Detailed Schedule

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Thursday, January 22

CMS Quality Reporting for ASCs (1:00pm–2:00pm)

CMS requirements and quality reporting can be challenging for perioperative leaders in the ambulatory surgery center setting. Participants will learn what quality reporting is required and the definitions and frequently asked questions for the indicators. In addition, participants will receive current information on the quality reporting program.

Gina Throneberry, RN, MBA, CASC, CNOR
Ambulatory Surgery Center Association

Operative Report Templates: A Help or a Hindrance? (2:05pm-3:05pm)

How often does your ASC code selections differ from the physicians' code selections due to documentation questions and/or deficiencies? Deficient documentation could result in erroneous payments, reimbursement delays or denials. Learn the "how, what, when, why and why not" to operative report template utilization and the financial impact when medical necessity is not met.

Cristina Bentin, CCS-P, CPC-H, CMA
Coding Compliance Management, LLC

2015 CPT Changes: Money Makers and Money Breakers (3:20pm-5:00pm)

This presentation includes an update on new, revised, and deleted CPT codes in 2015 that are commonly performed in ASCs. It will include AMA applications and scenarios for reporting these changes. Reimbursement potentials and impacts from a CMS perspective for established codes will also be addressed. A review of the CMS ASC list of approved procedures, payment indicators and multiple procedure reporting guidelines will be reviewed during this session to assist in the understanding of “if” and “how” a procedure will be reimbursed.

Cristina Bentin, CCS-P, CPC-H, CMA
Coding Compliance Management, LLC

Friday, January 23

(You can change rooms throughout the day.)

Room 1

Speaker: Cindy Wulbern, RHIT, CPC, CASCC, COC, CUC

  

Room 2

Speaker: Margie Scalley Vaught, CPC, CPC-H, CPC-I, CCS-P, MCS-P, ACS-EM, ACS-OR

  

Room 3

Speaker: Marvel Hammer, RN, CPC, CCS-P, ACS-PM, CPCO

Gastroenterology: EGD/Colonoscopies (8:00am–9:00am)

Ensure your ASC is maximizing reimbursement by appropriately reporting GI procedures. Participants will gain an understanding of the difference between a screening versus a diagnostic colonoscopy and learn when additional documentation is needed to determine code selection. Local coverage determination will be discussed as well as the potential application of the PT versus the 33 modifier.

   

Orthopaedic Updates (8:00am–9:00am)

This session will specifically focus on orthopaedic changes for 2015 including certain Category III code conversions to a Category I status, further bundling of imaging guidance and options for cyroablation of bone tumors from both CMS and AMA perspectives. Arthrocentesis codes with potential revisions will also be discussed.



   

Urology at Its Best (9:05am–10:05am)

This session is a must to ensure that accurate coding and reimbursement are achieved and maintained. The presentation will include a review of AMA and CMS coding guidelines for the more common ASC procedures, such as cystoscopies, bladder tumors, ESWL and/or cystoureteroscopy with stone lithotripsy and J stent placement, as well as other related urological coding topics.

   

Hands and Wrists (9:05am–10:05am)

During this break out session, participants will discuss CTR versus tenosynovectomies and when to report one or both. Can tenolysis with tendon repairs be reported? Identification of pertinent documentation within an operative note to support the correct coding will be covered along with excisions, incisions and repair codes.

   

Cardiology in the ASC (10:20am–12:00pm)

With more cardiology procedures making the Medicare ASC list of approved procedures, it is important that ASCs have a realistic view of reporting and reimbursement policies. This session will review coding guidelines for pacemaker and implantable cardiac defibrillator generators from both AMA and CMS perspectives.







   

Hips, Knees and In-Between
(10:20am–12:00pm)

With AAOS making recommendations regarding some surgical treatments on knees, it appears that some carriers have changed their policies regarding when they will pay for meniscectomies. In addition to scope procedures, common open procedures such as patellar realignment procedures, posterolateral corner procedures and MPFL repairs/reconstructions will be reviewed. Since more total joint procedures are being performed in the outpatient setting, participants will want to know appropriate code selection and how patellofemoral arthroplasties come into play. A review of CMS’s specific LCDs regarding total hips/knees with specific documentation rules and ICD-9 linkage will be included.

   

ENT: Avoiding the Pitfalls
(1:00pm–2:00pm)

This session will review the pertinent coding guidelines from AMA, CMS and specialty perspectives as they relate to common ENT procedures. Tympanoplasties, endoscopic sinus surgeries (FESS), cochlear implantation and tonsil/adenoid reporting will be up for discussion.






   

Shoulder Reporting Clarified
(1:00pm–2:00pm)

When it comes to shoulder surgery coding, being able to know what is considered inclusive vs. separately reportable is becoming more and more of a payer/carrier policy. Understanding what is considered inclusive in total shoulder arthroplasties and how to report reversal total shoulder procedures will be included in this session. Participants will also review coding guidelines for common shoulder arthroscopies and open procedures.



 

Part 1: Dissecting ASC Coding for Pain Management Sympathetic Procedures (1:00pm–2:00pm)

No need to resort to “fight or flight” when coding sympathetic nervous system pain management procedures for your ASC. This session will cover the anatomy, common diagnoses with corresponding ICD-9 / ICD-10 codes, and compliant CPT ASC coding and billing associated with interventional pain management. Procedures to be covered include sympathetic nervous system injections and neurolytic destruction. Focus will include which procedures can be reported as bilateral as well as those that need to be reported under code 64999 (unlisted procedure, nervous system).

