HEALTHCON Regional: Charleston

Sunday, October 3, 2021

Pre-Conference

8:00 AM - 4:00 PM, EDT | 8.00 CEUs COC, CPC, CPC-P, CPB, CPPM

Pre: Teach the Teacher

This workshop provides certified instructors with tools to improve their teaching and communication skills. This is also a great opportunity to network with other instructors. Earn 8 CTUs or 8 CEUs for participation in this workshop.

Monday, October 4, 2021

Pre-Conference

9:00 AM - 9:45 AM, EDT | 0.75 CEUs CPMA, COC, CPC, CPC-P, CDEO, CIC, CPB, CPC-9, CPCO, CPPM, CRC

Pre: CPMA Speed Networking - Invitation Only

9:00 AM - 9:45 AM, EDT | 0.75 CEUs COC, CPC, CPC-P, CPB, CPPM

Pre: HEALTHCON Regional Rookies - Learn the Ropes

General Session

10:00 AM - 11:00 AM, EDT | 1.00 CEUs COC, CPC, CPC-P, CPB, CPPM

GS1: Conference Welcome

Bevan Erickson, AAPC CEO

11:00 AM - 12:15 PM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CASCC, CCC, CCPC, CCVTC, CDEI, CDEO, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIMC, COBGC, COPC, COSC, CPB, CPCD, CPCO, CPEDC, CPMS, CPPM, CPRC, CRC, CRHC, CSFAC, CUC

GS2: 2021 E/M Lessons Learned

Raemarie Jimenez, CPC, CDEO, CIC, CPB, CPMA, CPPM, CPC-I, CANPC, CRHC

In preparation for the implementation of the new 2021 E/M guidelines for office visits, AAPC conducted many provider and coder trainings. In this session we will discuss comments questions and lessons learned along the way.

Exhibit Hall

12:15 PM - 1:30 PM, EDT

EH1: Networking Lunch with Exhibitors

Breakout Session 1

1:30 PM - 2:45 PM, EDT | 1.25 CEUs COC, CPC, CPC-P, CPB, CPPM

1A: Healthcare Business Analytics - Why it Matters?

MariaRita Genovese, CPC; Jordan Goldberger

The importance of analytics for decision support in market share, RVU allocation, yearly budgeting, quality scoring as well measuring revenue. It increases the visibility of daily or monthly operations. Analytics provides a snapshot in real time to gauge industry performance.

1:30 PM - 2:45 PM, EDT | 1.25 CEUs COC, CPC, CPC-P, CANPC, CASCC, CCC, CCVTC, CIC, CPB, CPPM

1B: CPT Coding and Identifying the Anatomy When Coding Cardiology Procedures

Sharon Jane Oliver, CPC, CDEO, CPMA, CRC, Approved-Instructor

Knowing the anatomy and the function of the body is critical when using the correct CPT codes to describe the procedure(s) performed. If you don't know where you are in the body, how can you code it? This presentation will take an in-depth look at CPT code description, and apply the anatomical area involved in that respective code. This will help ensure all services performed are captured for accurate billing and proper reimbursement.

1:30 PM - 2:45 PM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CDEI, CDEO, CEMC, CIC, CPB, CPPM

1C: DRG Tips for Clinical Validation

Leonta Williams, CPC, CPCO, CRC, CEMC, CHONC

This session will encompass review of those typical conditions (e.g. sepsis, AMI, encephalopathy, AKI, etc.) that trigger a DRG or clinical validation audit. We will discuss what your CDI teams should be looking for to validate those conditions and how to effectively draft physician queries in a manner that is non-leading and supports clinical indicators found in the medical record.

1:30 PM - 2:45 PM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CDEO, CPB, CPCO, CPPM

1D: Steps for a Successful Facility Internal Audit - A-Z

Marianne Durling MHA, RHIA, CCS, CDIP, CPC, CPCO, CIC, Approved-Instructor

This session will review the new OIG compliance program requirements as well as steps for the planning, implementation and conducting of a facility based internal audit through corrective action plan.

1:30 PM - 2:45 PM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CASCC, CCC, CCPC, CCVTC, CDEI, CDEO, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIMC, COBGC, COPC, COSC, CPB, CPCD, CPCO, CPEDC, CPMS, CPPM, CPRC, CRC, CRHC, CSFAC, CUC

1E: 2021 E/M Guidelines - Compliance for Medically Relevant History and Exam

Jaci J. Kipreos, COC, CPC, CDEO, CPMA, CPC-I, CEMC

The 2021 E/M guidelines for office and outpatient services no longer require quantifiable elements for history and exam. The new guidelines require a medically appropriate history and exam. In this session we will discuss best practices for compliant documentation to support the new guidelines.

