New York City Regional Conference

Sunday, August 18, 2019

Pre-Conference

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

Teach the Teacher

Ana Yanez-Marrero, COC, CPC, CPCO, CDEO, CPMA, CRC, CPC-I; Katherine Abel, CPC, CPB, CPMA, CPPM, CPC-I; Kris Taylor, Education Operations Manager In PMCC; Raemarie Jimenez, CPC, CDEO, CIC, CPB, CPMA, CPPM, CPC-I, CANPC, CRHC

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, August 19, 2019

Pre-Conference

8:00 AM - 10:00 AM | 2.00 CEUs COC, CPC, CPC-P, CPB, CPPM

Pre2:Local Chapter Leadership Training

Information

9:00 AM - 4:00 PM

Registration/General Info/Product Store

General Session

11:00 AM - 12:00 PM | 1.00 CEUs COC, CPC, CPC-P, CPB, CPPM

GS1:Conference Welcome

Bevan Erickson, AAPC CEO

Join Bevan Erickson, AAPC’s CEO for his State of AAPC address. He will cover exciting new and upcoming developments within your organization, why we’re moving in these directions, and how these evolutions will impact your daily life, both inside and outside of work.

12:15 PM - 1:30 PM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CPB, CPCO, CPPM

GS2:Anatomy of a Healthcare Fraud Investigation: Implications and Stop-Gap Measures for Compliance Professionals

Eric Rubenstein

This presentation will provide attendees with information on the variety of ways in which an OIG healthcare fraud investigation is initiated. The presentation will then provide a high-level overview of the lifecycle of the investigation, and include areas where compliance professionals (including compliance officers and billing and coding staff) can work in a proactive manner to ensure that billing, coding and professional relationships are conducted in a way that can mitigate an OIG healthcare fraud investigation.

1:45 PM - 3:00 PM | 1.25 CEUs COC, CPC, CPC-P, CPB, CPPM

GS3:Legal Trends and Issues

Michael D Miscoe, Esq, CPC, CPCO, CPMA, CASCC, CCPC, CUC; Christopher Adam Parrella, JD, CHC, CPC, CPCO; Karina Annette Johnson, Esq, COC, CPC, CPCO, CDEO, CIC, CPB, CPMA, CPPM, CPC-I, CANPC, CCC, CCVTC, CGSC, CHONC, COBGC, COSC, CPCD

This panel discussion, led by AAPC’s Legal Advisory Committee, offers insights into today's – and tomorrow’s – most pressing legal concerns for medical practices and facilities facing increased financial scrutiny and regulation. Join us for this perennial favorite!

Breakout Session 1

3:15 PM - 4:30 PM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CCC, CCPC, CCVTC, CDEO, CDEO-I, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIC-I, CIMC, COBGC, COC-I, COPC, COSC, CPB, CPC-9, CPCD, CPEDC, CPMS, CPPM, CPRC, CRC, CRHC, CSFAC, CUC

1A:Modifier 25

Lori A Cox, CPC, CPMA, CPC-I, CEMC, CGSC, CHONC

Modifier 25 is likely the most confusing and misused CPT modifier of all time. The OIG targets this modifier constantly, and CMS has published many reports on the millions of dollars paid incorrectly due to this simple little modifier. During our presentation, we will have an interactive conversation on the proper use of modifier 25, along with advice on how to discuss this potentially harmful modifier with your providers. Actual case examples will be discussed and clues given on how to audit records with modifier 25.

3:15 PM - 4:30 PM | 1.25 CEUs COC, CPC, CPC-P, CCC, CCVTC, CIRCC, CPB, CPPM

1B:Interventional Radiology and Cardiac Catheterization Lab Procedures

David Zielske, MD, COC, CIRCC, CCC, CCVTC

Procedure descriptions, images and coding guidelines will be reviewed. This basic overview is intended for coders interested in specialty coding for Interventional Radiology and Cardiology.

3:15 PM - 4:30 PM | 1.25 CEUs COC, CPC, CPC-P, CPB, CPPM

1C:What Kind of Leader Are You?

MariaRita Genovese, CPC

Effective leaders guide and inspire others to achieve their very best. Identify your leadership style, recognize the keys to successful leadership, and identify the pitfalls that could inhibit your success.

