on each other’s note? Can the physician countersign the resident’s notes? You learn the details of newly revamped teaching physician rules from Myra Wiles. With many years experience dealing with academic institutions, Myra clarifies which providers fall under the teaching physicians rules, who precisely is a resident, and how much time can elapse between the resident and attending’s note and still allow you to tether to the resident’s documentation. She details when to use the -GC and -GE modifiers and explains how and when the primary care exception works best. Bonus: You get CMS-approved examples of legitimate E/M documentation.

Mix & Match! Customize your conference by attending the sessions that suit your needs. Don’t forget to review the agendas for the Billing Track and Compliance Track.

Coding Track Day 2 – Friday, Oct. 1, 2004

7:30 a.m. Continental Breakfast

9:30 a.m. - 10:45 a.m.
Surgical Coding: Tips & Strategies to Capture All Billable Services
from Your Op Notes
Nancy Reading, RN, BS, CPC, independent coding/reimbursement consultant, Salt Lake City, Utah

Don’t be fooled into picking your code solely from the op note procedure line. Not only might you be missing billable services, you may end up with the wrong code entirely. In this session, coding pro Nancy Reading explores the fine art of dissecting an operative note. Nancy walks you through actual op notes to reveal her comprehensive approach to coding and reimbursement for surgeries – including an intensive review of applicable modifiers. You get tips and strategies to make sure you uncover the correct diagnosis code(s) and follow any NCCI edits, plus Nancy’s pointers on when to drop to paper, appeals and when to use and how to get paid for unlisted services. Hands-on coding scenarios include Ortho, Trauma and ENT, but all surgical specialties will benefit from the exercises. IMPORTANT: Bring your coding books to this session for a real hands-on learning experience.

11:00 a.m. - 12:15 p.m.
Tips, Tactics and Templates: Building Great Office and Inpatient Encounter Forms
Jane Tuttle, Compliance/HIPAA Manager, Harvard Medical Faculty Physicians,
Boston, Mass.

If you are the designated coding educator in your practice, this session is for you. Jane Tuttle will show you how to get and keep your providers' attention. You get concrete instruction on how to be an effective educator, simplify complex coding concepts, and develop tools and templates that your providers will actually find helpful and want to use! Jane's learned from experience that providers are much more likely to use templates and tools if you get their input in developing them, but don't give them too many choices. Hear about common pitfalls to steer clear of when discussing coding, billing and compliance guidelines. Jane's advice: Make sure you have written documentation from a reputable source to back up what you say or risk your credibility! You also learn helpful tips on preparing your talks and responding to challenging situations that can occur. Get tips to use empathy as a powerful tool for responding to frustrated physicians, and develop your skills through role playing some actual difficult situations. Want some great advice on developing your presentation style? Here's a hint: humor can go a long way, but be careful not to go too far! Plus, you take home several sample tools, including training grids for E/M documentation guidelines, inpatient and outpatient charge tickets and office note templates .  

1:30 p.m. - 2:45 p.m.
Tackle Physician Coding Conflicts in the Inpatient Setting
George Alex, CPC, ACS-OR, ACS-FP, Managing Partner, Iatro, Baltimore, Md.

When your physician walks into the hospital, the coding rules can change – and you'll face payment hurdles you don't see in the office. Join George Alex for a session that reveals “hidden” roadblocks to payment for inpatient services - and solutions to overcome them. You learn how to avoid coding conflicts with the facility and other providers for services you provide in the inpatient environment, including: How services provided around the “witching hour” of 12:00 a.m. create date of service conflicts and subsequent payment denials; How you code services provided by a sub specialist at the request of a specialist; How PCPs should bill for a visit during hospitalization ordered by the specialist; How “100% technical” or “100% professional” status influence CPT code and modifier assignment when you bill for diagnostic services provided in the inpatient hospital environment. Get answers to these dilemmas and more at this information-packed session.

3:00 p.m. - 4:15 p.m.
Ready, Set, Code: Using the Right Coding Tools to File Clean Claims
Nancy Maguire, ACS, HCS-D, APC, AFC, CRT, Director, Coding Compliance Information, DecisionHealth, Rockville, Md.

You can’t master any skill without the right tools. In this truly practical session, Nancy Maguire, coder extraordinaire, points you to the must-have resources every coder needs in easy reach (or a quick click!). And more importantly how to use them to solve your coding quandaries. Get a handle on how to use the Federal Register and the Fee Schedule Database to get more than just the RVUs – they’re full of coding guidance (but she also tells you when the RVUs affect more than just the calculation of your fee – sequencing codes for multiple surgeries correctly means you’ll get the correct payment). Can you bill that surgery with an assistant? With a co-surgeon? If so, will you need to submit additional documentation with the claim? Do you bill that procedure bilaterally? Don’t wait for an EOB to come back to tell you how you should have billed the service – file a clean claim the first time for prompt pay. Plus, Nancy shares her top online resources -- including some hard-to-find sites within the Medicare/CMS website.

Mix & Match! Customize your conference by attending the sessions that suit your needs. Don’t forget to review the agendas for the Billing Track and Compliance Track.

-| top |-