Breakout Session 2

3:05 PM - 4:20 PM, EDT | 1.25 CEUs COC, CPC, CPC-P, CPB, CPPM

2A: Strategic Recruitment: Planning, Hiring, and Onboarding

Kathy Burkhardt, MSL, RHIA

According to Glassdoor, the average company spends approx $4k and can take up to 52 days to fill a position, not to mention the costs associated with disruption to workflow and onboarding costs. To keep turnover rates at a minimum, it is imperative to take the time to strategically recruit, hire and onboard new employees. This process will ensure you an action plan that will allow you to select and hire the best candidates for your environment that will be able to grow and develop within your company, thereby providing you with a streamlined succession plan that will keep your business flowing smoothly.

3:05 PM - 4:20 PM, EDT | 1.25 CEUs COC, CPC, CPC-P, CANPC, CASCC, CEMC, CIC, COSC, CPB, CPPM

2B: Orthopedic Surgery Coding - The Present and Future

Lynn M Anderanin, CPC, CPMA, CPPM, CPC-I, COSC

Orthopedic surgery coding is always going through constant changes from a CPT perspective as well as commercial insurance carriers. Medical necessity, site of service, and prior authorization continue to affect reimbursement in orthopedics. This session will look at current trends and guidelines changes as well as look into the future with 2022 coding changes that are long overdue.

3:05 PM - 4:20 PM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CHONC, CPB, CPPM

2C: Infusion, Hydration, and Injection Coding

Michele M Stevens, CPC, CPMA

Understanding the hierarchy of infusion, hydration, and injection coding while following coding guidelines that appear to point you in another direction as you've just read an NCCI edit for a specific drug that required hydration pre/post a chemo infusion that you thought you didn't code hydration. Let's dig into this together, but remember each MAC has their own specific guidance that must be researched well before you determine how to write a policy for your department and this is as one of those areas that every organization should have one on file.

3:05 PM - 4:20 PM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CASCC, CCC, CCPC, CCVTC, CDEI, CDEO, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIMC, COBGC, COPC, COSC, CPB, CPCD, CPCO, CPEDC, CPMS, CPPM, CPRC, CRC, CRHC, CSFAC, CUC

2D: Developing, Implementing, and Delivering an Audit Program for Physician Services

Kimberly Garner Huey, COC, CPC, CPCO; Sandra Kay Giangreco Brown, RHIT, COC, CPC, CPC-I, COBGCDirector of Coding & Revenue Integrity

We will cover the elements that a physician practice needs to consider when designing and implementing an audit plan for their practice. Being aware of the deciding factors in the creation of the audit program and considerations to make prior can eliminate headaches down the road. When to consult an attorney to potentially perform the audit under Attorney Client Privilege will be reviewed and the guidelines to consider will be discussed. This session will cover valuable information for new or seasoned auditors or practice managers and coders.

3:05 PM - 4:20 PM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CCC, CCPC, CCVTC, CDEI, CDEO, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIMC, COBGC, COPC, COSC, CPB, CPCD, CPCO, CPEDC, CPMS, CPPM, CPRC, CRC, CRHC, CSFAC, CUC

2E: Double Dip, Its OK This Time, Capitalizing on the New E/M Guidelines to Maximize the Assessment and Plan

Jacob Swartzwelder, CPC, CRC, CEMC

Attendees will walk through how to combine 2021 E/M guideline changes and Risk Adjustment Initiatives within the Assessment and Plan. We will explore a high-level overview of 2021 Evaluation and Management Office and Other Outpatient Services guideline changes, ways to positively integrate Risk Adjustment information into the Assessment and Plan, and tips for educating providers on maximizing the impact of their documentation.