3:15 PM - 4:30 PM | 1.25 CEUs COC, CPC, CPC-P, CASCC, CPB, CPPM

1D:Building Proficiency in Facility Billing

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

Skill building is a constant for our profession. Understanding how facility billing is managed will add to your bank of knowledge. While the end goal is to get proper reimbursement in an appropriate manner, facility billing is signifcantly different from professional billing. Find out about these differences and how you can be an asset to a facility billing team.

3:15 PM - 4:30 PM | 1.25 CEUs COC, CPC, CPC-P, CPB, CPPM

1E:How You Can Negotiate Payor Contracts Like a Pro!

Marcia Brauchler, MPH, CPHQ, COC, CPC, CPC-I

You can do it! Negotiating your payor agreements can be the difference your practice needs for maintaining profits and independence in these complex times of narrow networks, increasing regulation, and pressure to contain costs system-wide.

3:15 PM - 4:30 PM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CPB, CPCO, CPPM

1F:How to Write an Audit Report

Amy Lee Smith, COC, CPC, CPMA; Jaci J. Kipreos, COC, CPC, CDEO, CPMA, CPC-I, CEMC

The audit has been completed and now it is time to relay the results. There are many ways to accomplish this task and the answer lies within the original scope. In this session we will look at a variety of templates that reflect audit findings and discuss what should be included in all written audit reports.

Exhibit Hall

4:30 PM - 5:30 PM

EH1:Welcome Break with Exhibitors

Tuesday, August 20, 2019

Information

7:00 AM - 4:30 PM

Registration/General Info/Product Store

Exhibit Hall

7:00 AM - 8:00 AM

EH2:Networking With Exhibitors

General Session

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

GS4:What Happens When E/M Guidelines Change?

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

How will this affect you? This session will discuss the upcoming changes to the E/M Documentation Guidelines released in the Proposed and Final Rules, and what changes to expect in years to come. We will review case examples and determine how overall code selection will be impacted applying changes to the guidelines. This will be an interactive session where the audience will be encouraged to share their best practices. Come be part of the solution to a complex coding structure.

9:15 AM - 10:30 AM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CCC, CCPC, CCVTC, CDEO, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIMC, COBGC, COPC, COSC, CPB, CPC-9, CPCD, CPCO, CPEDC, CPMS, CPPM, CPRC, CRC, CRHC, CSFAC, CUC, I

GS5:Diagnosis Coding Insights from the Experts

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

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 2

10:45 AM - 12:00 PM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CDEO, CEMC, CPB, CPCO, CPPM

2A:How to Avoid These 3 Major Coding Compliance Issues

Christopher Chandler, MHA, MBA, CPC, CGSC

With more and more healthcare companies being fined for compliance concerns, it is important to ensure that you are compliantly documenting and coding these three major compliance areas: (1) misuse of modifiers 25 & 57, (2) incorrect reporting of shared and incident-to services with non- physician practitioners, and (3) inappropriate copy & paste "cloning" practices. This course will cover important coding guidelines, examples of incorrect use, relevant case studies, and risk mitigation strategies for these three compliance areas.

10:45 AM - 12:00 PM | 1.25 CEUs COC, CPC, CPC-P, CIRCC, CPB, CPPM

2B:Percutaneous Embolization Procedures

David Zielske, MD, COC, CIRCC, CCC, CCVTC

This session will review common percutaneous, catheter directed embolization procedures performed in Interventional Radiology and Cardiology. Procedure indications, details, images and coding guidelines will be discussed.

10:45 AM - 12:00 PM | 1.25 CEUs COC, CPC, CPC-P, CPB, CPPM

2C:Creative Education in an Ever Changing World

Shelley V Garrett, CPC

Learn how to meet the educational requirements of your compliance plan by using low and no cost resources that are available to assist you. By effectively planning your education program and utilizing ways to meet the needs of different learning styles, you can successfully engage your practice in the process.

10:45 AM - 12:00 PM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CDEO, CFPC, CIMC, CPB, CPCO, CPPM

2D:Correct Coding and Billing for Outpatient Mental Health Providers

Laurie Bouzarelos, CPC

Are you working in a mental health practice or an integrated care model now incorporating mental health providers in a primary care setting? Know the details! Mental health services bring with them distinct documentation and coding requirements to support correct billing for services. Make sure your practice is up-to-date

10:45 AM - 12:00 PM | 1.25 CEUs COC, CPC, CPC-P, CDEO, CIC, CPB, CPPM, CRC

2E:How to Review Records for Risk Adjustment

Colleen Gianatasio, CPC, CPC-P, CPMA, CRC, CPC-I

You've learned the Essentials of Risk Adjustment and now you want to learn more. This session will allow participants the chance to review some chart review challenges as it pertains to accurately coding for risk adjustment. We will dissect and code charts for some of the most prevalent chronic conditions like diabetes, COPD, and congestive heart failure.

