The Recovery Auditor Contractors (RACs) are finding a high percentage of errors on Evaluation and Management services (E/M). In the most recent CMS Provider Compliance Newsletter, CMS lists “E/M services provided to patients admitted to an inpatient hospital setting” as common billing error. On 10/14/13, the RAC Region contractor Performant posted the review of Physìcian Observation codes (CPT 99234-99236) for Connecticut and New York.
Distinguishing between inpatient admissions and different CPT® categories of outpatient observation services continues to be a problem for many physicians and it just got harder with the new documentation requirements published in the FY2014 Hospital Inpatient Prospective Payment System (HIPPS) Fìnal Rule requires physicians to certify inpatient admissions. Physìcian documentation must also support a reasonable expectation of the need for the patient to require a medically necessary stay lasting at least two midnights.
Join expert our speaker Elin Baklid-Kunz, MBA, CHC, CPC, CCS in this informative session to understand the physicians’ role in this process, and also comprehend the physìcian codìng criteria for both initial hospital & observation services as both have been identified by CERT and MACs to have high error rates. Plus, Elin will provide a comprehensive view of observation codìng and give a compliance checklist to help you remain compliant.
Topics covered in the session:
Who should attend? Coding Professionals, Billing Specialist, Practice Managers, HIM Directors, Compliance Officers, Case Managers And, Physicians
Kunz is a national speaker and published author on topics related to medical practice compliance, coding, reimbursement, chart audits and federal regulations. Her twenty years of healthcare experience includes six years as Director of Physician Services for a large health system, seven years in corporate finance and four years in compliance. She presents workshops for the American Academy of Professional Coders and delivers keynote presentations for Eli Research...
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