Exhibit Hall

4:30 PM - 6:00 PM, EDT

EH2: Welcome Reception with Exhibitors

Tuesday, October 5, 2021

Exhibit Hall

7:00 AM - 8:00 AM, EDT

EH3: Networking Breakfast with Exhibitors

General Session

8:00 AM - 9:15 AM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CCC, CCPC, CCVTC, CDEI, CDEO, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIMC, COBGC, COPC, COSC, CPB, CPCD, CPCO, CPEDC, CPMS, CPPM, CPRC, CRC, CRHC, CSFAC, CUC

GS3: E/M Panel

Raemarie Jimenez, CPC, CDEO, CIC, CPB, CPMA, CPPM, CPC-I, CANPC, CRHC; Jaci J. Kipreos, COC, CPC, CDEO, CPMA, CRC, CPC-I, CEMC; Samuel Le Church MD, MPH, CPC, CRC, CPC-I

During this session, an expert panel made up of a physician, coder, auditor, payer and representative from the AMA will answer audience questions regarding the 2021 E/M guidelines for office visits.

9:30 AM - 10:45 AM, EDT | 1.25 CEUs COC, CPC, CPC-P, CEMC, CPB, CPCO, CPPM

GS4: Telemedicine Panel

Colleen Gianatasio, CPC, CPC-P, CPMA, CRC, CPC-I; Marianne Durling MHA, RHIA, CCS, CDIP, CPC, CPCO, CDEI, CIC, Approved-Instructor; Stephanie M Sjogren, COC, CPC, CDEO, CPMA, CPC-I; Leonta Williams, CPC, CPCO, CRC, CEMC, CHONC

During this session a panel of experts representing the provider, facility, and payer perspectives will be discussing best practices for navigating the ongoing changes with telemedicine and telehealth regulations. There are so many changes occurring it is difficult to keep up. The panel will answer questions from the audience.

Breakout Session 3

11:00 AM - 12:15 PM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CCC, CCPC, CCVTC, CDEI, CDEO, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIMC, COBGC, COPC, COSC, CPB, CPCD, CPCO, CPEDC, CPMS, CPPM, CPRC, CRC, CRHC, CSFAC, CUC

3A: Understanding Principal Care Management and Changes to the Care Management Code Family

Samuel Le Church MD, MPH, CPC, CRC, CPC-I

This session will introduce you to the newest code set to the Care Management code family. PCM facilitates non-face-to-face care by the health care team for patients with at least one high risk condition. While PCM will typically be provided by subspecialists, the new codes may be used by any specialty. In addition to review of program requirements, we will review several case examples along with best practices for documentation and coding.

11:00 AM - 12:15 PM, EDT | 1.25 CEUs COC, CPC, CPC-P, CANPC, CASCC, CGSC, CIC, CPB, CPPM

3B: General Surgery Coding - Head to Toe

Kimberly Garner Huey, COC, CPC, CPCO; Sandra Kay Giangreco Brown, RHIT, COC, CPC, CPC-I, COBGCDirector of Coding & Revenue Integrity

In this session, we will begin with the CPT codes in the Integumentary section in CPT and work our way through the surgery chapter codes. We will discuss a variety of codes and the definitions and guidelines both found in the front of the chapters and those within the applicable chapters. We will review codes and their instructions so the attendees can have a better understanding of CPT General Surgery procedure coding. The sections that will be covered include but are not limited to: Integumentary biopsies, mastectomy coding, Gastrointestinal procedures, Thyroid procedures and some neurology procedures.

11:00 AM - 12:15 PM, EDT | 1.25 CEUs COC, CPC, CPC-P, CDEI, CDEO, CEMC, CPB, CPPM

3C: Sepsis 2, 3 What?

Heather Greene, CPC, CIC, CPMA

In this presentation, we will review and discuss the clinical indicators support the diagnosis of Sepsis 2 or Sepsis 3. We will evaluate documentation and discuss query options for clarification.

11:00 AM - 12:15 PM, EDT | 1.25 CEUs COC, CPC, CPC-P, CIC, CPB, CPPM

3D: Conducting a Charge Audit To Boost Your Revenue

Dorothy D Steed, COC, CPCO, CPMA, CPC-I, CEMC, CFPC

Discover missing revenue opportunities by conducting a charge capture audit. Departmental charge entry through the hospital's charge master requires understanding the reportable services, timely data entry, correct number of units and matching of services rendered. Although financial success is heavily dependent upon accurate and timely charge capture, providers may not fully realize the risks involved in not implementing charging controls. This session will focus on the risks and consequences of missed charges.