10:45 AM - 12:00 PM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CDEO, CEMC, CIC, CPB, CPCO, CPPM

2F:The Complexities of Inpatient E/M Services

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

During this session you will be provided real world inpatient encounters to audit. They will vary from initial inpatient, subsequent inpatient, observation, and critical care. Attendees will be provided a few minutes to audit the note themselves, and then we walk through each note in detail (line by line) and answer all questions regarding what counted toward each level of service. An inpatient-specific audit tool and documentation cheat card will be provided to each attendee of this session.

Exhibit Hall

12:00 PM - 1:30 PM

EH3:Lunch with Exhibitors

Come enjoy a southern comfort lunch complete with BBQ slow cooked beef brisket, corn meal crusted catfish, and peach jalepeno glazed chicken. Don't forget to stop by and see what our exhibitors have to offer after!

Breakout Session 3

1:30 PM - 2:45 PM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CASCC, CCC, CCPC, CCVTC, CDEO, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIMC, COBGC, COPC, COSC, CPB, CPC-9, CPCD, CPCO, CPMS, CPPM, CPRC, CRC, CRHC, CSFAC, CUC, I

3A:AWV/IPPE/Preventive Medicine; Not Apples to Apples

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

The Welcome to Medicare and Annual Wellness Visit are covered services in specific instances and time periods for Medicare Beneficiaries, but have distinct documentation criteria and are not annual physicals which are still statutorily excluded. Providers often confuse an AWV for Preventive Care and want the codes to be interchangeable and they are not. Medicare beneficiaries are confused, as they also do not understand and think the AWV covers their 'annual'. What is covered? How frequently? What must be documented?

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

3B:Pulmonary Function Testing

Louis Jimenez, RRT, CHT

When coding pulmonary function tests for lung disease, it helps to understand the underlying disease process and why they are performed. Pulmonary function tests are performed during the non-acute phase of pulmonary disease and provide the measurements of the patient’s lung volumes, capacities, flow rates, airway resistance, and lung compliance. This session will review pulmonary diseases, types of pulmonary functions tests and when they are used, which codes report the services, and tips for code selection, so you can apply codes appropriately.

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

3C:Intro to HEDIS

Colleen Gianatasio, CPC, CPC-P, CPMA, CRC, CPC-I

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

3D:Hospital Compliance

Marianne Durling MHA, RHIA, CCS, CDIP, CPC, CPCO, CIC, CPC-I

This session will focus on current hospital compliance issues. These will include OIG work plan topics, as well as using the PEPPPER report and other methods of discovery for possible compliance concerns. We will also discuss some recent DOJ and OIG findings and their importance. Our goal is to help create a well-rounded compliance office with the necessary resources to stay current. This session will be beneficial for those working in compliance as well as those looking to move into compliance roles.

1:30 PM - 2:45 PM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CCC, CCPC, CCVTC, CDEO, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIMC, COBGC, COPC, COSC, CPB, CPC-9, CPCD, CPCO, CPEDC, CPMS, CPPM, CPRC, CRC, CRHC, CSFAC, CUC

3E:How to Better Utilize Medicare Resources for Physician Coding

Tyler Griffeth, CPC, CPRC

Many of you may already use Medicare resources, such as the Claims Processing Manual, NCCI Manual, and Physician Fee Schedule. This course will provide tips on how to use these resources to help you get the maximum benefit from them for physician coding. These resources will help you understand documentation requirements, code correctly, and know when to appeal denials.

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

3F:Auditing for Risk and Revenue

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

The audit process and plan must change to adapt to the changes in the delivery of healthcare services and the changes in the payment methodology. This presentation will address how to update the scope of an existing audit plan to adjust to the changing environment of the healthcare setting and payment policies. The presentation will introduce real life examples of these changes and suggest how they can be incorporated into the scope of the audit. The new audit plan should be able to recognize risk and verify reimbursement.

Breakout Session 4

3:00 PM - 4:15 PM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CASCC, CCC, CCPC, CCVTC, CDEO, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIMC, COBGC, COPC, COSC, CPB, CPC-9, CPCD, CPEDC, CPPM, CPRC, CRC, CRHC, CSFAC, CUC

4A:Modifier Maze

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

The objectives for this session will be to clarify the definitions of modifiers and understand what occurs when modifiers are reported on claims. Modifiers can affect reimbursement or can allow payment for services that are typically bundled. Some modifiers have been misused and are under scrutiny with payers.

