Salt Lake Regional Conference

Monday, October 16, 2017

General Session

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

GS1: Conference Welcome

Bevan Erickson , President AAPC Member Solutions

Come hear AAPC’s President, Bevan Erickson, discuss the future of healthcare, AAPC updates, and opportunities for its members.

Breakout Session 1

12:15 PM - 1:30 PM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CANPC, CASCC, CCC, CCPC, CCVTC, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIMC, COBGC, COPC, COSC, CPB, CPC-9, CPCD, CPCO, CPEDC, CPPM, CPRC, CRC, CRHC, CSFAC, CUC

1A: Navigating NCCI and its Modifiers

Angela B Clements, CPC, CPC-I, CEMC, CGSC, COSC

Modifier 59 is the most abused modifier. Stop relying on software edits to tell you to place the modifier on a CPT® code. Learn how to look up NCCI edits and appropriately apply modifier 59, XE, XP, XS and XU

12:15 PM - 1:30 PM | 1.25 CEUs COC, CPC, CPC-P, CANPC, CEMC, CHONC, CPB, CPPM

1B: The Magical World of Oncology

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.

12:15 PM - 1:30 PM | 1.25 CEUs COC, CPC, CPC-P, CEMC, CFPC, CIMC, CPB, CPPM

1C: The ABC's and Z's of Sleep Diagnostics

Louis Jimenez

During this session, we will discuss the pathophysiology of sleep apnea, how sleep studies are performed and selection of the correct codes for sleep studies.

12:15 PM - 1:30 PM | 1.25 CEUs COC, CPC, CPC-P, CASCC, CDEO, CPB, CPMS, CPPM

1D: Outpatient Documentation Improvement in the Facility

Pamela J Brooks, COC, CPC

Although many healthcare organizations utilize Clinical Documentation Improvement (CDI) Specialists in the inpatient setting to improve provider documentation, the idea of outpatient CDI specialists in the outpatient setting is not widely recognized. Learn how one hospital implemented a documentation improvement program in the outpatient setting to identify issues, reduce denials and appeals, implement creative solutions, and capture more complete clinical data.

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

1E: How to Attain Your Dream Job in 3 Easy Steps

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

This session will help participants explore all the possibilities available in coding whether they are seeking their first coding job or looking to make a change. Participants will learn resume and interviewing tips as well as how to effectively utilize networking in their search.

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

1F: Risk Based Compliance Audits vs. Forensic (Error) Audits – Understanding the Difference

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

When asked to perform an audit it is important to understand the type of audit you have been asked to perform and on that basis, how to characterize and communicate the results. Forensic Auditing differs substantially from Compliance/Risk Auditing based on the criteria that can be applied and the significance (from a disclosure perspective) of the results. This program will outline the difference between these two types of audits as well as clarify the types of criteria, how to delineate conditions of participation from conditions of payment, the difference between coding and reimbursement rules and how these differences influence your audit conclusions.

Breakout Session 2

1:45 PM - 3:00 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, CPEDC, CPMS, CPPM, CPRC, CRC, CRHC, CSFAC, CUC

2A: Advanced E/M: New vs. Established Patients and Modifier 25 Usage

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

We will discuss some complex situations when trying to determine if a patient is new or established; such as when a provider is covering for another provider or a new provider joins a practice. Modifier 25 is a hot topic and it is sometimes difficult to determine when it can be used and when it cannot. We will review actual case examples for when an E/M is performed on the same day as a procedure or another service.

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

2B: Interventional Vascular Coding

Caren J Swartz, COC, CPC, CPB, CPMA, CRC, CPC-I, CPCD

An overview of peripheral vascular surgical procedures, the anatomy, coding rules, areas of confusion as well as review of many of the new codes. Gain more understanding with hands on coding of notes. This will cover interventional as well as open procedures.

