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Payment Models and Practice Changes: Meeting Requirements of OCM & MACRA
Recent legislation and policy has fast-tracked the shift of healthcare payment from volume- to value-based reimbursement under the Medicare Access and CHIP Reauthorization Act (MACRA) for oncology care. Today, oncologists have the option to be reimbursed for Medicare patients under the CMS Oncology Care Model (OCM), an alternative payment model spanning a 6-month chemotherapy episode-of-care. This activity will provide insight into the program’s structure and challenges. It will also review ... |
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The Unrelenting Issue of Medical Errors
This course will examine the top patient safety issues causing medical errors, the patient safety organizations involved in the improvement process, tools we currently have to reduce these issues, and best practice steps to take now!
At the conclusion of the activity, participants will be able to:
• Analyze medical error data
• Evaluate medical error case studies
• Define national patient safety improvement standards and guidelines
• Identify prevention techniques to reduce med... |
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MACRA - Changing How Medicare Pays Providers
The Medicare Access and Chip Reauthorization Act of 2015 (MACRA) is federal legislation enacted by the United State Congress and signed into law by President Obama on April 16, 2015, intended to contain healthcare costs and to focus Medicare spending on the quality of services beneficiaries receive rather than the quantity of those services. MACRA repeals previous Medicare physician payment formulas, modifies and combines quality and information technology programs, and reauthorizes the 1997 S... |
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Coding and Billing for Electrodiagnostic Medicine Webinar
In this webinar, Dr. Andrea Boon discusses basic CPT and RUC processes, commonly used CPT codes and the history of recent changes, the use of common modifiers, and AANEM’s position on billing for an evaluation and management (E/M) on the same day as an electrodiagnostic procedure. |
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What is Sepsis?
There are currently multiple definitions of sepsis in use, and each continues to drive certain aspects of research, quality, and improvement. This course covers the evolving definitions of sepsis, and the controversies therein, to aid providers in understanding the diagnosis, coding, and regulatory aspects of sepsis.
At the conclusion of the activity, attendees will be able to:
Define the symptoms of sepsis.
Discover the evolution from Sepsis 1 through the release of Sepsis 3.
Describe ... |
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DSM-5 and ICD-10: Uses, Challenges, and Documentation
Explore DSM-5 Coding issues, uses and misuses in the world of ICD-10. Dr. Peck will define the clinical dilemmas in the use of DSM-5 or ICD-10 and the important changes Psychologists need to know in certain clinical diagnoses.
Examine clinical documentation improvement efforts in transitioning to ICD-10. MHMD Memorial Hermann’s journey to improve documentation and coding.
At the conclusion of the activity, attendees will be able to:
Explain the correlation of DSM-5 and ICD coding as... |
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Physician Leadership Development and Challenges
Physician leaders are essential to improving the safety, efficiency, and accessibility of health care. Where do you find such a leader and what are the keys for success? This session advises on the selection, development, support, challenges, and accountability of successful physician leaders.
Now is the time to gain an in-depth understanding of what is required to be a successful practitioner under the ACA. Protect your practice and improve the health of both your patients and community i... |
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Leveraging Physician Engagement
Discover what motivates physicians and health care professionals to work together to create an improved patient experience. Physician engagement seeks to reduce suffering for patients and improve upon safety and quality measures. This session discusses the importance of culture and communication in driving physician engagement, and how to measure success.
Now is the time to gain an in-depth understanding of what is required to be a successful practitioner under the ACA.
Protect your pr... |
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The Expanding Role of the Physician Advisor and Utilization Management
As the landscape and focus on health care changes, key players will emerge as important factors in securing safer, more effective practices in the realm of quality and patient safety. In support of our alliance with the American College of Physician Advisors and in conjunction with the Physician Advisor sub-specialty of the HCQM Certification, this activity explores the importance and roles of the Physician Advisor in our remodeled culture.
Now is the time to gain an in-depth understanding... |
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Evolving Practices in Patient Health & Safety
Learn about two initiatives that seek to improve patient health and safety by targeting practitioners. Huddle for Care is an online environment that brings health care professionals together to collaborate on transitional care. Psychological assessment is then discussed as it pertains to predicting outcomes and how this can contribute to safety for both the practitioners and the patients.