3:00 PM - 4:15 PM | 1.25 CEUs COC, CPC, CPC-P, CCC, CCVTC, CEMC, CPB, CPPM

4B:Cardiology at a Glance For Beginners

Belinda Inabinet, CPC, CCC

Office Cardiology at a Glance will provide an overview of the cardiac anatomy. This should help explain why physicians are ordering tests and what's involved in these tests. We will cover basics such as EKGs, echoes, treadmills, nuclear studies, etc. Along with the testing, we'll cover why these tests are performed. This session will also hit on some of the most common diagnosis for these test, as well as possible areas of denials/claims issues.

3:00 PM - 4:15 PM | 1.25 CEUs COC, CPC, CPC-P, CPB, CPPM

4C:Passionately Productive

Vanessa Best, CPC, CPC-I

If you need to find an extra day in the week to work on your daily
to do list , attend this session to find it. We will help you identify your direct deposit of 86,400 and show you how to allocate it so you walk away happy. Being passionately productive is a must as a busy HIM Professional because it will make you more efficient, calmer and allow you to achieve what you want to and need to faster.

3:00 PM - 4:15 PM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CASCC, CCVTC, CDEO, CGSC, CIC, COSC, CPB, CPCO, CPPM, CPRC, CSFAC

4D:Surgical Complications Don’t Have to Be Complicated

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

We’ll explore some “common” conditions that might be classified as a surgical complication. Some of these are inherent to the procedure performed, completely unavoidable, and not a complication at all! As we examine real-life scenarios, we’ll see the necessity of good documentation and identify instances where a follow-up query would help clarify. Objectives: Identify conditions which typically are inherent and/or unavoidable Review common diagnosis which are typically surgical complications Define cause and effect relationships

3:00 PM - 4:15 PM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CDEO, CEMC, CPB, CPCO, CPPM

4E:New CMS Guidelines for Student and GME Documentation

Christopher Chandler, MHA, MBA, CPC, CGSC

Did you know that CMS recently changed their guidelines regarding the use of student documentation? Did you know they also made changes to GME coding guidelines? This course will help you be up to date on these changes and how they impact your practice. The current coding and documentation requirements for GME services will be reviewed, along with the areas of risk associated with using GME and student documentation.

3:00 PM - 4:15 PM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CDEO, CPB, CPCO, CPPM

4F:Developing and Implementing a Physician Audit Program

Sandra Kay Giangreco Brown, RHIT, COC, CPC, CPC-I, COBGC; Kimberly Garner Huey, COC, CPC, CPCO

You know you need to audit, but you want to make the most of your limited resources – how do you focus on what’s most important and structure your audits for the most impact? We will discuss why physician practices don’t audit, the benefits of an audit program, what areas should be audited, the benefits of an internal auditor versus an external auditor, the protection provided by attorney-client privilege and more. From timing of the audit to choosing the auditor and the audit sample to delivering the results and educating the physicians, this session walks you through every aspect of the physician audit process.

Wednesday, August 21, 2019

Information

8:00 AM - 2:00 PM

Registration/General Info/Product Store

Exhibit Hall

8:00 AM - 9:00 AM

EH4:Breakfast with Exhibitors

Get your day off on the right start with some farm fresh scrambled eggs, home fried potatoes, applewood smoked bacon and country sausage links! Don't forget to stop by and see what our exhibitors have to offer after!

Breakout Session 5

9:00 AM - 10:14 AM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CDEO, CEMC, CPB, CPCO, CPPM

5A:Telehealth/Telemedicine

Brenda R Edwards, CPC, CDEO, CPB, CPMA, CRC, CPC-I, CEMC

Telemedicine, telehealth…whatever you call it…what is it? This is an increasing area of interest for providers and could be a viable alternative for patient care. Knowing the rules as they pertain to Medicare compared to other payors is paramount in order to get correct payment. We will discuss what it is, the specific parameters tied to Medicare, the alternative views from other payors, and share some resources to help a practice get started.

9:00 AM - 10:14 AM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CDEO, CEDC, CEMC, CPB, CPCO, CPPM

5B:Coding Critical Care Services

Betsy A Nicoletti, CPC

Medicare contractors and private payers often review critical care notes, and the denial rate for these services is high. Coders and physicians need to understand the requirements for the patient condition, the intensity of intervention and using time, and the differences in CPT and CMS rules.