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

2C: Top Billing Mistakes and Myths (Panel)

Ann M Bina, COC, CPC, CPC-I; Rhonda Buckholtz, CPC, CDEO, CPMA, CRC, CPC-I, CENTC, CGSC, COBGC, CPEDC; Peggy A Stilley, CPC, CPB, CPMA, CPC-I, COBGC

This panel of industry leading billers will address the most common billing mistakes and myths surrounding claims submissions. The interactive session will delve into your current issues and problem solve your billing nightmares. Come prepared to participate.

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

2D: Pediatrics

Charla Prillaman, CPC, CPCO, CPMA, CPC-I, CCC, CEMC

In this session, we will discuss common areas of concern in a pediatric practice with attention to solutions. We will look at the following categories. 1. Preventive services & screenings 2. Acute care OV 3. Neonatal care 4. Ancillary Services 5. FAQs

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

2E: "Save Your Drama for Your Mama” and Other Resources for Creating a Strong Culture of Success

Dixon Davis, MBA, MHSA

A consistent, positive culture of shared values leads to success in a practice setting and helps minimize management time spent on trivial and less important conflicts between employees. Attendees of this course will leave with an understanding of the importance of practice culture and with an exposure to several readily available resources that can help build and reinforce a positive culture within their practices.

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

2F: Setting Up an Audit Program in the Office

Angela M Jordan, CPC, COBGC

The ACA lists seven core elements that are necessary for an effective compliance program. Setting up ongoing auditing and monitoring of systems to assess the effectiveness of the compliance program and identify issues is one of the seven core elements. During this session, we will discuss the steps of setting up an office audit program. Outlining the program components for service selection, audit tools, audit criteria, reporting, action plan, education and the necessary follow-up. We will also explore the different types of audits that can be performed in the office and why they would be necessary.

Exhibit Hall

3:00 PM - 4:30 PM

EH1: Welcome Break with Exhibitors

Tuesday, October 17, 2017

Exhibit Hall

7:00 AM - 8:00 AM

EH2: Continental Breakfast with Exhibitors

General Session

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

GS2: Toughest Coding Concepts - Panel Discussion

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A panel of multispecialty coding experts will host an interactive discussion of the most challenging coding concepts. The panel will respond to questions from attendees regarding specialty coding topics. The perspective of each panel member on these common issues will provide attendees with answers to their toughest coding questions.

Breakout Session 3

9:15 AM - 10:30 AM | 1.25 CEUs COC, CPC, CPC-P, CDEO, CPB, CPPM

3A: Is Your Physician Ready…Coding, Communication, and Documentation

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

Is your provider willing to ‘roll the dice’ with current documentation? Whether we discuss documentation from a CDI standpoint or for ICD-10 readiness, the common thread is being prepared. Topics included effective provider education, documentation, and compliance in EHRs. This interactive session includes ‘how-to’ as well as ‘how-to-not’ communicate with your providers when delivering coding and documentation education.

9:15 AM - 10:30 AM | 1.25 CEUs COC, CPC, CPC-P, CANPC, CEMC, CIC, COBGC, CPB, CPPM

3B: Obstetrics - Is it Global?

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

Coding for Obstetrics can seem complex and the nuances associated with in OB can create issues for the provider as well as the patient. Global OB care includes antepartum care, delivery, and routine postpartum care. The most common questions asked by coders deal with interrupted pregnancies, services provided in a complicated pregnancy or complicated delivery and care provided in the postpartum period. Knowing reimbursement policies and guidelines is also critical and vary among payers. This session will address some of the most commonly asked questions, discuss industry standards and review coding guidelines in CPT and ICD-10-CM.

9:15 AM - 10:30 AM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CPB, CPCO, CPPM

3C: HEDIS

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

This session will offer a deep dive into the Healthcare Effectiveness Data and Information Set that is used by more than 90% of American health plans to report performance. The discussion will focus on how this program helps health plans, providers and patients achieve better outcomes.

9:15 AM - 10:30 AM | 1.25 CEUs COC, CPC, CPC-P, CDEO, CPB, CPPM

3D: Outpatient Provider Queries

Leonta Williams, CPC, CPCO, CEMC, CHONC

This presentation will outline steps for creating an effective provider query based on clinical indicators in the medical record. Attendees will learn why queries necessary in the outpatient setting, when to query, options for querying, and how to manage those queries.

