Session 1 – March 19, 2021

How Successful Coders can Develop an Auditor’s Mindset
Matt Monk

Using personal experience and current trends within the coding industry, this presentation seeks to convey how each coder can develop a mindset like a coding auditor which can lead to success in their career and current job.

Code it Right!
Leigh Poland, RHIA, CCS
Srivalli Harihara

Presenters at this session will discuss spinal fusion coding, which continues to be an area that many struggle with due to the complexity of coding these procedures and their confusing documentation. An understanding of spinal anatomy, physiology, medical terminology, and surgical descriptions included in operative reports is required to achieve correct coding assignment for spinal fusions. ICD-10-PCS and CPT Coding will be covered in the presentation.

Social Determinants of Health and ICD-10-CM Coding
Margaret Foley, PhD, RHIA, CCS

This session will address what are Social Determinants of Health (SDOH) and their relationship to patient health outcomes and costs. The need to collect SDOH information to better assess patient risks and outcomes will also be discussed. The current state of ICD-10-CM coding and documentation for SDOH will be addressed as well as other efforts underway to improve standardize definitions, documentation and coding of SDOH. Steps to improve the capture of SDOH documentation and codes will be provided.

At the completion of this session, participants will be able to:

• Learning Objective 1 Understand what social determinants of health (SDOH) are and their impact on patient outcomes.
• Learning Objective 2 Apply ICD-10-CM official guidelines for coding social determinant of health information (SDOH).
• Learning Objective 3 Describe current efforts underway to capture SDOH using classification systems and clinical terminologies.
• Learning Objective 4 Implement strategies to improve the documentation and coding of SDOH.

Understanding the Revenue Cycle Plus the Impacts of the New Physician E&M Coding Changes
Day Egusquiza

Attendees will learn the key components within the revenue cycle including the handoffs within the organization. Attendees will learn the at-risk issues with documentation time vs MDM and payer audits.

Diabetes Coding Back to the Basics
Esta Lynn Farmer, RHIA, CDIP, CHPS, CCS, CCS-P

• Types of Diabetes
• “With” Guideline
• MCC/CCs
• Documentation needs for coding of uncontrolled or poorly controlled diabetes
• Multiple Diabetic Conditions
• HCC reporting

Hospital Re-Admissions
Gwen Hail, LPN

Audience will learn about:

• The history of the Hospital Re-Admission Measure
• How Penalties are Calculated
• Performance Improvement Strategies

Session 2 – June 18, 2021

Strategies for Dealing with Payer Denials
Joy King Ewing, RHIA, CCS, CCDS

With payor denials on the rise due to increased scrutiny and complicated claim submission criteria, it’s more important than ever to ensure your organization receives complete reimbursement. Clinical and coding downgrades of DRGs are becoming more and more common, and have a significant impact on organizations’ revenue cycle. In this session, we will discuss the different types of denial issues from payors, and learn how to distinguish them. We will identify core reasons for DRG changes, and discuss the most effective resources to effectively appeal these changes.

CDI – The First 48 hours – CDI Query Response Time
Kelli Hill, BSN, ACM-RN, CCDS

How we used team collaboration with multiple disciplines in order to improve the response time to concurrent CDI queries.

• learn key stakeholders in the process
• learn how to involve providers
• learn how to maintain improvements

Does the Documentation Tell the Story
Betty Hovey, CCS-P, CDIP, CPC, CPMA, COC, CPCD, CPB, CPC-I

In this session, come hear from an educator/auditor with over 30 years’ experience in the field who has performed thousands of audits.  The critical part that documentation plays in supporting medical necessity will be discussed, along with proper modifier usage.  Examples of both good and poor documentation will be shown to ensure comprehension. 

Learning Objectives:

• Describe documentation’s role in supporting medical necessity
• Distinguish good documentation from bad
• Describe necessary documentation points for a visit note, a procedure note, and an operative report
• Discuss problem areas, including modifiers 25 and 59
• Describe how a payor’s medical policy is imperative in supporting medical necessity

Coding Updates Plus Reimbursement Impact & Documentation Requirements for Surgeries Eliminated from the Inpatient Only List
Karen Kvarfordt, RHIA, CCS-P, CCDS. AAHIM Approved ICD-10 Trainer
Day Egusquiza

Attendees will learn about the 2021 coding updates with ‘impact’ highlights. Attendees will learn the financial impact and documentation requirements to support inpt with the procedures moving off the inpt only list.

Coding Productivity
Tonya Macon, RHIT, CDIP, CCS
Rachel Pratt, RHIA, CDIP, CCS

We are working to develop an automated IP Coding productivity Standard for the U based on service lines, difficulty of accounts as well as coder levels. All of these things affect productivity and need to be taken into consideration when setting a standard for the coders that is both challenging as well as achievable. We want to be able to hold our coders accountable without making it impossible for them to reach.

Charge Analysis
Terri Graham

The importance of Charge Analysis