Physician Coding and Reimbursement For Observation Services

Event Information
Product Format
Prerecorded Event
Elin Baklid-Kunz, MBA, CHC, CPC, CPMA, CCS
60 Minutes
Product Description

Say NO to the Audit Risk with these Physician Observation Reimbursement and Coding Guidelines

Distinguishing between inpatient admissions and different CPT categories of outpatient observation services continues to be a problem for many physicians. Are you prepared for the increased audit risk and scrutiny?

Understand the risk areas for physician observation coding and take home tools to assess your compliance with our expert presenter Elin Baklid-Kunz in this expert healthcare webinar.  With the expert tips to ensure correct payment, you get compliance checklists for physician observation coding.    

Here are few highlights of the session:

  • Why the Focus on Observation Services?
  • Increased Government Scrutiny
          1. Record Breaking Recoveries

          2. Increased Error Rates

          3. RAC/MAC/OIG Reviews
  • E/M- Trends in Coding Claims
  • Inappropriate Admissions (Site of Service) Cases
  • Financial Impact: Inpatient vs Outpatient
  • MAC/Carrier Expanded Medical Reviews & Recent Updates
  • Areas of Vulnerability & Physician Payment Differences
  • Physicians’ Responsibility
            1. Inpatient or Outpatient?

          2. Physician’s Responsibility

          3. UR Committee - UR Committee Requirements

          4. Case Management Protocol (CMP)
  • Documentation Requirements
           1. Observation Services Defined

          2. Medical Record Requirements

          3. CPT Code Categories & Reimbursement
  • Physician Observation Categories & Observation for Unexpected Complications
  • Subsequent Observation Care CMS Clarification
  • Observation and Discharge Same & Different Date
  • Hospital Observation Services & Decision for Surgery, Modifier -57
  • Related Observation During Postoperative Period
  • Status Change & Condition Code 44
           1. Requirements & Frequency

          2. Documentation & Billing

          3. Observation Hours From Beginning?

          4. Who Can Change the Status?
  • Clerical Error Correction Process
  • Status Change Based on Patient Request
  • Resources and Case Study
  • And much more…

Ask  a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.

Who should attend? Practice managers, HIM directors, compliance officers, case managers, physicians, Coding professionals and billing specialist

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About Our Speaker

Elin Baklid Kunz - Medical Billing Coding Expert

Elin Baklid-Kunz 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...   More Info
More Events By The Speaker

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