9:15 AM - 10:30 AM | 1.25 CEUs COC, CPC, CPC-P, CPB, CPPM

3E: Optimizing Patient Flow/Mastering the Appointment Schedule

MariaRita Genovese, CPC

Few practices have mastered the appointment scheduling process. Learn how to diagnose an inefficient schedule and understand its potential side effects. Explore strategies to get to the root problems and enhance your facility’s schedule. We will identify the barriers which are preventing your practice from achieving optimal patient flow. Come learn the type of strategies that can be implemented to make improvements.

9:15 AM - 10:30 AM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CPB, CPCO, CPPM

3F: What to do When the Audit Letter Comes

Sarah Jane Reed, CPC, CPC-I

Ms. Reed will address with the attendees the different types of external audits and their purpose (including, but not limited to, CERT, OIG, HEAT, ZPIC, MAC, MIC and commercial payer). In addition to defining and educating on what the intent of the audit is, she will provide information on how to respond and track these audits in your practice. Who should be involved - from manager to coding staff to providers - and how should you respond? Ms. Reed will also give some education tips for sharing in the practice so that staff understands the process and the importance of the audit in progress.

Breakout Session 4

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

4A: Ethics, Professionalism and Coder Liability Post Yates

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

This session will outline the revised AAPC Code of Ethics to include its core principles and why adherence to such principles is necessary in every professional discipline. We will compare professional standards expected of AAPC members with those of other recognized professional disciplines and the role that ethics plays in not only your own professional image but in the image of our members as an integral part of the healthcare team. We will then apply these principles to outline the potential liabilities that coder’s face under the False Claims Act in light of the DOJ Yates memo and conclude with examples where administrative personnel have been prosecuted for misconduct.

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

4B: Pathophysiology of Respiratory Failure and Clinical Documentation Improvement

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

This presentation will provide: An in depth review of anatomy, physiology and pathophysiology of the respiratory system and respiratory failure; Documentation criteria for acute versus chronic respiratory failure; DRG impact based on the diagnosis of respiratory failure and the risks incurred when documentation does not support the billed diagnoses.

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

4C: Wanna Cry? – Don't! – Prevent Cyber Chaos and Ransomware Attacks

Paul Hales, JD

The U. S. Healthcare industry is heavily targeted by Cyber Criminals – Business Associates including billing and coding companies and Healthcare Providers alike. 72 % of Healthcare Cyber Attacks involve Ransomware according to the Verizon 2017 Data Breach Investigations Report. New types of Ransomware are particularly dangerous. They not only lock up your information system – they steal Protected Health Information (PHI). The U. S. Department of Health and Human Services (HHS) underscored the danger by announcing that a Ransomware attack is presumed to be a Breach under the Breach Notification Rule requiring notification of all affected individuals if it encrypts a Business Associate's or Covered Entity's Electronic Protected Health Information (EPHI) unless the organization can demonstrate and document the Ransomware Attack resulted in only a low probability of compromise to the EPHI. In this session Paul Hales will capture your attention with visual presentations and up to date information that explains – step-by-step – how to prevent, prepare for, respond to and recover from a Ransomware Attack using the HIPAA Rules. HIPAA provides a blueprint to combat Ransomware. Following HIPAA Rules is easy when you know the steps. Key Takeaway – A Blueprint to Prevent Cyber Chaos and Ransomware Attacks using and complying with the HIPAA Rules.

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

4D: Inpatient Coding 101: The Transition from Outpatient to Inpatient Coding

Leonta Williams, CPC, CPCO, CEMC, CHONC

This presentation will highlight general knowledge-based criteria needed to transition to inpatient coding including terminology, policy/procedure, facility coding guidelines, productivity/accuracy goals, etc.

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

4E: Billing Compliance: Denials and Appeals

Angela C Boynton, COC, CPC, CPCO, CPC-P, CPMA, CPC-I

Ever been frustrated by the wall payers tend to surround themselves with? Ever seem like payers speak a foreign language? Then this session is for you! In this session we'll cover claims issues, denials and appeals, basic communications, and the importance of policy in the payer world. We'll discuss strategy and tactics of how we can begin to break down barriers to successful payer communications.

