Incorrect coding for evaluation and management (E/M) services has become a repeating and most challenging problems for healthcare organizations. E/M claims are usually denied for two reasons: incorrect coding or no record of the extent and amount of time spent in counseling and/or coordination of care when it is used to qualify for a particular level of E/M service. The message from Medicare Administrative Contractors (MACs) is that E/M services are a top contributor to the Comprehensive Error Rate Testing (CERT) error rates, and that there is an obvious need for education among providers.
In this webinar we will review some key physician audit targets, such as common documentation errors related to E/M services and issues related to non physician practitioners, such as incident-to. We will also Focus on how to avoid these errors and improving compliance.
- Update on Current Recoveries & Scrutiny
- Review Common E/M Coding Errors: “The Dirty Dozen”
- Best Practices to Improve Compliance
- Review Education Resources Available & Links
Areas Covered in the Session:
- Current Recoveries & Scrutiny Updates
o HCFAC (Health Care Fraud & Abuse Control) Program Report
o CERT (Comprehensive Error Test Rating)
o OIG Strategic Plan
- Documentation Requirements
- E/M Service Components
- Determining E/M Level
- E/M Services: “The Dirty Dozen”
- Compliance Oversight and Best Practices
- Medical Necessity
- Under documentation
- Time-based codes
- Resources& Links
- Live Q&A Session
- Coding Professionals
- Billing Specialists
- Compliance Officers
- HIM Directors
- Case Management Director
- Office Managers
- Practice Managers
- Non-Physician Practitioner such as Nurses practitioners, Physician Assistants
About the Presenter:
Elin Baklid-Kunz, MBA, CHC, CPC, CPMA, CCS is an expert in medical coding compliance who supports clients in matter across the United States with over 20 years of experience in the field. Ms. Kunz is a national speaker and published author. Recent speaking engagements include the 2018 European Symposium on Ethics and Governance in Paris for the Organization of Economic Cooperation and Development; American Bar Association 2018 Physician Legal Issues Conference, 2017 American Health Information Management Association National Conference; 2016-2008 American Academy of Professional Coders Coding & Compliance workshops; 2018-2009 keynote presentations for Eli Research Coding Institute & Audio Educator.
In addition to teaching documentation guidelines and ICD-10 to physicians, Ms. Kunz’ experience includes six years as an adjunct professor and curriculum developer at Seminole State College where she taught courses pertaining to healthcare reimbursement and data analysis and served on the advisory committee for the health information management (HIM) program.
Ms. Kunz earned her master’s degree in business administration from Stetson University where she currently serves as Head Judge for the Southeast Regional Business Ethics Case Competition. She is certified in Healthcare Compliance. She is a Certified Professional Coder; a Certified Professional Medical Auditor; a Certified Coding Specialist and an American Health Information Management Association-Approved ICD-10-CM/PCS Trainer.
Ms. Kunz has enormous practical and personal experience with serious compliance issues. She was the Director of Physician Services for Halifax Health in Daytona Beach, Florida until she discovered Medicare fraud being perpetrated by the Hospital and worked with federal authorities to stop it. In 2014, Halifax settled the matter with the U.S. Department of Justice by repaying to Medicare $86 million. Ms. Kunz’s extraordinary efforts to ensure compliance resulted in her being awarded the 2014 Taxpayers Against Fraud Whistleblower of the Year award.
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