Now is the time to gain an in-depth understanding of what is required to be a successful practitioner ... |
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“In the Crosshairs”: US Healthcare in the Era of ACA
Health care today expands beyond treating the patient. Practitioners, health plans, patients, and administrators are all seeking ways to measure care, find the value, and improve upon outcomes. This activity features dynamic content from the leaders of this transformative era, giving you the information you need to provide the best care possible to our population. Now is the time to gain an in-depth understanding of what is required to be a successful practitioner under the ACA.
Protect yo... |
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ICD-10 & Accountable Care- Financial and Legal Implications
Address the new financial and legal implications introduced by the Affordable Care Act (ACA) and ICD-10. Expand your understanding of the legal responsibilities faced by ACOs working with CMS data, discover tools for ACO success, evaluate the financial implications of the ACA, review ICD-10, and recognize the importance of documentation
Now is the time to gain an in-depth understanding of what is required to be a successful practitioner under the ACA. Protect your practice and improve the ... |
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ICD-10 Musculoskeletal
We will review the musculoskeletal section of ICD-10-CM to understand the differences of ICD-10-CM and the information needed from our providers that we may not currently receive to assign the appropriate code. We will review several chapters of ICD-10-CM, including those that hold the codes to replace V-codes and E-codes.
You Will Learn:
Important documentation that will be needed for proper ICD-10 coding
What do we need to be doing now in preparation of ICD-10
Review of the musculoskel... |
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Gray Areas of E/M and Where to Find the Answers
Abuses, honest mistakes in billing for physician visits, account for estimated national losses in billions each year. How can this be true when the vast majorities of physicians are committed to billing accurately and are legitimately surprised when mistakes are uncovered? Evaluation and Management codes are subjective in nature. From the aspect of medical necessity, the correct level of service is determined simply by how sick a patient is. Further, the rules that govern documentation require... |
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Specialized DME Coding
DME Is a target for many audits due to lack of documentation and proof of delivery. The issues surrounding DME include incorrect usage of place of service, diagnoses that do not meet ordering requirements along with Incomplete and outdated Certificates of Medical Necessity and lack of Advanced Beneficiary Notifications. We will discuss what is required for Specialized DME ordering, delivery and what you, as a DME provider; need to do to avoid recoupments.
You Will Learn:
The correct use of... |
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The Lab Maze: Navigating Basic Laboratory/Pathology Coding
Laboratory and pathology services can be challenging to navigate the maze of codes throughout each of the sections. Should I code the panel or the individual test? Is it qualitative or quantitative? Now with the major 2013 changes to the molecular pathology section; this maze can make you feel as if there is no way out. This presentation will help you navigate through the difference sections and assist you with information needed to help you properly code.
You Will Learn:
2013 Molecular Pa... |
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Coding for Diabetes: Pregnancy and Beyond
Approximately 26 million patients in the United States has been diagnosed with diabetes. There are also 79 million pre-diabetics and 7.0 million people still undiagnosed. 5% of pregnant patients develop gestational diabetes and 50% of these patients will develop diabetes in later years. Coders need to have a through understanding of the pathophysiology of this disease, the coding guidelines as well proper coding techniques. We will also take a peak into our future by reviewing diabetes coding ... |
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Coding with Modifiers: CPT, Medicare, and the Real World
Assigning the correct CPT code for a certain service rendered isn’t always the end of the story, as important circumstances often exist that can’t be represented by the code alone. Enter MODIFIERS. These two digit codes are often an invaluable addition to your procedural reporting. Without them, the claim could be paid at the incorrect rate, or in many cases not paid at all. But how can modifiers be applied correctly when instruction regarding their use has evolved over the years, and modi... |
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Mastering Documentation Review
This 4-hour hands-on workshop will uncover the secrets of documentation review to identify when E/M codes can be billed separately and other common errors plaguing your practice. We’ll then reveal the key steps to ensure proper documentation, compliant coding, and correct billing, as well as the impact on reimbursement if any of these are not done correctly.
You'll Learn to:
Identify the 10 most commonly missed billable charges
Append modifiers to assure appropriate reimbursement
App... |
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The Relative Value File and CCI Edits: What Changes Affect Your Practice?
CMS publishes two files to assist coders in proper coding guidelines for their beneficiaries. Most other insurance carriers utilize these files in one way, shape or form, to establish their coding and policy guidelines. It is critical that everyone working in the revenue cycle knows and understands these two files and how they apply adjudication of claims for maximum reimbursement.