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

4F: Audit Scope and Sampling

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

These two parts of the audit process set the tone for the whole audit. In this session, we will discuss the steps needed and questions to consider to determine the scope and make the selection to ensure the audit provides the information that was requested.

Exhibit Hall

12:00 PM - 1:30 PM

EH3: Lunch with Exhibitors

Breakout Session 5

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, CPEDC, CPPM, CPRC, CRC, CRHC, CSFAC, CUC

5A: Long live MACRA Coders

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

This is a 2017 MACRA Survival Guide-- an immunization against the changes that a can harm a provider’s revenue cycle when they work with coders who don’t know what they don’t know. Frustrations over the complicated new law known as MACRA are looming for physicians who are already drowning in change fatigue. In addition to evaluating APMs and MIPS practices have the daunting task of training. They need to create communication workflows to support conversations with individual providers about their performance under the problem program, which for many will be complicated by weighted performance categories. For many coders, the quality payment under MACRA program is not clearly understood ---which means we can’t help (and might even hurt) our providers’ revenue cycle. Join Raemarie Jimenez to learn the basics, map a strategy, and implement a planned survival guild to help providers make the move smoothly and with as little disruption as possible.

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

5B: Neonatal Abstinence Syndrome

Tami DeLuca, CPC, CPC-I

This presentation provides the definition and prominence of the growing epidemic of Neonatal Abstinence Syndrome. In this session we will discuss typical clinical scenarios, management options and how to appropriately determine CPT and diagnosis code selections. Additionally we will review cost and current legislative trends.

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

5C: Keys to Effectively Lead and Influence Successful Revenue Cycle Management Without Doing the Work Yourself

Dixon Davis, MBA, MHSA

Be confident as an administrator or manager to lead revenue cycle activity in your practice by applying leadership skills, key metrics, and communication specific to RCM. You will leave renewed on how you can solve problems, lead process improvement, and set the right culture for a strong revenue cycle.

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

5D: Charge Description Master (CDM), Best Practices and How to Sustain

Robert Gilbert, COC

This presentation will go over the topic of the Charge Description Master (CDM). By the end of the presentation the user should be able to know what a CDM is, how organizations use them. Where the common pitfalls are, how to set one up and then maintain it.

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

5E: Spinal Coding - Coding for Spine takes a real 'back-bone' to get it right

Margie Scalley Vaught, COC, CPC, CPC-I

With all the changes, bundling and unbundling of codes it is hard to keep up with everything. During this breakout session we will look at the fusion codes, decompression codes, instrumentation and cage coding as well as the many options for a discectomy. But one of the most important aspects is the Medicare policy that is taking form regarding medical necessity issues relating to ICD-10 diagnosis conditions.

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

5F: Coding Vs Auditing

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

Coders are taught very strict guidance and rules of code selection look-up, proper order of selection, and linking codes correctly, but the art of abstracting medical necessity from the documentation is oftentimes not taught until one reaches the world of auditing. This creates problems in that coders typically assign the codes prior to claim submission which may mean that medical necessity is not evaluated. During this session, we will explore this difference and how to ensure that medical necessity can be extrapolated through all areas of coding and auditing. 

Exhibit Hall

2:45 PM - 3:15 PM

EH4: Break with Exhibitors

Breakout Session 6

3:15 PM - 4:30 PM | 1.25 CEUs COC, CPC, CPC-P, CCC, CCVTC, CEMC, CFPC, CIMC, CPB, CPPM, CUC

6A: Coding Chronic Conditions

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

Chronic conditions account for a large percentage of healthcare dollars. The accurate capture of these charges is critical. Our discussion will include helpful tips to ensure documentation is thorough and complete. We will review the importance of reporting manifestations and combination codes. Chronic conditions discussed in this presentation include diabetes mellitus, congestive heart failure, kidney disease, heart disease, and sepsis.

