Orthopaedic Coding Course
9:00 a.m. – 3:00 p.m.
Friday, April 13, 2018
Created for orthopaedic surgeons and billing/coding staff members, Margi Maley of Karen Zupko & Assoc. will teach this all-day course that will focus on the latest orthopaedic coding updates.
Learning Objectives:
- Choose the correct E/M categories for office and hospital services.
- Define a “procedure to procedure edit”
- Differentiate CPT code definitions from NCCI procedure-to-procedure edits and narrative guidelines.
- Apply E/M and surgical modifiers so that reimbursement is optimized and accurate.
Agenda:
| Certification of TKA for inpatient surgery- are you getting denied?
Fact vs Fiction |
| Medical Necessity-What is it? Why is it SO important?
The role of diagnosis coding in medical necessity |
| Anatomy of a Payment Policy- are you getting denials for Arthroscopy?
Do you know why? |
| E/M Categories of Service and when to use them.
New vs Established Patient What is a consultation? What about Medicare What do you use when you go to the ER? |
| E/M Levels of Service and how to document them.
History, Physical Examination, Medical Decision Making |
| Any Update on the simplification of these guidelines? |
| Global Surgical Package
Pre-operative H&P – can this be reported? |
| E/M modifiers 24,25,57
Modifier-25 reductions and denials-What to do? Are the payors going to reduce my E/M service by 50% when I do an injection? |
| CPT Rules, Medicare Rules, AAOS Global Service Data Guide |
| Fracture Care and fracture package
ER, Office and Outpatient hospital. Is there a difference in reporting fracture care? Medicare rule for fractures treated with a single cast |
| Modifier 59 VS 51: Finally explained so you can understand it.
Most common orthopaedic examples. |
| Modifier 58: Staged procedures Modifier 78: Return to the OR to treat a complication Modifier 79: Unrelated procedure in the global period Modifier 22: Unusual Service Modifier 52: reduced Service |