Outpatient Therapy CPT Coding, Billing and Documentation for Rehabilitation Reimbursement
Speaker: Rick Gawenda, PT
Insurance payers are increasingly reviewing therapy claims to ensure that the therapy provided to the beneficiary required the skills of a therapist, was billed appropriately and the required documentation was present in the patient's medical record. The Centers for Medicare and Medicaid Services continue to focus their efforts on reducing inappropriate payments to providers of therapy services in all settings. The Office of the Inspector General continues to focus on outpatient therapy services in their yearly work plans. Congress authorized the Recovery Audit Contractors to be a mandated program due to the extreme success of recovering nearly 1 billion dollars during the 3-year demonstration project. An accurate understanding of the coding and documentation process is critical for rehab professionals to ensure that they are paid correctly and in a timely manner if medical records are reviewed prior to payment and will keep their money upon a post-payment medical record audit.
Outpatient Therapy CPT Coding, Billing and Documentation for Rehabilitation Reimbursement covers the correct use of CPT codes, G and L Level II codes, and modifiers used by Physical and Occupational Therapists as well as Speech-Language Pathologists in all outpatient settings including private practice, hospital-based, rehab agencies, comprehensive outpatient rehabilitation facilities, skilled nursing facilities and in a patient's home. The course also covers ICD-9-CM coding guidelines as they pertain to outpatient therapy services. Billing scenarios are discussed and reviewed to ensure therapists can accurately charge patients correctly for their services. This course thoroughly reviews Medicare Part B and other third party payer documentation guidelines for initial evaluations, re-evaluations, progress and discharge reports, daily notes, certifications/recertifications, and plan of care. Resources and references are provided to help therapists and assistants stay current with the ever-changing reimbursement guidelines and regulations as they pertain to outpatient therapy services.
1. Describe the rationale for the use of CPT, G and L codes in all outpatient settings?
2. Be able to read the CCI edit chart and appropriately append modifier-59 to the correct CPT code(s)?
3. Understand how ICD-9 codes support medical necessity by the various insurance payers?
4. Be able to charge correctly for the services you provide under outpatient therapy benefits?
5. Describe and implement the necessary components of documentation to support skilled therapy services for reimbursement?
6. Provide the definitions and requirements for developing plan of care and the certification/recertification process?
Dates & Locations
ST. LOUIS - June 26, 2012
St. Clare Health Center
1015 Bowles Ave, Fenton, MO 63026 636-496-2000
COLUMBIA - June 27, 2012
Holiday Inn Select
2200 I-70 Dr SW, Columbia, MO 65203 573-445-8531
KANSAS CITY - June 28, 2012
220 W 43rd St, Kansas City, MO 64111 816-756-1720
WICHITA - June 29, 2012
Doubletree by Hilton Wichita Airport
2098 Airport Rd, Wichita, KS 67209 316-945-5272
CLICK HERE TO DOWNLOAD COURSE BROCHURE
CONTACT NAME: Customer Service Department
Program Content Area: Other
Course Type: Traditional
Instructional Level: Intermediate
Intended Audience: PT, PTA, Health care professionals
CE Contact Hours: 6
Course Approval: IPTA Approval # 75-4341
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