11:00 AM - 12:15 PM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CCC, CCPC, CCVTC, CDEI, CDEO, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIMC, COBGC, COPC, COSC, CPB, CPCD, CPCO, CPEDC, CPMS, CPPM, CPRC, CRC, CRHC, CSFAC, CUC

3E: 2021 E/M Guidelines – Risk Associated With Coding for Time

Raemarie Jimenez, CPC, CDEO, CIC, CPB, CPMA, CPPM, CPC-I, CANPC, CRHC

In this session we will discuss compliance risks associated with the new 2021 E/M time guidelines for office and outpatient services. We will discuss best practices to implement time based coding.

Exhibit Hall

12:15 PM - 1:30 PM, EDT

EH4: Networking Lunch with Exhibitors

Breakout Session 4

1:30 PM - 2:45 PM, EDT | 1.25 CEUs COC, CPC, CPC-P, CPB, CPPM

4A: What Makes a Successful Medical Practice Manager?

MariaRita Genovese, CPC

The skills needed to be a successful Practice Manager, the responsibility of a Practice Manager, how to get the most from your employees and how to standout as an effective manager.

1:30 PM - 2:45 PM, EDT | 1.25 CEUs COC, CPC, CPC-P, CEMC, COBGC, CPB, CPPM

4B: Gynecology in the Office

Peggy A Stilley, CPC, CPB, CPMA, CPC-I, COBGC

This session will include services and procedures performed in the office. We will look at payer policies and authorizations that may be needed. We will discuss colposcopy, preventive services, contraception management, and office visits.

1:30 PM - 2:45 PM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CDEI, CDEO, CPB, CPCO, CPPM

4C: Anesthesia Coding, Billing, and Documentation Nuances

Kristen R Taylor, CPC

This session will differentiate anesthesia procedures including modifiers, concurrency, and medical direction based on who is performing the service. Provide knowledge of interaction between anesthesologist and CRNA throughout anesthesia procedure. Clarification of different anesthesia modifiers and how to determine the correct one. Discussion of chart documentation relation to billing.

1:30 PM - 2:45 PM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CEDC, CPB, CPCO, CPPM

4D: Emergency: Audit Risk Areas in the ED

Marianne Durling MHA, RHIA, CCS, CDIP, CPC, CPCO, CIC, Approved-Instructor

This session will focus on audit risk areas for Emergency Depts. Learn the most common areas of compliance concern for emergency departments. We will review the risks and things you should be doing ahead of any audit.

1:30 PM - 2:45 PM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CCC, CCPC, CCVTC, CDEI, CDEO, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIMC, COBGC, COPC, COSC, CPB, CPCD, CPCO, CPEDC, CPMS, CPPM, CPRC, CRC, CRHC, CSFAC, CUC

4E: Documentation Deficiencies

Jaci J. Kipreos, COC, CPC, CDEO, CPMA, CPC-I, CEMC

The 2021 E/M guidelines for office and other outpatient services have been in use for almost a year. There have been some struggles and confusion along the way. This session will highlight areas that have created documentation confusion and questions. We will look at the documentation struggles in each of the three categories that define medical decision making and we will touch on time documentation.

Exhibit Hall

2:45 PM - 3:05 PM, EDT

EH5: Networking Break with Exhibitors

Breakout Session 5

3:05 PM - 4:20 PM, EDT | 1.25 CEUs COC, CPC, CPC-P, CEMC, CPB, CPPM

5A: Health Conditions of the American Trucker

Sarah Ragan, COC, CPC, CPMA, CRC, CFPC; Jake Ragan

The trucking industry moves America, but who moves the trucking industry? This is the health story of the backbone of America; truck drivers! Please join us as semi truck driver instructor Jake Ragan, and his wife Sarah Ragan, CPC, CPMA, CRC, CFPC discuss the health conditions that drivers face during their careers. We will touch base on smoking, hypertension, diabetes, hernias, and depression, among other issues.

3:05 PM - 4:20 PM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CEMC, COPC, CPB, CPCO, CPPM

5B: Sight Seeing in Charleston

Shannon O'Tyson DeConda, CPC, CPMA, CPC-I, CEMC

Teaching a session on the Ophthalmologic Services Codes (the eye codes) would pale in comparison to an E&M session- although they are essentially the bread and butter of an eye practice. Teaching when to use eye vs. E&M is a trickier and more gray area topic to approach. There are variations and disagreements amongst the payors- so what do you do? This session, we will explore best practice and how to create an optimum compliance path for your practice.

