Image of 2018 Coding and Billing for Therapy and Rehab
Digital Seminar

2018 Coding and Billing for Therapy and Rehab


Faculty:
Sherry Marchand, CPMA
Duration:
5 Hours 37 Minutes
Format:
Audio and Video
Copyright :
Jan 29, 2018
Product Code:
POS020212
Media Type:
Digital Seminar


Description

2018 Coding and Billing for Therapy and Rehab

Stay current with CPT, ICD-10-CM, and HCPCS Level II Codes.

Discover what must be done to comply with coding regulations and documentation standards. 

  • Master changes to the Medicare Therapy Cap Exception process and how it will effect patient’s out of pocket expenses.
  • Learn about orthotic and prosthetic management and training services by differentiating between initial and subsequent encounters.
  • New CMS code for development of cognitive skills to improve attention, memory and problem solving.
  • Master documentation elements, CPT coding and expected payment changes for Evaluations and Re-Evaluation codes for Physical and Occupational Therapy and Speech and Language Services.
  • Be prepared for complicated MACRA law: Physical Therapists, Occupational Therapists and Speech and Language Pathologists have new 2019 reporting requirements for MIPS and APM bundled payments. Learn what is the best next steps for your organization.

Learn the most current and accurate coding procedures coupled with documentation tips and complete definitions to ensure prompt and optimal payments for future insurance claims.

This course will equip Therapy and Rehab providers with an understanding of industry coding and billing changes that are needed to survive in this changing healthcare environment.

These topics include 2018 CPT, HCPCS and ICD-10-CM coding updates, effective billing, revenue and documentation techniques and best practices. Claims processing guidelines for 837p and 837i claim format. Prevent denials, delays and rejections by understanding how to combat these with effective appeals. Gain strategies for optimal reimbursement from Medicare, managed care, and insurance companies.

Denials, delays, and "more information required" are increasingly common responses for therapy and rehab insurance and Medicare claims. New codes and reimbursement policy changes have further complicated the claims process for physical and occupational therapists and facility-based rehabilitation providers. Effective Medicare and insurance billing requires a thorough understanding of coding, documentation and billing procedures. Consolidating all of the new requirements with existing coding rules and implementing proven billing techniques are the objectives of this seminar. You will learn the most current and accurate coding procedure coupled with documentation tips and new definitions to ensure prompt and optimal reimbursement on future claims.

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 non-interactive self-study package. Please note, your state licensing board dictates whether self-study is 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


Nurses, Nurse Practitioners, and Clinical Nurse Specialists

PESI, Inc. is accredited as a  provider of continuing nursing education by the American Nurses Credentialing Center’s  Commission on Accreditation.

Nurses completing these self-study materials will earn 5.8 contact hours. Expires: 01/29/2021.


California Nurses

PESI, Inc. is a provider approved by the California Board of  Registered Nursing, Provider #: 17118 for 5.5 self-study contact hours. 

** You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.


Florida Nurses

CE Broker

PESI, Inc. is an approved provider by the Florida Board of  Nursing. Provider #: FBN2858. These materials qualify for 5.5 self-study contact hours.


Iowa Nurses

PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 5.8 self-study contact hours. Please email cepesi@pesi.com with your license number, include the title, speaker name and date. PESI must have this number on file in order for your hours to be valid.


Occupational Therapists & Occupational Therapy Assistants

AOTA

PESI, Inc. is an AOTA Approved Provider of continuing education. Provider #: 3322. This self-study course qualifies for 5.5 self-study contact hours or .55 CEUs in the Category of Domain of OT and Occupational Therapy Process. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA. Course Level: Intermediate. Expires: 01/29/2020.


Florida Occupational Therapists & Occupational Therapy Assistants

CE Broker

PESI, Inc. is an approved provider with the Florida Board of Occupational Therapy. Provider Number #50-399. This course qualifies for 5.8 self-study continuing education credits.


Physical Therapists & Physical Therapist Assistants

This self-study course consists of 5.75 clock hours of instruction that is applicable for physical therapists. CE requirements for physical therapists vary by state/jurisdiction. Please retain the certificate of completion that you receive and use as proof of completion when required.


California Physical Therapists & Physical Therapist Assistants

PESI, Inc. is recognized by the Physical Therapy Board of California as an approval agency to approve providers. This self-study lecture qualifies for 5.75 continuing competency hours.


Illinois Physical Therapists & Physical Therapist Assistants

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 self-study course qualifies for 5.5 CE credit hours.


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 self-study course qualifies for 7.0 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 5.75 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.


Speech-Language Pathologists & Audiologists

This course contains 5.5 hours of self-study continuing education. It was not offered for ASHA CEUs. Please retain your certificate of completion. If audited for ASHA Certification Maintenance, you can submit this certificate of completion at that time. For state licensure, teacher certification renewal, or other credential renewal, contact those agencies for information about your reporting responsibilities and requirements.


California Speech-Language Pathologists & Audiologists

PESI, Inc. is an approved provider with the California Speech-Language Pathology and Audiology Board, #PDP 319. This course meets the qualifications for 5.5 hours of self-study continuing professional development credit for Speech-Language Pathologists or Audiologists, as required by the California Speech-Language Pathology and Audiology Board.


Kansas Speech-Language Pathologists

Approved for 7.0 self-study continuing education clock hours for Kansas licensed Speech-Language Pathologists by the Kansas Department for Aging and Disability Services.



