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

Thursday: Office and Hosptial Coding: What to Bill, How to Document & Appeal

Is the visit part of the global or can it be billed separately?  What about pre-op visits and complications during the post op period?  Failing to understand what is and isn’t included in the global package can cost money.  Neglecting to use the right modifier will result in denial and delay.  This seminar designed for surgeons, surgical coders, billers and managers will describe the global surgical package, provide a fool proof chart on how to select the right category of code. 

Confused about critical care billing during the pre-op and post-op period? This session will provide specific examples for each.

Some surgeons bill all low level codes, and some surgeons think everything is the highest level. This seminar will describe the level of history and exam that are needed and how those relate to the nature of the presenting problem and the complexity of the patient.  Many practices are using an electronic health record now, and should heed the warnings about their use and the use of templates.

The OIG has defined over documentation and copy-paste in a recent report.  Learn what you need to do to protect yourself and your practice from these EHR documentation dangers CMS is committed to implementing ICD-10 in 2015.  Is your practice ready?  Are you hoping your mapping program will do all of the work?  What documentation improvements should you make today? "Diagnosis coding: it's not just for claims.  How diagnosis coding will affect (effect?) your payments under risk based contracts."  "Why your non-specific ICD-9 codes will sabotage your ICD-10 implementation."  

Who is responsible for coding: the physician or the coder?  This session will describe coding models, ways to deal with disagreements, strategies for employed surgeons.
Who Should Attend This Course
Practice Executives, Administrators and Practice Managers
You are the chief compliance officer in most private practices. In order to supervise the economic engine of the practice you must understand the business office operations.

Coders and Billers
If you’re responsible for entering data, working denials, applying modifiers, posting payments and filing appeals, your expertise in surgical and office coding must be exacting in its execution!

Hospital or MSO Executives Running General Surgery Practices
Maximize your profits! Understand what is special and unique about billing for the general surgery service line, and keep your surgeons happy and bonus-able. (Not to mention reduce compliance headaches.) Learn the rules and avoid using incorrect and expensive assumptions that result in fiscal disaster.

Team Attendance Produces The Best Results!
Getting paid is a team effort— and surgeons lead the team. If the doctors don’t understand what’s needed in an operative report from a coding and reimbursement point of view (something they don’t teach in residency) they are short changing themselves.

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Learning Objectives
As a result of this course participants will be able to:
  • Select the right type of code and level of service in all situations
  • Identify E/M services that are part of the global payment and those that may be separately billed
  • Describe top three key activities in order to transition to ICD-10
What's on the Agenda
Registration 7:15am — 8:00am
Selecting the Correct Type of E/M Service and E/M Modifier
  • Global surgical package
  • E/M modifiers
  • Increased risk from mis-use of modifier 25
  • What to bill? Selecting the correct category of code
8:00am — 10:00am  
Break 10:00am — 10:15am 
Selecting the right level of E/M service and avoiding audit risk
  • Level of E/M service
  • Electronic health records and templates—reduce your risk and create useful notes
  • Avoiding cloning and over-documentation, as defined by the OIG
  • Selecting a level of service based on medical necessity and complexity
  • Critical care
  • Screening colonoscopy
10:15am — Noon
Lunch 12:00pm — 1:00pm
ICD-10
  • Last call: ICD-10 readiness
  • How non-specific ICD-9 codes will hinder the transition to ICD-10
  • Critical documentation changes
  • Mapping program do’s and don’ts
  • Diagnosis coding and risk based contracts
1:00pm — 2:30pm
Break 2:30pm — 2:45pm 
Practice Management
  • Key performance financial indicators
  • Detailed appeal strategy
  • Who is responsible for coding?
2:45pm — 4:00 pm
Course Adjourns 4:00pm
CME/CEU Accreditation
AMA PRA Category 1 Credits™ will be provided for this activity

Office and Hosptial Coding: What to Bill, How to Document & Appeal


To begin registering, click the button describing your ACS membership status
Schedule
7:15am Registration/Continental Breakfast
8:00am Course begins
10:00am 10:15am Break
12:00pm 1:00pm Lunch provided
4:00pm Program adjourns

Download the Brochure

What 2014 Attendees Said

2014 Thursday Attendees

“This was well-done and informative. Teri did a great job of clarifying and answering questions. It was a great course – essential early on in a general surgeon’s career”

Charles St. Hill, University of Nevada School of Medicine

“Very informative. I have done family practice coding for 10 years, and I am new to the surgical end of coding. This is such a great review and an informative course.”

Andy Beesley, IF Surgical Specialists

“I went to an Optum course last year. Exact reading from the slides with no additional clarifications or explanations. I appreciate the 2-way conversation and explanation as to why this is the way… not just ‘This is how!’”

Dianne Brattain, Alaska Bariatric Center

“This course has been very informative as I am new to coding. The content of this course answered a lot of questions that I have been struggling with.”

Rae Sanchez, Delta Surgical Associates

2014 Friday Attendees

“Great course. I would highly recommend it to others.”

Joshua Froman, MCHS

“This course was amazing even though it pointed out how much I don’t know! Very helpful. Thank you!”


Debbie Barley, Green County Surgical Arts

 “Excellent for both young and ‘old’ surgeons and their staff.”

Shleton Viney, MD, Midland Surgical Associates

2013 Past Attendees

“This course was incredibly well put together by knowledgeable staff. Speaker and content was extremely helpful.”

Cynthia Serafine, Admnistrator,
Winter Park, FL


“This course was superb. I wish I had taken this course six years ago. It should be mandatory for all new surgeons!"

Peter F Lalor, MD, Bowling Green, OH


This is my fourth year attending and I am still learning new techniques!”

Hope Dayi, Billing Manager, Provo, UT


I am extremely pleased with the information presented at these courses and am happy I made the decision to attend. I would like to get my physicians to attend next year.”

Jennifer McNabb, CPC, CGSC,
Chattanooga, TN


“Great value! Should be mandatory.”

Robert Marema, MD, Ponte Verda, FL


“Excellent!! Great resource for any practicing physician and any resident/fellow who is about to enter practice.”

Avi Bhavaraju, MD, Marietta, GA



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