3:05 PM - 4:20 PM, EDT | 1.25 CEUs COC, CPC, CPC-P, CEMC, CPB, CPPM

5C: COVID-19 Pulmonary Complications and Ventilator Management

Louis Jimenez, RRT, CHT

In this session we will cover the pulmonary complications associated with COVID 19. A review of normal pulmonary physiology followed by restrictive pulmonary pathologies associated with COVID 19, including pneumonitis, pneumonias, ventilator acquired pneumonia, and Adult Respiratory Distress Syndrome. A review of basic ventilator functions as they relate to ventilator modes, ventilator settings, positive pressure, and enhanced oxygenation modalities, followed by the challenges posed by restrictive disease and how those challenges are met through management of the airway and the ventilator.

3:05 PM - 4:20 PM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CDEO, CEMC, CIRCC, CPB, CPCO, CPPM

5D: Revenue Cycle Audit Tips for Home Health and Hospice

Amy Lee Smith, COC, CPC, CPMA

Home Health and Hospice billing and coding is complex and very different from other settings. This session will present a high-level overview of the revenue cycle process along with tips for auditing the high risk areas of documentation, coding, and billing for these services.

3:05 PM - 4:20 PM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CEMC, CPB, CPCO, CPPM

5E: Counting of Data

Leonta Williams, CPC, CPCO, CRC, CEMC, CHONC

This session will address some of the more pressing questions and remaining ambiguity around assigning data points for MDM. We will discuss the definitions of review of a test vs. interpretation of a test. We will explore the rationale of why credit is given at the time of order and not the review by the same provider, regardless of what day the review happened. Come get clear direction on what is an independent test and what really happens when both time and MDM is documented. It is important that you fully understand all the definitions around “Data” and how to communicate those definitions to providers.

Wednesday, October 6, 2021

Exhibit Hall

8:00 AM - 9:00 AM, EDT | 1.00 CEUs COC, CPC, CPC-P, CPB, CPPM

EH6: Networking Breakfast

General Session

9:00 AM - 10:15 AM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CASCC, CCC, CCPC, CCVTC, CDEI, CDEO, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIMC, COBGC, COPC, COSC, CPB, CPCD, CPCO, CPEDC, CPMS, CPPM, CPRC, CRC, CRHC, CSFAC, CUC

GS5: Diagnosis Coding Insights from the Expert

Marianne Durling MHA, RHIA, CCS, CDIP, CPC, CPCO, CDEI, CIC, Approved-Instructor; Jaci J. Kipreos, COC, CPC, CDEO, CPMA, CRC, CPC-I, CEMC; Leonta Williams, CPC, CPCO, CRC, CEMC, CHONC; Colleen Gianatasio, CPC, CPC-P, CPMA, CRC, CPC-I

Led by a panel of experts from various backgrounds, this discussion offers perspective into the often blurred lines of the proper rules surrounding diagnosis coding for professional fee coding, risk adjustment coding, and facility coding. The panel will review hospital inpatient medical records and compare what diagnosis codes would be acceptable/reportable based on the focus of the billing: the provider, facility, or risk adjustment.

Breakout Session 6

10:30 AM - 11:45 AM, EDT | 1.25 CEUs COC, CPC, CPC-P, CPB, CPPM

6A: Start With Empathy: How Practicing Empathy Can Elevate and Improve Organizational Productivity

Rhonda Buckholtz, CPC, CDEO, CPMA, CRC, CENTC, CGSC, COBGC, COPC, CPEDC, Approved-Instructor

Collaboration is essential to any successful organization – but unfortunately how we individually perceive the world can sometimes cause miscommunication and conflicts that hinder effective teamwork. Learning how empathy can help influence teams and build productivity will help you take your organization to higher levels. Empathy must be the driving force and catalyst in todays business models. This presentation will show you how to leverage those skills.

10:30 AM - 11:45 AM, EDT | 1.25 CEUs COC, CPC, CPC-P, CPB, CPPM

6B: Case-Based Complex Vascular Coding

Eva P Alexander, CPC; Dr. Carmen Piccolo III, DO

We will be going over the indications, the procedural steps, evaluating and interpreting the intraoperative images and the billing for complex vascular and endovascular surgical procedures. These will include cases for May-Thurner syndrome, covered endovascular repair of aortic bifurcation and complex endovascular peripheral reconstruction.