General Surgery Tips and Traps
(2:05pm–3:05pm)

In this session, learn how to enhance the accuracy of general surgery code selection and optimize revenue integrity by reviewing coding pitfalls relative to common integumentary procedures including lesions, excisions and grafts. Discussions will continue with correct reporting tips for hernia repairs and AV fistulas.











 

Toes Stink: A Coder’s Perspective (2:05pm–3:05pm)

The most confusing anatomic surgical section tends to be the foot/toes. Part of the problem is the verbiage that the surgeon utilizes. Was it really an acute joint dislocation or was it a chronic joint contracture? Was it a joint arthroplasty (total replacement) or was it a joint debridement? It makes a BIG difference when it comes to code selection. During this session, participants will attempt to dissect some operative report excerpts to see if the correct codes can be ascertained.








 

Part 2: Dissecting ASC Coding for Common Pain Management Peripheral Nerve Procedures (2:05pm–3:05pm)

Providers not only perform spinal interventional pain management procedures in your ASC, but also injections, chemodenervation and neurolytic destruction on peripheral nerves. Do you know the difference between the lateral femoral cutaneous nerve versus the femoral nerve? This session will cover the anatomy, common diagnoses with corresponding ICD-9 / ICD-10 codes and compliant CPT ASC coding and billing associated with interventional pain management peripheral nerve procedures. Focus will include the differentiation between chemodenervation and neurolytic destruction procedures as well as ASC billing for botulinum toxins. Last year, many new chemodenervation codes for pain management were created–don’t miss out on revenue for your ASC by incorrectly billing for these procedures!

Ophthalmology/Gynecology Reporting (3:20pm–4:20pm)

In the first part of this session, learn valuable coding tips to ensure your facility receives every reimbursement dollar it deserves for common eye procedures such as retinal, DCR, yag laser and eyelid reconstructions. The second half of this session will review coding guidelines related to some of the more common gynecological procedures performed in ASCs to include anterior/posterior colporrhaphy, sling placement and revision.

   

Spine Coding in Your ASC
(3:20pm–4:20pm)

This session will review the pertinent coding guidelines from AMA, CMS and specialty perspectives as they relate to common spinal procedures. Arthrodesis, discectomy, decompressions, vertebroplasties and post-op infections will be the topics of discussion as well as other spine-related topics of interest including “when” diagnoses impact CPT code selection.


 

Compliant ASC Coding for Pain Management Neurostimulator Services (3:20pm–4:20pm)

This session will cover ASC-compliant coding for the common pain management neurostimulator procedures, including epidural trial and permanent neurostimulators. Focus will also include distinguishing between peripheral nerve neurostimulation versus peripheral subcutaneous field stimulation as well as the auricular point stimulation procedure.

Questions (4:30pm–5:00pm)

 

   

Questions (4:30pm–5:00pm)

 

 

Questions (4:30pm–5:00pm)

 

Saturday, January 24

Speaker: Joanne Schade-Boyce, MS, BSDH, CPC, ACS

In order for the participants to get the most out of these sessions, it is important that the participants already have a basic to intermediate level of understanding of Anatomy and Physiology (A&P). These sessions will incorporate hands-on coding. Participants should be prepared to spend approximately 20-30 minutes working coding examples.

Attendees will need to bring either the 2014 or 2015 ICD-10 Coding Book for these sessions. Specific page references will be made from the 2015 ICD-10 Coding Book.

ICD-10-CM Code Structure and Building Codes Using the System (8:00am–9:00am)

This session will review and practice the key concepts to using the ICD-10-CM coding system. The structure of the coding system will be reviewed, with discussions on comparing and contrasting various codes between ICD-9-CM and ICD-10-CM, as well as building codes in ICD-10-CM.

Integumentary CM Coding (9:05am–10:05am)

Common diagnosis codes utilized in an ambulatory surgery setting will be highlighted, as well as the introduction of new diagnosis codes offered in the ICD-10-CM coding system, such as the difference between inclusion and sebaceous cysts. Participants will be given time to code operative report diagnosis examples using the new ICD-10 system, such as diagnosis codes relative to benign and malignant lesions, breast procedures, pilonidal cysts and more.

Musculoskeletal CM Coding (10:20am–12:00pm)

Diagnosis coding for the musculoskeletal system makes up a large percentage of the changes in ICD-10-CM due to the additions of site, laterality and 7th character application. After the review, participants will be given time to code common diagnosis utilized in an ambulatory surgery setting, such as fractures and conditions relative to shoulder, hand, finger, knee and toe procedures.

ENT and Respiratory CM Coding (1:00pm–2:00pm)

Common diagnosis codes utilized in an ambulatory surgery setting will be reviewed, as well as the changes and modifications made in these areas with the new ICD-10 coding system. Participants will practice coding diagnoses relative to tonsils and adneoids, FESS, bronchoscopy procedures, etc.

Eye and Auditory CM Coding (2:05pm–3:05pm)

Common diagnosis codes utilized in an ambulatory surgery setting will be reviewed, as well as the changes and modifications made in these areas with the new chapters added for the “sense” organs in the ICD-10 coding system. Participants will practice coding diagnoses associated with eye and ear procedures, such as cataracts and strabismus, as well as review diseases of the ear.

GI and Pain Management CM Coding (3:20pm–5:00pm)

A review of the salient coding changes, including guideline changes, will be covered along with the increased level of specificity with the addition of 4th, 5th and even 6th character levels. A special emphasis will be made to avoid NOS (unspecified codes), and thorough discussion of the potential ramifications of NOS codes with third-party payors. This presentation will include a review of title changes that better reflect terminology of today’s medical practices, along with the noted organizational changes. Participants will practice reporting diagnosis codes relative to common GI procedures and select pain management diagnosis codes.