9:00 AM - 10:14 AM | 1.25 CEUs COC, CPC, CPC-P, CPB, CPPM

5C:How To Talk So Providers Will Listen. How To Listen So Providers Will Talk

Lisa Balsam, CPC, CRC

Have you ever felt like providers you were educating were not understanding, nor trying to understand what you were teaching? This presentation will give insight on the clinical thought process of a provider and why it gets in the way of your education. After attending this session, you will be able to understand the importance of using different training practices to get the most from your education session.

9:00 AM - 10:14 AM | 1.25 CEUs COC, CPC, CPC-P, CPB, CPPM

5D:Understanding Clinical Trial and Research Coding and Billing

Marianne Durling MHA, RHIA, CCS, CDIP, CPC, CPCO, CIC, CPC-I

This session will focus on regulatory requirements for clinical trials and research coding and billing. It is imperative to operate within the regulatory walls to remain compliant in research. We will examine the clinical trials process from beginning to end - so if you are new this area of coding and billing this session is for you. If you are looking for a new area of coding and have thought about getting into clinical trials this will give a good background in the flow and regulatory requirements so you can really understand the process. If you currently work in this field, this session will be a good review to ensure you remain in compliance.

9:00 AM - 10:14 AM | 1.25 CEUs COC, CPC, CPC-P, CDEO, CIC, CPB, CPPM, CRC

5E:Advanced Risk Adjustment: What's the Impact Once the Encounter is Coded

Donna Malone, CPC, CRC

The encounter is coded so what happens next? Value Based Care is dependent on the accuracy of coding the members health status (the members clinical story). We will take a journey through the impact of diagnosis coding on all components of the CMS-HCC model. In addition, we will walk through the the impact when the complete story of the member is not identified.

9:00 AM - 10:14 AM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CPB, CPCO, CPPM

5F:Breaking into the Auditing Field

George James Blake, CPC; Amy Lee Smith, COC, CPC, CPMA; Lori A Cox, CPC, CPMA, CPC-I, CEMC, CGSC, CHONC; Leonta Williams, CPC, CPCO, CRC, CEMC, CHONC; Jaci J. Kipreos, COC, CPC, CDEO, CPMA, CPC-I, CEMC

Too many times we walk in the door to meet with a provider to review their coding and auditing reports to be met with the eye roll of, UGH, they are back! During this session we will provide a teach-the-teacher, interactive session on the best how-to’s for positive provider engagement for positive impacts on compliance. This will include not only guidance and teaching tips, but it will also include a sample report review and walkthrough on how to build the best report, what to include, and most importantly – how to present it.

Breakout Session 6

10:15 AM - 11:30 AM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CASCC, CCC, CCPC, CCVTC, CDEO, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIMC, COBGC, COPC, COSC, CPB, CPC-9, CPCD, CPCO, CPEDC, CPPM, CPRC, CRC, CRHC, CSFAC, CUC

6A:The National Correct Coding Initiative and Medically Unlikely Edits

Michelle Coleman, CPC; Michele Poulos

This seminar will assist Part B providers with navigating the NCCI tables and the MUE table. This will also cover the proper modifiers to use to avoid denials. We will review each of the adjudication indicators for the MUE values so you can properly bill your Medicare claim.

10:15 AM - 11:30 AM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CDEO, CEMC, COBGC, CPB, CPCO, CPPM

6B:Gynecology Coding

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

Being knowledgeable of female anatomy and terminology provides a better understanding of correct code selection for hysterectomy, pelvic repairs, and colposcopy. This session will include specific CPT® and ICD-10-CM coding for common office and surgical procedures. We will also dive into wellness visits and CMS BPP exams, with discussion of documentation requirements, Advanced Beneficiary Notices, and reimbursement issues.

10:15 AM - 11:30 AM | 1.25 CEUs COC, CPC, CPC-P, CPB, CPPM

6C:Benchmarking for Practice Gains

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

Running a practice in todays healthcare environment is messy at best. Most often we are stuck in the weeds just trying to make it through the day. By learning how to best benchmark key tasks in our practice we can tie that into system reports to get the best gains and to show the value behind those gains in order to influence all stakeholders.

