Debra Mitchell – Insurance Coding and Billing for the Medical Office: 2019

Outline

FIRST LOOK AT 2019

• The coding process
• What to expect for 2019
• The OIG Work Plan
• Proper use of prolonged time codes – how this can help your practice, immediately

THE CODING PROCESS IN THE CHANGING HEALTHCARE ENVIRONMENT

• 2019 ICD-10-CM codes—a closer look
• OIG work plan issues for physician billing
• An overview of CPT changes
• Modifiers and which ones can enhance reimbursement
• Unraveling the complexities of Medicare, Medicaid, and Third Party Insurance

NAVIGATING THE INS AND OUTS OF THE CLAIMS SUBMISSION PROCESS

• Know when documentation must be submitted with the claim
• The elements of an incident-to claim
• Recognize CCI edits (bundling) and understand how and when to unbundle

DOCUMENTATION, DOCUMENTATION

• What to do if you have been downcoded
• How to analyze and solve difficult billing problems
• What to look for with a denial for medical necessity
• Understand what to use from the documentation for an appeal or correction

EFFECTIVE TECHNIQUES FOR BETTER BILLING

• How to avoid the most common errors
• Know when to appeal and when to “write it off”
• Understanding the importance of physician profiling
• News from the CMS front that may impact your billing