You Will Learn:
In depth look at the information in these CMS files
How to utilize the information in your d... |
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Neurovascular Interventional Coding
This webinar will review CPT coding as it pertains to neurovascular interventional procedures. A basic review of catheter placement guidelines, imaging documentation and bundling issues with some interventions will be discussed, along with the myriad of catheter-based neurointerventional procedures performed in many labs around the country.
You Will Learn:
Common missteps in Neurovascular Interventional Coding
Areas of Neurovascular Interventional Coding watch out for in 2013
The best me... |
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The Impact of ICD-10
ICD-10-CM will bring about some massive changes in healthcare. No matter what the implementation date, you need to understand what you should be doing now to prepare for ICD-10 implementation. This webinar will help you understand what the changes are all about, what you should be focused on now, and provide you direction on how to prepare.
You Will Learn:
Where to start your implementation process
How ICD-10 differs from ICD-9
Changes needed for clinicians and coders
Successful impleme... |
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HCC Coding and Documentation: A Doctors View
"I don't need to know about Medicare Part C and HCC coding, it doesn't affect me." This might have been true at one point but now both Medicare and Medicare Part C are dependent on HCC rules and regulations. More than 1 in 4 Medicare patients nationally and 1 in 3 in many states are in the Medicare Part C model. Coders (and some doctors) must know part A and B rules and now it is just as important to be aware of Part C. This is the diagnosis-dependent capitated model that has doubled its enrol... |
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A Closer Look at Molecular Pathology
Molecular Pathology can be a tricky area of coding. We want to make sure you are best prepared in understanding the in's and out's of why we do what we do and what Molecular Pathology coding truly entails.
You Will Learn:
What Molecular Pathology requires
How to code Molecular Pathology
Common errors to avoid in Molecular Pathology |
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CPT 2014 Updates
Accurate coding is top priority. Each year, CMS releases code changes to help you more accurately code each procedure. Each year, we also learn more pitfalls to avoid in our specialties to assure the most accurate coding and most accurate reimbursement. This webinar will review the CPT® updates for 2014.
You Will Learn:
CPT Code changes for 2014
Top Errors to Avoid for 2014
Case studies to accurately reflect examples of the above |
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E/M: Coding Updates for 2014 and Top Errors to Avoid
Accurate coding is top priority. Each year, CMS releases code changes to help you more accurately code each procedure. Each year, we also learn more pitfalls to avoid in our specialties to assure the most accurate coding and most accurate reimbursement. This webinar will review the updates for this specialty, as well as the top errors to avoid in 2014.
You Will Learn:
CPT Code changes for 2014
Top Errors to Avoid in this specialty for 2014
Case studies to accurately reflect examples of t... |
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General Surgery: Coding Updates for 2014 and Top Errors to Avoid
Accurate coding is top priority. Each year, American Medical Association releases code changes in CPT to help you more accurately code each procedure. This webinar is fast paced and geared toward the coder who wants to develop a new awareness of the 2014 general surgery coding nuances and the pitfalls to avoid in general surgery coding.
You Will Learn:
CPT Code changes for 2014
Top Errors to Avoid in this specialty for 2014
Case studies to accurately reflect examples of the above |
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Emergency Department: Coding Updates for 2014 and Top Errors to Avoid
Accurate coding is top priority. Each year, CMS releases code changes to help you more accurately code each procedure. Each year, we also learn more pitfalls to avoid in our specialties to assure the most accurate coding and most accurate reimbursement. This webinar will review the updates for this specialty, as well as the top errors to avoid in 2014.
You Will Learn:
CPT Code changes for 2014
Top Errors to Avoid in this specialty for 2014
Case studies to accurately reflect examples of t... |
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2014 CPT Coding Updates
It’s that time again! More than 300 CPT® changes are being made for 2014:
175 new codes
47 deleted codes
107 revised codes
Guideline changes
Preparing for 300+ code updates is more than just learning what has changed. You need to recognize why they’ve changed, how to apply the new codes, and what should be documented to support them. Our half-day, interactive workshop will provide personalized, in-depth instruction with hands-on application of the coming CPT® code and guideline ch... |
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2014 Updates for Cardiology and Peripheral Cardiology
Accurate coding is top priority. Each year, CMS releases code changes to help you more accurately code each procedure. Each year, we also learn more pitfalls to avoid in our specialties to assure the most accurate coding and most accurate reimbursement. This webinar will review the updates Cardiology and Peripheral Cardiology.