10:15 AM - 11:30 AM | 1.25 CEUs COC, CPC, CPC-P, CANPC, CEMC, CFPC, CHONC, CPB, CPPM

6D:The Magical World Oncology Billing

MariaRita Genovese, CPC

Oncology billing and coding can be challenging. This session will highlight common denials, authorization processes, place of service issues, and new chemotherapy medication procedures, as well as hydration protocol for billing.

10:15 AM - 11:30 AM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CDEO, CPB, CPCO, CPPM

6E:FWA- Overpayment Recovery Demand - Risk Reduction

Alicia Ann Shickle, CPC, CPCO, CPMA, CPPM, CRC

Many Providers are experiencing increased payer audits, are dealing with prepayment reviews, and are receiving letters for large overpayment demands. Some are being terminated from participation, and even charged with fraud. Learn about some of the top issues and how to mitigate risk through documentation content compliance, and the benefits of implementing an effective compliance program.

10:15 AM - 11:30 AM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CPB, CPCO, CPPM

6F:Forensic Auditing – Defining the Process and Purpose

Michael D Miscoe, Esq, CPC, CPCO, CPMA, CASCC, CCPC, CUC

In this session we will define the forensic process and its application to auditing of healthcare service billings. We will also review industry standard guidance for auditing of healthcare claims published by the OIG Office of Audit Services, the federal rules of evidence relative to expert testimony and their relevance to the performance of a forensic audit, the steps of the process for performing such an audit and the circumstances for which a forensic audit is performed and the implications for the findings of such an analysis.

Breakout Session 7

11:45 AM - 1:00 PM | 1.25 CEUs COC, CPC, CPC-P, CPB, CPPM

7A:How to Dissect an Operative Report

Robert Anthony Kiesecker, CPC, CPPM, CPC-I, CCC

Being able to identify key elements of an operative report is a fundamental skill as a coder. Unfortunately, it is also one of the most difficult skills to master. In this presentation we will review true operative reports from different specialties and identify key points and ways to help improve and extract the needed information to successfully code.

11:45 AM - 1:00 PM | 1.25 CEUs COC, CPC, CPC-P, CPB, CPPM

7B:Proper Coding and Billing for OT, PT, and SLP Services

Monica Wright, CPC, CPCO, CPMA

Therapy coding has experienced major changes over the past few years. This session will review the proper use of the therapy evaluation codes, discuss the new payment modifier for OTAs and PTAs coming in 2020, and review how to properly bill for timed therapy services.

11:45 AM - 1:00 PM | 1.25 CEUs COC, CPC, CPC-P, CPB, CPPM

7C:Technology: Is it the Downfall of Healthcare?

Chanda Day, COC; Jill Roeting, CPC, CEMC

I have seen how technology has changed healthcare. We were promised that it would change how the clinician would care for a patient. I agree that this has changed, but has it really changed for the better? How can we come together and put the focus back on the patient?

11:45 AM - 1:00 PM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CASCC, CCC, CCVTC, CDEO, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIMC, COBGC, COPC, COSC, CPB, CPC-9, CPCD, CPCO, CPEDC, CPMS, CPPM, CPRC, CRC, CSFAC, CUC

7D:When is an Excision Not an Excision?

Heather Greene, CPC, CIC, CPMA

Choosing a CPT code can often be much different than choosing the correlating PCS code. When dealing with your coding counterpart (facility/physician), how do you ensure you’re comparing apples to apples? We’ll take a look at some of the basic PCS definitions and compare them to their CPT equivalents to avoid miscommunication.

11:45 AM - 1:00 PM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CPB, CPCO, CPPM

7E:Revenue Cycle Management. A "Ride-along" journey with a claim

Gina Piccirilli, CPC, CPMA

This presentation will cover the life cycle of a claim. From the creation process at the front desk throught the appeal process, We will discuss Check in and out process; the first line of defense. Charge capture, charge entry auditing. Claims management and compliance with insurance carriers claim requirements. Patient statements. Payment and denial posting, Insurance followup and denial and appeals management. Patient collections and Payor management.

11:45 AM - 1:00 PM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CDEO, CPB, CPCO, CPPM

7F:Audit Scope and Selection

Kimberly Garner Huey, COC, CPC, CPCO

When beginning an audit the more effort that is put into determining the scope will make for an easier time with the selection and the delivery of the results. In this session we will discuss the meaning of a scope, discuss how to make a selection and look at various types of audits. We will review what should be asked at the beginning of the audit process to help determine the actual scope of the audit to be performed.