2 - Two & a half Hour Sessions of Coding for Physicians and Staff

Most Commonly Audited Codes in Podiatry

• 11720/11721 (nail debridement)
• E/M Codes - all (-25 modifier)
• 11730 (nail avulsion)
• Wound Care Codes
• 10060/10061 (I&D of abscess)
• 11050 series (paring of skin lesions) (corns/calluses)
• Orthotics Codes
• 59 Modifier
• Injection codes (Morton's neuroma, plantar fascitis)

Session Highlights:-

Correct Reimbursements From Indemnity payers, Managed Care & Medicare

• Proposed E/M payment changes can occur as early as January 1, 2021. Single-fee E/M pay rates are poised to take over for new and established encounters. To make matters worse, podiatry may have its own, new "G codes" to replace E/M codes that will reimburse less than every other medical specialty. What do I need to know?
• Evaluation & Management guidelines for documentation of "office, home, nursing home, and consultations" are changing. We'll discuss the latest. Time and intensity are contributory factors to payment. Diagnoses count!
• Document and code for what you do. Charge and file claims according to your contracts. This principle for doing business with insurance is critical to survival.
• Modifiers, a key to opening the door to accurate reimbursement. Dealing with the latest definition of the -25 modifier could impact an increase or decrease in your revenue. It depends on your understanding and working within the new guidelines. We'll explore Podiatry's use of them all.
• What E & M service codes should be used instead of consult codes?
• Correlating your coding: New payment methods mean making those diagnoses count! Don't lose out on money that's rightfully yours. Good vs. bad diagnoses! Stay out of trouble with Medicare.

Learn Coding Techniques That Work!

• Advanced information on the legislated Medicare billing changes and the CPT coding changes for the year 2021. Who can sign for the patient?
• Using both Volumes I & II to code ICD-10 CM diagnoses correctly - Coding to the highest degree of specificity is required for accuracy & payment: How to avoid "Rule Outs" to improve reimbursement. Signs, symptoms, and ill-defined conditions are the key to proper reimbursement. What impact on podiatry?
• Exercises in Coding: Doing it right for Podiatry by reviewing your codes and making them work.
• Guidelines for HCPCS Coding: We'll show you when to use each level: Use all of the coding "Extras": Modifiers and Podiatry's special needs.

The "Tid Bits" and Fighting Back

• What triggers an audit on your claims? Can you afford it? We'll provide a superb handout with Podiatry coding techniques to help. What's happening with RAC audits?
• Eliminate the fear of fighting Medicare. You can win an audit. Don't accept down-coding when it isn't right. Medicare appeals can be appealing!
• Getting paid on the first insurance form submission. Learn the basics of what works. It is different between private, government, and managed care insurers. Be aware of computer audits on ICD-10 vs. CPT in Medicare's Correct Coding Policy. You'll learn how to cut down on payment turnaround time.
• Documentation guidelines are more critical than ever. The basis of a Compliance Plan.

Learning Objectives:-

• The 2021 ICD-10-CM changes went into effect on October 1, 2020. Have you incorporated the changes? We can help.
• The new CPT codes and changes go into effect on January 1, 2021. Are you ready?
• CMS has come up with the top issues that they are going to audit for 2020? Let's be proactive.
• Preparing for a Medicare audit.
• Use E & M services coding properly. Important clarifications for 2021.
• Understanding the new "foot care codes".
• Avoid coding errors that may trigger an audit.
• Develop your "Voluntary Compliance Program".
• How to use modifiers properly.
• Avoid claim inquiries, downloading & denials.
• The most appropriate way to code for nail debridements.
• Therapeutic shoes for patients with diabetes.

Areas Covered:-

• What is the appropriate documentation that is needed on every encounter for wound care/debridement?
• Podiatry has been and continues to be a highly audited medical specialty. What are the most commonly audited codes?
• What are the highest levels of E/M services that a podiatrist can bill?
• Medical Decision Making is the most important of the three Key Components that make up E/M service. Why?
• Beware of templates and EMRs that encourage you to improperly code higher E/M levels.
• CPT code 11730 is targeted for fraud and abuse by Medicare. What is the appropriate documentation?
• What are the appropriate rules to follow for treating a patient in a Nursing Facility?
• What documentation protects me from a prepayment audit for diabetic shoes and ultimately gets me paid?

Who Will Benefit?

• Physician
• Podiatrists
• Coding/billing