Catalog Number : cra1279
Title : ED Coding, Billing & Reimbursement for Critical Access Hospitals
Speaker : Duane Abbey

Webplay Recording Date : 7-16-2009
Webplay Price : $ 150 for two weeks viewing

Webinar Overview:

A major reason for your Critical Access Hospital is to provide virtually all levels and types of emergency services. As such, special requirements involving coverage and use of non-physician personnel are allowed. While your payment is not directly related to coding and billing, you must still follow standard guidelines when coding and billing for emergency and urgent care conditions.

Is your hospital receiving the appropriate reimbursement for all the services that are provided in the emergency department?

Good question… but would the answers be frightening.

The procedures that are performed in the emergency room and sufficiently documented should be coded and billed, but this is where a dilemma still exists. Are your coders not clear at times what should be and should not be coded? Injections and infusions, for example, tend to be the most frequently performed procedures, but are not coded or coded incorrectly.

A LIVE Webinar at 1 p.m. Central - on Thursday, July 16, 2009

Webinar Level: Advanced

Webinar Objectives:

• To review the levels and types of services in the ED
• To understand the general coding and billing requirements for ED services for the Critical Access Hospital
• To discuss the both technical and professional component claims generation for ED services
• To appreciate Method II billing and payment advantages
• To understand E/M level coding and relationship to the EMTALA mandated MSE (Medical Screening Examination)
• To appreciate surgical services and the associated coding and billing for such services
• To appreciate the need for special ED coding and billing policies and procedures
• To work through a series of exercises that illustrates the difficulties in coding and billing for ED services
• To address special issues such as non-physician practitioners and the provision of clinical level services

A few of the Topics that will be covered:

• Overview of ED Services
  • Emergency Care
  • Urgent Care
  • Clinical Services Provided in the ED
• EMTALA Considerations
  • MSE - Medical Screening Examination
  • Stabilization and Transfer Rules for the Critical Access Hospital
• Billing ED Services
  • “-25” and “-59” Modifiers
  • Multiple Encounters on Same Day
  • Interface to Observation Services
  • Interface to Inpatient Admissions
• Documentation Systems and Processes in the ED
  • Check-Off Systems
  • Dictated Notes
  • Handwritten Flow Sheets
• E/M Coding in the ED
  • Physician E/M Coding
  • Hospital E/M Coding
  • Case Studies
• Surgical Coding and Billing for the ED
  • Lacerations o Fracture Care
  • Burn Care
  • Injections and Infusion Therapy
  • Case Studies
• Special ED Coding and Billing Situations
  • Correlating Physician and Hospital Coding
  • Use of Non-Physician Practitioners in the ED
  • Special Considerations for the Critical Access Hospital
• The Future of ED Coding and Billing

Prerequisites for Participating:

• General knowledge of Critical Access Hospital payment along with some knowledge of CHA payment methodologies.

Target Audience:

• ED and urgent care coding and billing professionals
• health information management professionals
• Chargemaster coordinators
• E/M hospital and physician coding professionals
• financial analysts
• compliance officers

Attendance Certificate: Upon attending this course you will receive a 1.5 Contact Hour Attendance Certificate. There is usually a reciprocal agreement between state associations to allow these to count for each state. If you have any questions, please ask your state association.

Full tuition is refunded immediately on request if the participant has not been sent the program materials and instructions. Once the instructions (including access codes) have been sent, a full refund will be issued only after the program runs and it is verified that the participant did not access the program.