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

6B: Documentation for ED Visits with "Additional Work-Up" Planned

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

One of the most debated areas of Evaluation/Management (EM) code documentation is the Emergency Department (ED) and what constitutes 'additional work-up planned' when using high level codes (99284-99285) in an ED place of service for a physician claim. CMS leaves the definition to payer discretion as well as providers can also have their own definition. This module will help to clarify some of the common areas of documentation that should be in place if a high level E/M code is used in an ED place of service.

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

6C: Creating Your Professional Path in Healthcare Compliance

CJ Wolf MD CHC CCEP CIA, COC, CPC

The health care compliance arena is a growing professional field. What is the best way for you to navigate your path in the compliance profession? What resources are available for those wanting to transition into the field of health care compliance? How can those who’ve been in the compliance profession take that next step in their compliance career? What does the future hold for the profession? The answers to these and more questions will be discussed. Submit questions in advance to the speaker who is a seasoned compliance professional by emailing him at cj.wolf@healthicity.com.

3:15 PM - 4:30 PM | 1.25 CEUs 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, CPEDC, CPPM, CPRC, CRC, CSFAC, CUC

6D: Documentation for Wound Care - It's in the Details!

Linda Martien, COC, CPC, CPMA

What’s in a note? It’s the details! Come to this session prepared to examine wound care encounter chart notes. We will review common standard criteria as well as Local Coverage Determination documentation requirements. But there are other standards, too. Do you know what they are? We will then review wound care encounter notes and their documentation provided and evaluate it based on what we learn.

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

6E: Resume Building and Interview Techniques for Coders

Pamela J Brooks, COC, CPC

Ever think about a new coding career? Has it been awhile since your last job interview? Not sure how to dust off your resume and make that first move? This interactive and fast-paced session will show you elements of a great resume, give you some job search ideas, help prepare you for that next interview, teach you how to sell yourself and get you started on thinking about that next career move. Pam Brooks, MHA, COC, PCS, CPC is a coding and hiring manager with over 25 years’ experience in healthcare and personnel management. She shares tips and tricks to help you nail that next interview and get the job of your dreams.

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

6F: Deep Dive – The Incident-To Rule – Common Misconceptions and Fraud Liability

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

This advanced interactive session will outline through common examples the more problematic elements of the CMS incident-to rule as well as address the compliance risks associated with reporting services under this rule. Common misconceptions leading to mis-reporting will be addressed. Even attendees with advanced knowledge of this rule will walk away with a more complete understanding of the “integral although incidental” and “auxiliary personnel” components of the rule.

Wednesday, October 18, 2017

Exhibit Hall

7:00 AM - 8:00 AM

EH5: Continental Breakfast with Exhibitors

General Session

8:00 AM - 9:00 AM | 1.25 CEUs COC, CPC, CPC-P, CDEO, CPB, CPPM

GS3: Codes - It's Not Always About Payment

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

Reimbursement models are ever changing and now emerging models will change how we get paid but does that mean the use of codes will change too? Learning how valuable data obtained from codes and how it can support any payment model (e.g., MACRA and MIPS) can help transform your practice, your documentation and your physician buy in.

Breakout Session 7

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

7A: The EMR said it was a 99215

Angela M Jordan, CPC, COBGC

Leveling E/M services in an EHR can be perilous. During this session we will explore the parts of the electronic health that are off limits, and areas that are questionable for compliance when determining the E/M level for an encounter.  We will apply CMS guidance to ROS, PSH, and template information in the EHR to E/M coding, with case studies from EHRs.

9:15 AM - 10:30 AM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CCPC, CPB, CPCO, CPPM

7B: Auditing and Coding Secrets for Physical Medicine (Chiro/PT)

Evan M Gwilliam DC, CPC, CPMA, CPC-I, CCPC

Post payment reviews and false claims analyses are increasing for physical therapists and chiropractors. In this presentation, Dr. Gwilliam, a clinician who is also a CPC and CPMA, will examine the difference between modalities and therapeutic procedures, and review the most common errors made by providers and coders when using physical medicine codes. He will also teach what the clinical indications are that support specific procedure codes, and how providers should document functional progress to support medical necessity.