You Will Learn:
CPT Code changes for 2014
Top Errors to Avoid in this specialty for 2014
Case studies to accurately reflect examples of the above |
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How to Defend an Adverse E/M Audit
It’s essential to understand what is in E/M guidelines, and more importantly, what is NOT. The information in this webinar will help you to defend decisions relative to the appropriate level of E/M code selection and to defend you against inappropriate down-coding.
You Will Learn:
Areas in E/M guidelines that require subjective analysis, leading to disputes regarding E/M code levels
Common approaches to E/M analysis that require you to use tools external to the guidelines and their impl... |
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Statistical Sampling
Sampling can be a confusing concept. There are various ways to pull a sample from a large population for statistic purposes. For your sample to be statistically valid, you need to know the proper amount of items to include in your sample. It’s also important to know which items to select for the sample and what you do with the results of the sample. This webinar will clear up some of the mysteries involved with sampling.
You Will Learn:
What sampling is and how to calculate sample size
... |
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DMEs for Orthopedics
Understanding DME devices and orthotics is essential to correct coding in an orthopedic physician practice. To provide for you a better look at the nuances of these services and devices, this webinar offers a discussion on topics such as DME terminology, orthotic vs. splint, navigating the DME MAC policies, documentation, and code 97760. A handout of a HCPCS Level II crosswalk to common orthopedic supports is available to webinar attendees.
You Will Learn:
Differentiating between custom fa... |
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What's in Store for Facilities Under the CY 2014 OPPS Final Rule?
Find out what CMS has in store for facilities under the 2014 OPPS final rule changes. This is the most comprehensive change the program has seen for several years. We’ll talk about the changes and their impact to facility reporting of services.
You Will Learn:
How policies in the rule will affect the industry as a whole
About big increases in packaging methodology
New cost center for cardiac catheterization
Hospital OP visits and national guidelines
New comprehensive APCs coming fo... |
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HCC and Risk Adjustment
It’s important for coders to know HCC guidelines, but FIRST to understand the concept of risk adjustment and why it’s becoming the hottest new healthcare tool. Find out about the risk adjustment model for Medicare HCC, as well as the Medicaid model, and how commercial plans are now creating their own models. These models are changing the way healthcare payments are being viewed and processed. Among the topics discussed in the webinar are stars ratings and how they connect to quality of car... |
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ICD-10 Specialty - Family Practice
We will discuss commonly-coded conditions seen in family practice and how they will transition to ICD-10-CM. Conditions covered will include diabetes mellitus, hypertension, and asthma. Applicable guidelines, documentation tips, and examples will be illustrated to ensure attendee understanding.
You Will Learn:
Coding guidelines or common conditions
Family practice documentation tips
Details for better coding in ICD-10-CM |
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Diabetes Didactics
Coding for diabetes depends on the abstractor's understanding of pathophysiology as well as compliant documentation by the provider. This session will provide background onmany forms of diabetes, a discussion of the evolution of the language surrounding diabetes documentation, and some tips for improving diabetes coding in your practice. Whether you are coding for risk adjustment or coding in a facility or physician office, you will find insight into the key issues for code selection in ICD-9-... |
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Avoiding Rejections, Delays, and Denials
From the time a service is rendered until payment is received, a number of people, processes, and pieces of documentation are involved. We'll review this spectrum and the five major players involved: provider, coder, biller, compliance officer, and payer. The focus of this Webinar will be on everything that affects billing a provided service to provide a better understanding of the entire revenue cycle.
You Will Learn:
Documentation requirements
Coding guidelines
Payer contracts and poli... |
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Fine Needle Aspirations
Pathologists and surgeons use fine needle aspirations to perform biopsies, which require minimal surgical intervention and may be less invasive and less expensive than more extensive surgical procedures. This presentation discusses how this could prompt faster diagnostic results when a cell block is not provided and how it’s a preferred method over more extensive surgical options. The different CPT® codes used for billing these procedures and guidelines are complex and often times confusin... |
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The HHS OIG Workplan - What is in it for You?
To assist you with tailoring your compliance education and internal auditing program efforts, this Webinar will show you the areas that OIG focuses its enforcement efforts. It will help to ensure your practice does not become a post payment statistic. You will have a better understanding of structuring internal audit programs so you can find and disclose errors in advance of any OIG or ZPIC inquiry.
