Consider these eye-popping statistics: a 19.7% error rate in critical care coding, billing and documentation, with 39.8% of those claims denied due to insufficient documentation (2018 CERT report). Now, with the arrival of 2022, we expect an even greater threat to revenues from critical care services. Effective January 1, 2022, are updated rules, including one that allows physicians and non-physician providers to share critical care services. These policy changes open up a Pandora's box of complications — adding to the confusion about what constitutes critical care, how to properly document it and how to bill for services when one physician sees a patient and then a covering partner continues care later in the day.
Embarking on a year of historic change, you'll definitely want to make this ICD10monitor webcast a top priority. Our presenter, Betsy Nicolleti, is widely regarded as the expert in critical care coding. She'll walk you through several key areas that can help you mitigate your risks: CPT® rules (which CMS is adopting) for reporting critical care; how a group membership and specialty designation affect coding; documenting medical necessity for concurrent services; when a surgeon is permitted to bill for critical care in the global period; and much more.
Why This is Relevant:
Critical care generates a lot of revenue for hospitals and physicians, but it comes with a commensurate level of financial risk. From this ICD10monitor webcast, you'll take away actionable knowledge that enhances your ability to receive the full appropriate payment for critical care services and retain those revenues in the event of an audit.
- Understand the new CMS policy regarding shared services for critical care
- Identify when a separate E&M service may be billed on the day of critical care
- Be able to assess documentation for critical care services
- Explain how to code for services that cross midnight
- Determine whether a service meets the criteria for reporting critical care
Who Should Attend:
Hospital coders, billers and administrators; medical staff who have hospital practices, including hospitalists, intensivists, emergency physicians and pulmonary medicine physicians; and staff in physician groups providing critical care services and employing non-physician practitioners and physician assistants.
CPT® is a registered trademark of the American Medical Association.
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