9:15 AM - 10:30 AM | 1.25 CEUs COC, CPC, CPC-P, CIC, CPB, CPPM, CRC

7C: Introduction to Risk Adjustment

Sheri Poe Bernard, COC, CPC, CDEO, CPC-I

This session will give you the low-down on risk adjustment, and how it is a growing opportunity for medical coders. Learn how risk adjustment differs from other types of coding, apply what you learn as we walk through some coding scenarios.

9:15 AM - 10:30 AM | 1.25 CEUs COC, CPC, CPC-P, CPB, CPPM

7D: How Psychiatry Plays a Role in ACOs Today

Glenda L Hamilton, COC, CPC, CPC-P, CPMA, CEMC

With the creation of Accountable Care Organizations (ACOs) a group of health care providers who agree to share responsibility for the quality, cost, and coordination of care with aligned incentives for a defined population of patients the Multi-specialties involvement can become complex. We will be looking at the new role Psychiatrist and Psychologists play along with PCPs both together and independently. What are acceptable codes for the POS and on same DOS.

9:15 AM - 10:30 AM | 1.25 CEUs COC, CPC, CPC-P, COPC, CPB, CPPM

7E: Ophthalmology Updates and Coding Tips

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

In this session, we'll be covering the 2017 coding updates for opthalmology. You'll also learn coding tips for dealing with top issues related to opthalmology as well as how to strategically work with physicians to capture information needed for medical policy.

9:15 AM - 10:30 AM | 1.25 CEUs CPMA, COC, CPC, CPC-P, CDEO, CPB, CPCO, CPMS, CPPM

7F: How to Successfully Communicate Audit Results in 4 Simple Steps

Stephani E Scott, CPC

While most auditors are committed to effectively communicating post-audit results, it can still be pretty tricky. Once a documentation audit has been performed, you have to deliver a thoughtful, clear explanation of those results to the provider. Sometimes it goes great, and other times you learn vital lessons that make you exponentially better in the future. In this session, you’ll learn how to prioritize the most pertinent information and help you learn how to interpret audit results and communicate those results in a meaningful way through: • Understanding Organizations and Their Unique Workflows • Preparing Results in an Engaging, Clear Manner • Delivering Education Through Succinct, Clear Lessons • Following up on Those Results Through Re-audits and Education

General Session

10:45 AM - 12:00 PM | 1.00 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: E/M Ambiguities - Panel Discussion (Open Forum)

Rhonda Buckholtz, CPC, CDEO, CPMA, CRC, CPC-I, CENTC, CGSC, COBGC, COPC, CPEDC; Michael D Miscoe, Esq, CPC, CPCO, CPMA, CASCC, CCPC, CUC; Jaci J. Kipreos, COC, CPC, CPMA, CPC-I, CEMC

A panel of industry experts including auditing, compliance/legal, physician and payer representatives will host an interactive discussion of the most common problems with proper reporting of E/M services.  The panel will respond to questions from attendees regarding troublesome E/M documentation and scoring issues.  The perspective of each panel member on these common issues will provide attendees with valuable insight that can be applied when developing internal compliance policies for resolving these concerns. 

Exhibit Hall

12:00 PM - 1:00 PM

EH6: Lunch with Exhibitors

General Session

1:00 PM - 2:00 PM | 1.00 CEUs CPMA, COC, CPC, CPC-P, CANPC, CASCC, CCC, CCPC, CCVTC, CDEO, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIMC, COBGC, COPC, COSC, CPB, CPC-9, CPCD, CPCO, CPEDC, CPPM, CPRC, CRC, CRHC, CSFAC, CUC

GS5: ICD-10-CM 2018 Coding Updates

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

Even though we have over 69,000 codes, it’s not the numbers we focus on but what is contained in them. There are many additions and revisions for 2018 that will help us to be able to better demonstrate the true clinical condition of the patient. We will discuss the ICD-10-CM coding updates, guideline changes that are available and the clinical aspects of the coding system. We will also discuss any new documentation challenges with the revised and new codes.