Handouts

Faculty

Sherry Marchand Related seminars and products: 2

CPMA


SHERRY MARCHAND, CPMA, is a reimbursement analyst and a billing, collection, and chart-auditing consultant with more than 25 years of experience in the health care industry, including hospital and physician group billing, and collection management. She has served as an expert witness/consultant in Medicare, Medicaid, ALJ hearings, and criminal fraud cases. Her vast knowledge of the practice management process has come from working in various levels of health care accounting, including the management of international hospital billing. As a certified, self-employed practice management consultant and chart auditor, Ms. Marchand has helped numerous medical offices take control of their cash flow through implementation of billing and documentation processes. Her specialties include Internal Medicine, Obstetrics, Mental Health, Physical Therapy, Cardiology, ENT, and Surgical Specialties. Ms. Marchand is skilled in installation training and implementation of hardware and software systems that are right for the health care arena. Ms. Marchand has many tips and tools to assist your office on the road to healthy patients and insurance collections.

Speaker Disclosures:

Financial: Sherry Marchand is the owner of Advanced Physician Services. She receives a speaking honorarium from PESI, Inc.

Non-financial: Sherry Marchand is a member of the American Academy of Professional Coders.


Additional Info

Program Information

Access for Self-Study (Non-Interactive)

Access never expires for this product.


Objectives

  1. Discuss required elements and problem areas of documentation for Therapy and Rehab Services
  2. Learn about how to document to support ICD-10-CM diagnosis coding through the use of signs and symptoms to support medical necessity
  3. Hands-on guidance on how to find and stay current on Medicare fee schedules, payment policy, internet only manuals, LCD’s and NCD’s. Commercial insurance rehabilitation services payment policies will also be explored
  4. Identify procedure codes for rehabilitation services
  5. Determine the correct usage of procedures and documentation requirements
  6. Discuss CPT and ICD-10 coding for optimal reimbursement
  7. Identify upcoming changes to billing and coding
  8. Explain effective use of modifiers and coding combinations
  9. Discover how place of service affects reimbursement
  10. Illustrate tips and techniques for medical record requirements
  11. Outline what you must know about physician certification requirements

Outline

CPT/HCPCS PROCEDURE CODES and COMPLIANCE WITH DOCUMENTATION STANDARDS
  • Provides credentialing resources
  • Explore the Revenue Cycle
  • Evaluations and Re-Evaluations for Physical Therapy, Occupational Therapy and Speech Services. (Includes tools for changes in criteria.)
  • Orders
  • Plan of Care, Certification/Re-certification Rules Checklist
  • CPT Procedure codes used in Therapy and Rehab
    • Evaluations, re-evaluations, and assessments
    • Supervised modalities
    • Guidelines for billing therapy minutes
    • Constant attendance modalities
    • Therapeutic procedures, included changes in orthotic and prosthetic management and training and development of cognitive skills
    • Speech Pathology Services
    • Neuromuscular procedures
    • Debridement, application of strapping, splints, casts
    • Using HCPCS Level II codes for DME
    • Orthotics billed by hospitals and other providers
    • Lymphedema Service
    • Woundcare
    • Physical Performance Testing 
  • Daily Session Note Checklist
  • Discharge Checklist 
  • NCCI Edits
  • Modifiers
  • HCPCS II Procedure codes used in Therapy and Rehab
  • Functional Limitation Requirements G-codes for functional limitations and severity modifiers – required for outpatient   claims filed to Medicare
  • Place of Service Codes
DIAGNOSTIC CODING
  • New tools to prepare for ICD-10-CM – Bring your WI-FI enabled device
  • Discuss chapters that effect Therapy and Rehab
  • Laterality documentation requirements
FEDERAL REGULATIONS MEDICARE'S BILLING RULES and Special Payer News
  • Medicare Therapy Cap
  • Documentation to meet Medical Necessity in Therapy and Rehab
  • Understand changes with congressional changes and their impact on Therapy and Rehab
  • Understanding Value-Based Payment issues: (i.e. MACRA, MIPS and APM)
  • Explore resources pertaining to CMS MAC, RAC, ZIP, and CERT program guidelines
  • OIG audit focus on behavioral health services
  • Medicare’s “incident to” guidelines, definition of “incident to” services vs payer supervision
  • Overview of Commercial Plans and Therapy Coverage
  • Common forms of health care fraud and abuse
COMPLIANCE
  • Components of an effective compliance plan
  • Understanding recent reports from CMS MAC, RAC, OIG, and GAO to reduce error rates in documentation
UNDERSTANDING THE REIMBURSEMENT PROCESS
  • Understanding the claim content 837p and 837i resources
  • Explore common revenue codes used with the 837i claims formats
  • Learn about the Medicare Learning Network 
THE APPEAL PROCESS
  • Understanding reasons for denials
  • Systematic steps of responding to an appeal
  • Formats for appeal letters

Target Audience

  • Physical Therapists and Assistants
  • Occupational Therapists and Assistants
  • Speech-Language Pathologists
  • Rehab Directors
  • Managers and Supervisors
  • Billing
  • Coding
  • Reimbursement Staff
  • Administrative Staff
  • Physicians
  • Nurses
  • Medical Assistants

Reviews

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Overall:     3.8

Total Reviews: 4

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