10:30 AM - 11:45 AM, EDT | 1.25 CEUs COC, CPC, CPC-P, CDEO, CEMC, CPB, CPPM

6C: CDI in the Outpatient World

Jennifer R Swindle, CPC, CIC, CPMA, CEMC, CFPC

CDI and concurrent review is common in the inpatient arena, but as healthcare continues to evolve, more work is done in the outpatient setting, with shorter stays, less time to query providers and significant higher volume; this presentation will focus on how to have an effective clinical documentation improvement program in the outpatient setting which focuses on quality and accurate capture of the acuity of the patient and the services provided. The patient is at the heart of healthcare and the documentation must support all aspects, which impacts reimbursement as well.

10:30 AM - 11:45 AM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CDEI, CEMC, CIC, CPB, CPCO, CPPM

6D: Critical Care - Compliant Coding and Documentation Require More Than an Admission to ICU!

Nancy L Reading RN, BS, CPC, CPC-P, CPC-I

This session will cover inpatient critical care documentation and coding nuances required to bill compliantly. The attendee will gain an understanding of the evolution of diagnosis coding as the patient’s condition changes. Documentation of the patient’s critical clinical picture, or the lack there of, will drive medical necessity and code assignment. We will compare and contrast the criteria for coding Critical Care by the American College of Critical Care Medicine versus Medicare’s criteria.

10:30 AM - 11:45 AM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CCC, CCPC, CCVTC, CDEI, CDEO, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIMC, COBGC, COPC, COSC, CPB, CPCD, CPEDC, CPMS, CPPM, CPRC, CRC, CRHC, CSFAC, CUC

6E: Determining Condition Complexity

Samuel Le Church MD, MPH, CPC, CRC, CPC-I

The 2021 outpatient E/M code changes have made everything simpler, right? The changes are easier in many ways, but there are new areas of confusions, both for providers and coders (and auditors). In this session we will focus on the first column of the Medical Decision Making (MDM) table, shedding light on the secrets of medical complexity. Examples from multiple specialties will be reviewed for each MDM complexity level.

Breakout Session 7

12:05 PM - 1:20 PM, EDT | 1.25 CEUs COC, CPC, CPC-P, CDEO, CPB, CPPM

7A: When Your Patient Has Both Medical and Behavioral Health Concerns

Dorothy D Steed, COC, CPCO, CPMA, CPC-I, CEMC, CFPC

Many providers have seen an increase in behavioral health problems that influence the medical management or require additional mental health management. The pandemic has increased these concerns and requirements for additional documentation, reporting of additional codes as well as reporting of applicable social determinants of health. This session will cover the reporting requirements to avoid medical necessity denials.

12:05 PM - 1:20 PM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CDEI, CDEO, CPB, CPCO, CPPM

7B: Understanding Radiology NCCI, LCD, and NCD

Ruby Woodward, CPC, CPB, CPMA, CPC-I, COSC, CSFAC

In this presentation we will review the various NCCI guidelines and edits, NCDs, and LCDs that relate to diagnostic radiology services. When are modifiers allowed, what documentation is required, what policies exist and how to apply them.

12:05 PM - 1:20 PM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CEMC, CPB, CPCO, CPPM

7C: Mental Health and the Opioid Crisis – What Do We Code?

Heather Greene, CPC, CIC, CPMA

In this course we will look at Chapter five, concentrating specifically at the substance abuse categories. We will delve into documentation requirements of top diagnoses and how the coding guideline “with” can affect the Principal/first listed diagnosis. This class is for all levels of coders.

12:05 PM - 1:20 PM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CPB, CPCO, CPPM

7D: Figuring Out Benchmarking

Shannon O'Tyson DeConda, CPC, CPMA, CPC-I, CEMC

Not all of us are statisticians by any stretch, but most of us, once trained on a way to work through data sets we understand how to approach a report, how to break it down, and how to use the data. During this session, we will review what data is valuable for benchmarking for your providers individually, collectively, and why. We will also have sample reports and review the data as we consider the outcomes at the impacts on the audit plan and overall compliance process of the organization.

12:05 PM - 1:20 PM, EDT | 1.25 CEUs CPMA, COC, CPC, CPC-P, CPB, CPCO, CPPM

7E: Stay Compliant During Physician Vacancies

Maryann C Palmeter, CPC, CPCO, CPMA, CENTC

This presentation will address various arrangements that may be entered into when a physician vacancy arises. Audience members will learn about locum tenens and reciprocal billing requirements and differences, proper billing, time and provider limitations, and patient notifications. This presentation will assist attendees stay in compliance with Medicare reassignment rules.