Clean Up Wound Care Coding, Reduce Audit Risk: 2018 Coding and Guideline Updates

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Clean Up Wound Care Coding, Reduce Audit Risk: 2018 Coding and Guideline Updates

Product Code: YHHA032818

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Clean Up Wound Care Coding, Reduce Audit Risk: 2018 Coding and Guideline Updates

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Loyal Listener Library

Presented on:
Wednesday, March 28, 2018
1:00-2:30 p.m. Eastern

Presented by:
Gloria Miller, CPC, CPMA, CPPM

Level of Program:
Intermediate

Sponsored by:
JustCoding

Wound care coding and billing often carries unique challenges compared to other specialties, as wound size, depth, and severity must be properly documented to report the most accurate codes. With the addition of new ICD-10-CM code combinations for reporting non–pressure ulcer diagnoses in 2018, coders’ jobs have become even more difficult. Wound care clinics are also facing increased scrutiny from auditors and the Office of Inspector General regarding the reporting of services such as hyperbaric oxygen treatment.

During this 90-minute webinar, Gloria Miller, CPC, CPMA, CPPM, will review the latest ICD-10-CM codes and coding guidelines applicable to wound care services. Miller will discuss best practices for wound care documentation, coding, and billing, as well as implications of both the Targeted Probe and Educate program and the 2018 OPPS updates on coding and reimbursement for clinics. She will also explain how to find available Medically Unlikely Edits (MUE) for certain procedures and proper application of the -X{EPSU} modifiers and modifier -59.

At the conclusion of this program, participants will be able to: 

  • Locate appropriate diagnosis codes for wound care local coverage determinations (LCD), as well as available MUEs for procedures
  • Describe LCD coverage limitations and pricing for high- and low-cost skin substitutes
  • Determine risk areas identified by CMS’ Targeted Probe and Educate program
  • Properly apply -X{EPSU} modifiers
  • Explain changes to payment for provider-based clinics in 2018


Who Should Listen? 

  • HIM managers and staff
  • Outpatient coding managers and staff
  • Wound care staff
  • Compliance staff
  • Chargemaster coordinators
  • Finance staff
  • Provider-based clinic billers and coders
  • Revenue integrity staff


Agenda 

  • Medical necessity for wound care procedures
    • Documentation necessary to meet medical necessity
    • Finding diagnosis codes related to medical necessity
  • 2018 ICD-10-CM wound care codes
    • Defining non–pressure related ulcers
    • Documentation needed to identify stages
  • When to use modifier -59 vs. -X{EPSU} modifiers
    • Case studies
    • CMS guidance
  • 2018 updates to payments for wound care clinics
    • Reductions associated with the latest OPPS final rule for off-campus, provider-based clinics
    • Pricing for high- and low-cost skin substitutes
    • LCD coverage limitations
  • CMS’ Targeted Probe and Educate program for identifying and correcting billing errors
    • Identifying high-risk areas for potential audit
    • Finding gaps in documentation to reduce audit risk
  • MUEs
    • Procedures likely to run against MUEs
    • Where to find available MUEs
  • Live Q&A

 

Tools

  • A list of the 72 new ICD-10-CM codes for non-pressure related ulcers


Meet the Speaker

Gloria Miller, CPC, CPMA, CPPM

Gloria Miller, CPC, CPMA, CPPM, is vice president of reimbursement services at Comprehensive Healthcare Solutions, Inc. in Seattle, where she assists hospitals with correct documenting, coding, and billing for wound care and hyperbaric oxygen services. She has many years of varied experience in healthcare reimbursement, including durable medical equipment, hospital billing, skilled nursing facility billing, and infusion pharmacy billing.


Webinar system requirements and program materials: 
To fully benefit from the webinar experience, please note you will need a computer equipped with the following:

Browser: Microsoft Internet Explorer 6 or later, Firefox, Chrome, or Safari, with JavaScript enabled 
Internet: 56K or faster Internet connection (high-speed connection recommended) 
Streaming: for audio/video streaming, Adobe Flash plug-in or Safari browser on iOS devices 

Prior to the webinar, you will receive an email with detailed system requirements, your login information, presentation slides, and other materials that you can print and distribute to all attendees at your location. 

CAN'T LISTEN LIVE? 
No problem. The On-Demand version is now available. Use it as a training tool at your convenience—whenever your new or existing staff need a refresher or need to understand a new concept. Play it once or dozens of times. A $259 value! 

PLEASE NOTE 
Participation in the webinar is just $259 per site. All materials must be retrieved from the Internet. 

Call your customer service representative toll-free 800-650-6787 or email customerservice@hcpro.com if you have questions.