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Digital Seminar

Coding and Billing for Therapy and Rehab


Faculty:
Sherry Marchand CPMA
Duration:
5 Hours 53 Minutes
Format:
Audio and Video
Copyright:
Jan 29, 2018
Product Code:
WDS020212
Brochure Code:
CBTHERAPYS5-V3
Media Type:
Digital Seminar
Access:
Never expires.

  • Program no longer active
 Purchase Additional Participant CE »

Description

2018 Coding and Billing for Therapy and Rehab

Stay current with CPT, ICD-10-CM, and HCPCS Level II Codes.

Discover what must be done to comply with coding regulations and documentation standards. 

  • New for 2018 Master changes to the Medicare Therapy Cap Exception process and how it will effect patient’s out of pocket expenses.
  • New for 2018 Learn about orthotic and prosthetic management and training services by differentiating between initial and subsequent encounters.
  • New for 2018 New CMS code for development of cognitive skills to improve attention, memory and problem solving.
  • New for 2018 Master documentation elements, CPT coding and expected payment changes for Evaluations and Re-Evaluation codes for Physical and Occupational Therapy and Speech and Language Services.
  • New for 2018 Be prepared for complicated MACRA law: Physical Therapists, Occupational Therapists and Speech and Language Pathologists have new 2019 reporting requirements for MIPS and APM bundled payments. Learn what is the best next steps for your organization.

Learn the most current and accurate coding procedures coupled with documentation tips and complete definitions to ensure prompt and optimal payments for future insurance claims.

This course will equip Therapy and Rehab providers with an understanding of industry coding and billing changes that are needed to survive in this changing healthcare environment.

These topics include 2018 CPT, HCPCS and ICD-10-CM coding updates, effective billing, revenue and documentation techniques and best practices. Claims processing guidelines for 837p and 837i claim format. Prevent denials, delays and rejections by understanding how to combat these with effective appeals. Gain strategies for optimal reimbursement from Medicare, managed care, and insurance companies.

Denials, delays, and "more information required" are increasingly common responses for therapy and rehab insurance and Medicare claims. New codes and reimbursement policy changes have further complicated the claims process for physical and occupational therapists and facility-based rehabilitation providers. Effective Medicare and insurance billing requires a thorough understanding of coding, documentation and billing procedures. Consolidating all of the new requirements with existing coding rules and implementing proven billing techniques are the objectives of this seminar. You will learn the most current and accurate coding procedure coupled with documentation tips and new definitions to ensure prompt and optimal reimbursement on future claims.

Credits


Occupational Therapists, Occupational Therapy Assistants - Florida

is an approved provider #50-466 with the Florida Department of Health Board of Occupational Therapy Practice. This course is approved for 6 contact hour(s) for Occupational Therapist and Occupational Therapy Assistants.


Other Professions

This educational offering qualifies for 6 continuing education hour(s) as required by many national, state and local licensing boards and professional organizations. Save your course outline and certificate of completion, and contact your own board or organization for specific filing requirements. 


Physical Therapists, Physical Therapist Assistants - Arkansas

This program has been approved by the Arkansas State Board Of Physical Therapy for 6.0 contact hour(s) for Physical Therapists.


Physical Therapists, Physical Therapist Assistants - California

The Physical Therapy Board of California recognizes California Education Connection as an Approval Agency to Approve Providers of Continuing Competency Courses in California for Physical Therapists and Physical Therapy Assistants. This course has been submitted for 6 CE(s) / Contact Hour(s) and approval is pending.


Physical Therapists, Physical Therapist Assistants - Illinois

is a Registered Physical Therapy Continuing Education Sponsor through the State of Illinois Department of Financial and Professional Regulation, Division of Professional Regulation. License #:216.000309. This course qualifies for 6 CE Credit Hour(s).


Physical Therapists, Physical Therapist Assistants - Kansas

This program has been submitted to the Kansas Physical Therapy Association for 6 contact hour(s).


Physical Therapists, Physical Therapist Assistants - Kentucky - Submitted

This program has been submitted to the Kentucky Physical Therapy Association for approval of 6 contact hour(s).


Physical Therapists, Physical Therapist Assistants - Minnesota

This program has been submitted to the Minnesota Board of Physical Therapy for 6 continuing education hour(s) for category 1.


Physical Therapists, Physical Therapist Assistants - New Jersey

This program has been submitted for 6 continuing education credit(s) to the New Jersey State Board of Physical Therapy Examiners for Physical Therapists and Physical Therapy Assistants.


Physical Therapists, Physical Therapist Assistants - New York

is recognized by the New York State Education Department's State Board for Physical Therapy as an approved provider for physical therapy and physical therapist assistant continuing education. This seminar is awarded 6 contact hour(s).


Physical Therapists, Physical Therapist Assistants - Oklahoma

This program has been submitted to the Oklahoma State Board of Medical Licensure & Supervision for preapproval of 6 contact hour(s).


Physical Therapists, Physical Therapist Assistants - Texas

This course has been submitted to the Texas Board of Physical Therapy Examiners for 6 continuing competence unit(s) for PTs and PTAs.


Physical Therapists, Physical Therapist Assistants - West Virginia

This program has been submitted to the West Virginia Board of Physical Therapy for 6 Continuing Education hour(s).


Speech-Language Pathologists, Audiologists (General)

This educational offering qualifies for 6.0 continuing education hour(s) as required by many national, state and local licensing boards and professional organizations. Save your course outline and certificate of completion, and contact your own board or organization for specific filing requirements. 