You Will Learn:
New and ongoing target areas for elevated enforcement in2014
How to identi... |
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How to Audit an Audit
This webinar will take you through the entire audit process. Items and questions at each phase of an audit will be discussed. This presentation is beneficial whether you are the auditor or the requester and whether the audit will be performed internally or externally.
You Will Learn:
How to scrutinize a compliance audit
How to choose reliable resources to ensure guidelines are being met |
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Free Webinar: ICD-10 is Still on Track
What is really going on with ICD-10 implementation? There have been so many explanations. Where was the industry prior to the delay? What are the future plans moving forward and is ICD-10 really as expensive to implement as once thought? How do I get going and what’s it really all about? We’ll answer these questions and more in this special webinar where industry experts point us in the right direction and tell us what really is going on.
You Will Learn:
Denesecia Green, Centers for Me... |
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Compliance - Preventive Medicine for Your Practice
It is always best to seize an opportunity to be proactive rather than having to be reactive when trouble strikes. Learn about key areas of an effective compliance program and how to prepare, implement, and manage them in your organization. It is never too late to do the 'right' thing; the first step is getting started!
You Will Learn:
An introduction to compliance
Resources for getting physician practices on the road to compliance |
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Developing a Compliance Plan for your Practice you can be Comfortable With
Compliance is the biggest risk area for physician practices. Learn the reason why there’s an increased risk and the benefits a compliance plan can bring to your practice. Learn how to create a culture of compliance while better managing risk and encouraging innovation. Make a compliance plan into a benefit versus a burden.
You Will Learn:
The 7 core elements of a “living compliance plan”
How to modify and expand it to your practice’s unique risks and culture
Who’s responsibl... |
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ICD-10 Specialty - Orthopaedic
Orthopaedic practices, along with any practice that treats orthopaedic injuries (emergency departments, urgent care centers, primary care, etc.) will see a great number of changes to how the code set looks and is used in ICD-10-CM. Applicable guidelines, documentation tips, and examples will be illustrated to ensure attendee understanding.
You Will Learn:
Seventh character extenders for injuries
The specifics of fracture care coding in ICD-10-CM
Acute versus chronic conditions |
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HIPAA - Avoiding Substantial Penalties Following a Breach
HIPAA privacy and security plans are mandatory. Having an effective plan should help you to avoid a breach. When a breach is unavoidable, however, an effective plan also is an important key for determining the penalty tier assessed as a result of the breach.
You Will Learn:
Obligations under HIPAA to enact practice-specific policies and procedures that provide appropriate administrative, physical, and technical safeguard to protect PHI.
Risks associated with inadequate or attempted impl... |
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Urinary Diagnostic Radiology and Intervention
The Urologic system includes the kidneys, ureters, urinary bladder, and urethra. We will review the structure and function of the kidneys and the diseases affecting the kidneys using graphics and radiographs. We also will discuss coding scenarios for radiology diagnostic and interventional procedures and other therapeutic procedures. An overview of the diagnosis coding guidelines will be discussed.
You Will Learn:
The anatomy and physiology of the urinary system
Common pathological condit... |
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Unlock the Secret to E/M Coding
Evaluation and Management (E/M) codes are the most commonly billed codes. Although there are guidelines to proper E/M code selection, Medical Necessity is the primary driver of correct coding. We are told that a physician may take a full history and provide a full physical, but without medical need to back it up … we should select a lesser code. For example, a resolved contact dermatitis with no other problem or complaint, is not a Level Five service because there is no need for a full Level... |
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Endoscopy
If you are an endoscopy coder, this webinar is for you. It includes information on billing for separate procedures vs. codes in the same family, rigid vs. flexible, and trans-nasal vs. trans-oral, so you can identify how 2014 changes affect code selection. You will become familiar with guidelines in the Endoscopy section of CPT®. Changes in this area also will be presented to give a compliant understanding of coding for endoscopy procedures in 2014.
You Will Learn:
2014 changes that af... |
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ICD-10 Specialty - OB/GYN
We will discuss commonly-coded conditions seen in the OB/GYN practice and how they will transition to ICD-10-CM. Applicable guidelines, documentation tips, and examples will be illustrated to ensure attendee understanding of the details necessary for reporting pregnancy and delivery in the new code system.
You Will Learn:
New coding concepts
Trimesters and weeks of gestation
Seventh character fetal extensions
Multiple gestations
Preventive services
Immunization coding |
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