2019 CPT Update: Get Paid Quickly & Correctly! Coding, Billing and Doc
Live Webcast

2019 CPT Update: Get Paid Quickly & Correctly! Coding, Billing and Documentation Strategies for Physical and Occupational Therapy Services


Faculty:
Rick Gawenda
Duration:
Full Day
Product Code:
LWC063495
Brochure Code:
PLW67632
Media Type:
Live Webcast


Description

Are you losing money? Do the documentation and CPT rules and regulations have you scratching your head?

Staying current with the ever-changing payment and documentation rules and regulations is critical to ensure that you are paid correctly and in a timely manner.

This exciting and up-to-date live webcast is your #1 source for PT & OT CPT codes, use of modifier 59, billing and documentation rules and regulations.

Watch insurance billing expert Rick Gawenda, PT, and learn how to accurately navigate the reimbursement guidelines and regulations as they pertain to outpatient therapy services. Billing scenarios will be reviewed to ensure you can accurately charge patients correctly for their service for Medicare and non-Medicare beneficiaries. At the end of the day, you will leave with a new found understanding of why claims are denied and how to maximize your reimbursement legally and ethically.

Watch and you will learn how to accurately:

  • Bill the appropriate PT & OT evaluation codes using the required components
  • Use CPT and L codes in all outpatient settings
  • Differentiate between Column 1 and Column 2 NCCI Edits
  • Use the new subsets of modifier 59 as they apply to outpatient therapy
  • Maximize reimbursement when faced with Medicare’s “8-Minute Rule”
  • Code for “each 15-minutes” and what is considered “substantial” portion for private insurance companies
  • Implement the necessary components of documentation to support skilled therapy services for payment
  • Write function-based short- and long-term goals based on the patient’s functional deficits
  • Provide the requirements for developing plan of care and the certification/recertification process

This live webcast is applicable to rehabilitation professionals in all outpatient settings, including private practice, hospital-based rehab agencies, comprehensive outpatient facilities, skilled nursing facilities, and even in your patient’s home.

Credits

*

NOTE: Tuition includes one free CE Certificate (participant will be able to print the certificate of completion after completing and passing the on-line post-test evaluation). 

Continuing Education Information: Listed below are the continuing education credit(s) currently available for this live interactive webcast. Please note, your state licensing board dictates whether web based activities are an acceptable form of continuing education. Please refer to your state rules and regulations. If your profession is not listed, please contact your licensing board to determine your continuing education requirements and check for reciprocal approval. For other credit inquiries not specified below, please contact cepesi@pesi.com or 800-844-8260 before the event.

Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals.  As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

CE Information is based on 100% attendance.

Information obtained in this course should be used within your scope of practice.


Coders

This program has the prior approval of the American Academy of Professional Coders (AAPC) for 6.25 continuing education hours. Granting of prior approval in no way constitutes endorsement by the AAPC of the program content or the program sponsor. AAPC approval good thru .


Nursing Home Administrators

This educational offering has been reviewed by the National Continuing Education Review Service (NCERS) of the National Association of Long Term Care Administrator Boards (NAB) and approved for 6.25 clock hours and 6.25 participant hours. Full attendance is required; no partial credits will be offered for partial attendance.


Occupational Therapists & Occupational Therapy Assistants

AOTA

PESI, Inc. is an AOTA Approved Provider of continuing education. Provider #: 3322. Full attendance at this course qualifies for 6.0 contact hours or .6 CEUs in the Category of Domain of OT and Occupational Therapy Process. Partial credit will be issued for partial attendance. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA. Course Level: Intermediate.


Florida Occupational Therapists & Occupational Therapy Assistants

CE Broker

PESI, Inc. is an approved provider with the Florida Board of Occupational Therapy. Provider Number BAP #77. This course qualifies for 6.3 continuing education credits.

** Florida Particpants Only: To automatically be reported to CE Broker, after completing and passing the online post-test/evaluation, please contact cepesi@pesi.com to have your Florida credits reported to CE Broker. You will need to provide the full title of the webcast, speaker name, date of live broadcast, your name and your license number in the email.


Physical Therapists & Physical Therapist Assistants

This activity consists of 6.0 clock hours of instruction that is applicable for physical therapists. This certificate is proof of your attendance. Please retain it in your records or use for submission as proof of completion when required.


California Physical Therapists & Physical Therapist Assistants

California Physical Therapists

PESI, Inc. is recognized by the Physical Therapy Board of California as an approval agency to approve providers. This course will qualify for 6.25 continuing competency hours.


Illinois Physical Therapists & Physical Therapist Assistants

MEDS-PDN, powered by PESI, Inc. is a Registered Physical Therapy Continuing Education Sponsor through the State of Illinois Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 216.000270. This course qualifies for 6.0 CE Credit Hours. 


Maryland Physical Therapists & Physical Therapist Assistants

This course meets the basic criteria of the Maryland State Board of Physical Therapy Examiners and has been approved for .6 CEUs.


New York Physical Therapists & Physical Therapist Assistants

PESI, Inc. is recognized by the New York State Education Department, State Board for Physical Therapy as an approved provider for physical therapy and physical therapy assistant continuing education. This course qualifies for 7.5 contact hours. 


Texas Physical Therapists & Physical Therapist Assistants

This activity is provided by the Texas Board of Physical Therapy Examiners Accredited Provider #2106032TX and meets continuing competence requirements for physical therapist and physical therapist assistant licensure renewal in Texas. This activity will provide 6.25 CCUs. The assignment of Texas PT CCUs does not imply endorsement of specific course content, products, or clinical procedures by TPTA or TBPTE. Full attendance is required; no partial credits will be offered for partial attendance.


