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Explore This IssueMarch 2019
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Due to the constant evolution of the healthcare industry, an earnest need exists for rheumatologists and practice staff to gain insights into best practices to navigate the continuing changes to coding and compliance. The Rheumatology Documentation and Coding Workshop will deliver hands-on training with a range of presentations on coding and billing best practices for practice workflow and revenue cycle management, as well as advanced networking opportunities.
Although the Centers for Medicare & Medicaid Services (CMS) has expanded flexibility in 2019 for documenting history and examination for established patients, considerable uncertainty surrounding updates or changes to third-party payer’s documentation policies remains. Presenters at the Rheumatology Documentation and Coding Workshop will delve into defining documentation risk areas when reporting evaluation and management services and provide insights on how to improve them, demonstrate how to comply with coding and payer rules when coding rheumatology procedures and review real-life charts for what payers are looking for when auditing rheumatology services.
Because the demands of risk-adjustment coding are complex and failure to comply can be costly, one key area of the workshop will illuminate proper coding methodology and medical necessity, and explain how to adapt rheumatology coverage policies and use of National and Local Coverage Determinations (NCDs and LCDs) in the coding, audit and reimbursement process.
The word audit generally strikes fear in the heart of many physician practices. Instead of anxiety and fear, practices should create an improvement plan to identify inappropriate documentation, coding and billing issues. The keys to a successful rheumatology practice are providing the best medical care to patients and knowing what it takes to run an office efficiently through best business practices.
This full-day workshop will address the biggest challenges practices face as they look to provide the same quality of patient care under rapidly shifting conditions. Attendees will explore hard data and sound strategies for:
- Scheduling and billing to better manage common rheumatology procedures;
- Preparing (and adjusting) for risk adjustments;
- Applying key strategies for ICD-10 coding to justify level of evaluation and management and/or prolonged codes; and
- Starting value-based contract negotiation with an advantage.
Although these quality and compliance initiatives are burdensome and do nothing to improve the quality of patient care, rheumatology practices still need to avoid any potential risk and liability associated with improper coding and billing.