Handouts

Faculty

Sherry Marchand CPMA Related seminars and products


SHERRY MARCHAND, CPMA, is a reimbursement analyst and a billing, collection, and chart-auditing consultant with more than 25 years of experience in the health care industry, including hospital and physician group billing, and collection management. She has served as an expert witness/consultant in Medicare, Medicaid, ALJ hearings, and criminal fraud cases. Her vast knowledge of the practice management process has come from working in various levels of health care accounting, including the management of international hospital billing. As a certified, self-employed practice management consultant and chart auditor, Ms. Marchand has helped numerous medical offices take control of their cash flow through implementation of billing and documentation processes. Her specialties include Internal Medicine, Obstetrics, Mental Health, Physical Therapy, Cardiology, ENT, and Surgical Specialties. Ms. Marchand is skilled in installation training and implementation of hardware and software systems that are right for the health care arena. Ms. Marchand has many tips and tools to assist your office on the road to healthy patients and insurance collections.

Disclosure:
Finacial- Receives a speaking honorarium from Vyne, LLC.
Nonfinancial-No relevant nonfinacial relationship exists.


Additional Info

Program Information

Access for Self-Study (Non-Interactive) Access never expires for this product.

Target Audience

Physical Therapists and Assistants, Occupational Therapists and Assistants, Speech-Language Pathologists, Rehab Directors, Managers and Supervisors , Billing, Coding, and Reimbursement Staff, Administrative Staff, Physicians, Nurses, Medical Assistants

Objectives

  1. Discuss required elements and problem areas of documentation for Therapy and Rehab Services
  2. Learn about how to document to support ICD-10-CM diagnosis coding through the use of signs and symptoms to support medical necessity
  3. Hands-on guidance on how to find and stay current on Medicare fee schedules, payment policy, internet only manuals, LCD’s and NCD’s. Commercial insurance rehabilitation services payment policies will also be explored
  4. Identify procedure codes for rehabilitation services
  5. Determine the correct usage of procedures and documentation requirements
  6. Discuss CPT and ICD-10 coding for optimal reimbursement
  7. Identify upcoming changes to billing and coding
  8. Explain effective use of modifiers and coding combinations
  9. Discover how place of service affects reimbursement
  10. Illustrate tips and techniques for medical record requirements
  11. Outline what you must know about physician certification requirements

Outline

CPT/HCPCS PROCEDURE CODES and COMPLIANCE WITH DOCUMENTATION STANDARDS
  • Provides credentialing resources
  • Explore the Revenue Cycle
  • Evaluations and Re-Evaluations for Physical Therapy, Occupational Therapy and Speech Services. (Includes tools for changes in criteria.)
    • New codes, new elements and easy-to-follow checklist
  • Orders
  • Plan of Care, Certification/Re-certification Rules Checklist
  • CPT Procedure codes used in Therapy and Rehab
    • Evaluations, re-evaluations, and assessments
    • Supervised modalities
    • Guidelines for billing therapy minutes
    • Constant attendance modalities
    • Therapeutic procedures, included changes in orthotic and prosthetic management and training and development of cognitive skills
    • Speech Pathology Services
    • Neuromuscular procedures
    • Debridement, application of strapping, splints, casts
    • Using HCPCS Level II codes for DME
    • Orthotics billed by hospitals and other providers
    • Lymphedema Service
    • Woundcare
    • Physical Performance Testing 
  • Daily Session Note Checklist
  • Discharge Checklist
  • NCCI Edits
  • Modifiers
  • HCPCS II Procedure codes used in Therapy and Rehab
  • Functional Limitation Requirements G-codes for functional limitations and severity modifiers – required for outpatient   claims filed to Medicare
  • Place of Service Codes
DIAGNOSTIC CODING
  • New tools to prepare for ICD-10-CM – Bring your WI-FI enabled device
  • Discuss chapters that effect Therapy and Rehab
  • Laterality documentation requirements
FEDERAL REGULATIONS MEDICARE'S BILLING RULES and Special Payer News
  • Medicare Therapy Cap
  • Documentation to meet Medical Necessity in Therapy and Rehab
  • Understand changes with congressional changes and their impact on Therapy and Rehab
  • Understanding Value-Based Payment issues: (i.e. MACRA, MIPS and APM)
  • Explore resources pertaining to CMS MAC, RAC, ZIP, and CERT program guidelines
  • OIG audit focus on behavioral health services
  • Medicare’s “incident to” guidelines, definition of “incident to” services vs payer supervision
  • Overview of Commercial Plans and Therapy Coverage
  • Common forms of health care fraud and abuse
COMPLIANCE
  • Components of an effective compliance plan
  • Understanding recent reports from CMS MAC, RAC, OIG, and GAO to reduce error rates in documentation
UNDERSTANDING THE REIMBURSEMENT PROCESS
  • Understanding the claim content 837p and 837i resources
  • Explore common revenue codes used with the 837i claims formats
  • Learn about the Medicare Learning Network 
THE APPEAL PROCESS
  • Understanding reasons for denials
  • Systematic steps of responding to an appeal
  • Formats for appeal letters

Reviews

5
4
3
2
1

Overall:      4.1

Total Reviews: 80

Comments

Sally A - GREENWOOD, South Carolina

"Presenter was very knowledgeable"

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