Other Professions

This activity qualifies for 6.25 continuing education clock hours as required by many national, state and local licensing boards and professional organizations. Save your activity advertisement and certificate of completion, and contact your own board or organization for specific requirements. 


Handouts

Faculty

Rick Gawenda Related seminars and products: 1

PT


RICK GAWENDA , PT, is a licensed physical therapist with 22 years of experience and currently serves as the founder and President of Gawenda Seminars & Consulting, Inc. He graduated with a Bachelor of Science degree in Physical Therapy from Wayne State University in Detroit, Michigan, in 1991. Mr. Gawenda is also Director of Finance for Kinetix Advanced Physical Therapy, a private practice with offices located in Southern California. In addition, he previously worked as the Director of Physical Medicine and Rehabilitation at Detroit Receiving Hospital, where he was responsible for physical therapy, occupational therapy, and speech-language pathology services, both in the inpatient and outpatient setting.

Mr. Gawenda has provided valuable education and consulting to hospitals, private practices, skilled nursing facilities, and rehabilitation agencies in the areas of CPT coding, ICD-9 and ICD-10 coding, billing, documentation compliance, revenue enhancement, practice management, and denial management as they relate to outpatient therapy services. Mr. Gawenda has presented nationally since 2004 and currently presents approximately 100 dates per year around the United States.

Mr. Gawenda is a member of the American Physical Therapy Association (APTA) and Michigan Physical Therapy Association (MPTA). Mr. Gawenda is the Past President of the Section on Health Policy & Administration of the APTA, as well as Past President of the Michigan Association of Medical Rehabilitation Program Administrators. Mr. Gawenda is also the author of “The How-To Manual for Rehab Documentation: A Complete Guide to Increasing Reimbursement and Reducing Denials” and “Coding and Billing For Outpatient Rehab Made Easy: Proper Use of CPT Codes, ICD-9 Codes and Modifiers”.

Speaker Disclosures:

Financial: Rick Gawenda is the founder and president of Gawanda Seminars & Consulting, Inc. He has an employment relationship with Kinetix Advanced Physical Therapy. He receives royalties as an author for HCPro, Inc. He receives a speaking honorarium from PESI, Inc.

Non-financial: Rick Gawenda has no relevant non-financial relationships to disclose.


Additional Info

Program Information

CD/DVD

Click here to purchase the DVD or CD recording from our product store.


Additional Resources

To order the book, Private Practice Essential, please visit our product store.

To order the book, Opioid Use Disorder, please visit our product store.


Access Period for Live Webcast

For live CE credit, you must watch the live webcast in its entirety at its scheduled time and complete the CE quiz and evaluation. You will have access for 90 days after the program for review. 


Webcast Schedule

Please note: There will be a lunch and two 15-minute breaks; one in the morning and one in the afternoon. Lunch and break times will be announced by the speaker and at their discretion. A more detailed schedule is available upon request.


Objectives

  1. Summarize the required components to bill the appropriate PT & OT evaluation codes.
  2. Articulate the rationale for the use of CPT and L codes in all outpatient settings.
  3. Differentiate between column 1/column 2 NCCI edits.
  4. Explain which CPT code(s) require modifier 59 appended to them on the claim form.
  5. Describe Medicare’s “8-Minute Rule’ to bill correctly and optimize reimbursement.
  6. Define “each 15-minutes” and what is a substantial portion for private insurance companies.
  7. Implement the necessary components of documentation to support skilled therapy services for payment.
  8. Develop function-based short- and long-term goals based on the patient’s functional deficits.
  9. Recite the definitions and requirements for developing plan of care and the certification/recertification process.

Outline

Therapy CPT and L Codes
  • Need to know components of Eval Codes
  • Time-based vs. service-based CPT codes
  • CPT code to bill based on your documentation and purpose of the activity
  • Settings that can be billed for pre-fabricated and custom-fabricated orthotics without needing a DME license
Modifiers
  • Accurate use of modifier-59 and how to document and support it
  • Differentiate between Column 1 and Column 2 NCCI Edits
NEW! Medicare’s “8 Minute Rule” and Post-Test Billing Scenarios
  • Bill the correct number of units for timed-based codes for Medicare and non-Medicare insurance payers
  • When to bill using Substantial Portion Methodology (SPM) for a time-based CPT code
Initial Evaluation Documentation Requirements
  • History of current illness/injury
  • Prior and current functional status
  • Objective data, functional deficits, and function-based goal writing
  • Plan of care requirements
Re-Evaluation, Progress Reports and Daily Documentation Requirements
  • Implement the necessary components of a progress report to:
    • Support the therapy already provided
    • The need for continued skilled therapy services
  • Medical Necessity
    • Apply strategies to more effectively support medical necessity and skilled services in your daily notes
  • When re-evaluation is appropriate to perform on a patient, then bill to an insurance carrier
Certification/Re-Certification
  • Certification and re-certification process for Medicare Part B therapy services
  • Required components of a Medicare certification/re-certification
  • What is considered a timely certification versus a delayed certification

Target Audience

  • Physical Therapists
  • Physical Therapist Assistants
  • Occupational Therapists
  • Occupational Therapy Assistants
  • Rehab Directors
  • Managers and Supervisors
  • Rehab Billers and Coders
  • Physicians
  • Nursing Home Administrators
  • Office Manages and Front Office Staff
  • Compliance Officers

Reviews

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