A practice management consulting and training firm working for and with physicians since 1985

Strategic Coding and Reimbursement for
Physical Medicine and Rehabilitation

Course Overview
This course is designed specifically for Physical Medicine and Rehabilitation specialists! From reducing claim rejections and improving accounts receivable management to decreasing the risk of an audit, appropriate coding and documentation are essential to your practice. This comprehensive and practical course delivers the information you need to select codes accurately, document them appropriately, and optimize revenue and cash flow.
Who Should Attend?
Physicians, practice managers and administrators, billing managers and members of the coding team.
Course Objectives
  1. Understand Evaluation and Management (E/M) Services including consultations, outpatient visits, hospital services (admissions and daily visits) skilled nursing facility services, and Medicare versus CPT rules.
  2. Review coding levels of service and reporting services in the inpatient and out patient setting based on time.
  3. Understand when to report an E/M service with injections and other therapeutic procedures and the appropriate modifiers to use.
  4. Review coding diagnostic testing and common procedures with appropriate modifier usage.
  5. Understand wound care therapy, which includes debridement, documenting wound care and E/M reporting on the same day as active wound care therapy.
  6. Review guidelines and documentation requirements for non-physician practitioner (NPP) billing.
What's Covered
Evaluation Management Coding and Documentation
  • Coding consultations: When is a consult a consult?
  • Outpatient visits: CPT vs. Medicare rules
  • Inpatient admissions, consultations and daily visits: CPT vs. Medicare rules
  • Skilled nursing facility admissions, consultations and daily visits: CPT vs. Medicare rules
  • Coding the level of visits
  • Billing based on time: Outpatient vs. Inpatient

Introduction to the Global Surgical Package and Evaluation and Management Modifiers

  • E/M modifiers
  • Billing E/M and injections or other therapeutic procedures: When is it appropriate?

Diagnostic Testing

  • Range of motion and muscle testing
  • Reflex testing
  • Neuromuscular junction testing
  • Electromyography (EMG)
  • Nerve conduction studies
  • Intraoperative neurophysiology
  • Autonomic function studies
  • Evoked potential testing

Injections and Other Therapeutic/Surgical Procedures

  • Fluoroscopy coding guidelines and use of modifier 26 (professional component), TC (technical component) vs. global billing
  • Surgical procedure modifiers: 50 (bilateral procedure), 51 (multiple procedure), 59 (distinct procedural service)
  • Injections
    • Soft tissue
    • Trigger point
    • Joint
  • Interventional spine procedure coding
    • Nerve blocks
    • Epidural and subdural injections
    • Sacroiliac injections
    • Destruction by neurolytic agent
    • IDET
    • Neurostimulators: spinal and peripheral
    • Spinal pumps: placement, reprogramming, refilling
  • NPP Billing

Contact us
at 312-642-5616 for more information!

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KarenZupko & Associates, Inc. • 625 North Michigan Avenue, Suite 2225 • Chicago, Illinois 60611 • 312.642.5616 • FAX: 312.642.5571

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