Medicare's Documentation Guidelines for Establishing Medical Necessity

Event Information
Product Format
Prerecorded Event
Kim Garner-Huey, MJ, CHC, CPC, CCS-P, PCS, CPCO
60 minutes
Product Description

Ensuring accurate documentation to establish medical necessity is critical, specially when the definition of medical necessity vary depending on who you are - physician, biller, payer, coder or someone else in the Medicare Reimbursement function. You need your physicians and staff to document appropriately to ensure that you have everything you need for an Optimized Reimbursement Cycle. You have to be updated through a number of different changes - right from filing appeals for accurate reimbursement, getting familiar with the guidelines on the right appeal language, links and advice on the new ABN forms and much more.

Topics covered:

  • Medical Necessity documentation guidelines .
  • How the definition of medical necessity has changed - and will continue to change.
  • Not medically necessary vs. not covered - What's the difference?
  • Examples of the right (and wrong) way to document medical necessity.
  • Use of the Advanced Beneficiary Notification - for Medicare and other payers.
  • Finding the Guidelines/Policies
  • Claim Form Language
  • Medical necessity for E&M
  • Clinical Descriptors
  • Balancing Medical Necessity and Meaningful Use
  • What are the auditors looking for - Authentication, Contradictions, Wording or grammatical errors, Medically impausible documentation
  • How to Document & Certificate of Medical Necessity
  • Appeal Testimony & How to Teach Your Providers
  • Advanced Beneficiary Notification & ABN Rules
  • Keys for using the medical necessity modifiers -GA, -GY, -GZ
  • And much more...

Who should attend? Compliance personnel, HIPAA Officer, Chief Information Officer, Health Information Manager, Medical Office Manager, CFO, CEO, COO, Physicians, coders, billers, office managers

Order Below or Call 1-866-458-2965 Today

We Also Recommend
Medical Necessity Documentation to ...

- Kim Garner-Huey, MJ, CHC, CPC, CCS-P, PCS, CPCO

The Future of Provider-Based Clinic...

- Duane C. Abbey, Ph.D.

The Nuts and Bolts of Being an Out-...

- Thomas J. Force, Esq.

Coding and Documentation for Time B...

- Kim Garner-Huey, MJ, CHC, CPC, CCS-P, PCS, CPCO

How to Avoid Common E/M Coding Erro...

- Elin Baklid-Kunz, MBA, CHC, CPC, CPMA, CCS, AHIMA-Approved

Order Form

(Select the format below)

You can also order through:



About Our Speaker

Kim Garner Huey - Health Care Management Expert

Kim is an independent coding and reimbursement consultant, providing audit, training and oversight of coding and reimbursement functions for physicians.

Kim completed three years of pre-medical education at the University of Alabama before she decided that she preferred the business side of medicine.

She completed a Bachelor's degree in Health Care Management and went on to obtain certification through the...   More Info
More Events By The Speaker

Why AudioEducator?
  • Save money on travel.
  • Meet your specific training needs.
  • Keep learning after the event.
  • Save time training your whole staff.
XImportant Update! Upgrade Your Browsers to the Latest Versions To Adjust to the Change Or You May Not Be Able to Access Your Websites Effective June 2016 Read more...