Healthcare Crossroads

A podcast showcasing the connections in Healthcare Data, Compliance and Patient Care

Surgery Coding: Dissecting an Operative Note

I get many questions about how to read and dissect an operative report. In an effort to answer some of those questions I have decided to talk about the process in this episode.

  • Operative Report Elements
  • Getting Organized
  • Understanding the Medical Necessity

Learn more about Surgery coding for OBGYN Services at our conference Saturday 2/12/22

www.obgynsummit.com

Join our Annual Patreon membership to get CEUS for select episodes. www.patreon.com/lifeasacoder

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Telehealth challenges during the PHE and Beyond 1 CEU available

During the Public Health Emergency our world in the Business of Healthcare is constantly changing. One area we see constant movement in is Telehealth Services. Today my special guest Christine Hall and I will discuss this topic and some reminders on Coding based on the current IC10-CM Covid 19 Guidelines.

  • What is the difference between Telehealth before and after the PHE?
  • How can practices to be successful in making sure the claims get out to the right POS?
  • For the Telehealth services there is a Telehealth Services List. How do we understand these different categories?
  • What changes occurred in 2022 for Behavioral Health how will this benefit this service line?
  • Under telehealth there are all these waivers and allowances. How can practices get organized and maneuver through all the changes?
  • What are some reminders when reporting ICD10-CM Covid 19 based on the guidelines?

Official Guidelines for ICD10-CM 2022

COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing

Medicare FFS Response to the PHE on COVID-19

ACP Resources for Practices

Check out the Authparency Website http://authparency.com/

Watch a Demo

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Be successful with Evaluation and Management in 2022

I’m going to make E/M coding easy for you in 2022 and review how to use the official AMA®️ MDM Table to level your codes. Plus key areas of Strategy for your practice. There will be 1 a CEU for this bonus episode if you are an All Access or VIP member. Join the membership at www.patreon.com/lifeasacoder

CPT® is a registered trademark of AMA

  • Work on your 2022 education plan
  • Understanding 2021 guidelines before more changes occur in 2023
  • Helping providers stay current with Internal and External Education
  • PHE Waivers and allowances
  • Using the right modifiers
  • Tracking Denials
  • Audit Strategy

Watch the Live Video to view the slides and comment with your questions: https://vimeo.com/662376984

Check out these cool references:

How to Use the MPFS Look-Up Tool

2021 AMA® Guidelines

Implementing CPT® Evaluation and Management (E/M) revisions

Check out the Authparency Website http://authparency.com/

Watch a Demo

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Risk Adjustment: Data driven Healthcare

In our first episode of Season 5 we are hitting the ground running with a popular topic. Creating a Risk Adjustment Education experience for Coders and Facilities will be so valuable for the Industry and help improve the quality of patient care. The data we collect and the education we provide as Risk Adjustment educators and coders helps to accomplish this.

  • How to improve your Risk Adjustment Team
  • What does it take to discoverthe financial Impact of your Risk Adjustment program integrated through data solutions?
  • How can a Risk Adjustment education program Reduce Coding Errors and ensure Complete code capture toaccount for proper reimbursements, manage costs of high-risk patient populations, and provide a high quality of care?
  • What is the value in bringing in Subject Matter experts to educate Coding staff on Risk adjustment?

Check out the Authparency Website http://authparency.com/

Watch a Demo

Contact jmcnamara@oncospark.com for more information on our Upcoming Risk Adjustment Experience. Support us by joining our Podcast membership. You can save up to 16% off your membership by paying annually. Visit www.patreon.com/lifeasacoder

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An Orthopedic Review and what’s new in 2022 1 CEU

There are many new changes to Orthopedic Coding in 2022. I will discuss those changes and how to be successful in reimbursement for these services. I will talk about the challenges I faced as a new coder and how I have been successful in Orthopedics.

  • New 2022 Guideline revisions
  • Fracture Care and Modifier 54
  • New Spine codes for Laminectomy
  • Understanding Fracture Care ICD10-CM Guidelines
  • Understanding NCCI guidelines and PTP Edits
  • Understand Modifier 25 in 2021 and beyond

Get a CEU if you are an All Access or VIP member

CPT® is a registered trademark of the AMA

NCCI Chapter 4a

AAOS on Fracture Care

Reference: CPT Changes 2022 AMA (C)

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Stay Compliant with Copay Collections

Did you know that Copay collections are required when you enter into a contract with an Insurance payer and that Routine Waiver of copays is against many Federal laws and regulations Including the Civil Monetary Penalties Law (CMPL), Anti-Kickback Statute (AKS), and the False Claims Act?

Today we dive into the Laws and the regualtions so we can be compliant.

  • What is a Copay?
  • How to Understand Cost Sharing
  • The Anti-Kickback Statute and Copays
  • The False Claims Act
  • QMB Status

Check out these great resources:

Why can Copay Waiving be Illegal?

UHC Administrative Guide

False Claims Act

OIG Special Fraud Alerts

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