Medical Necessity Documentation to Support Billing in ICD-10-CM

Event Information
Product Format
Prerecorded Event
Presenter(s)
Kim Garner-Huey, MJ, CHC, CPC, CCS-P, PCS, CPCO, COC
Length
60 minutes
Product Description

Manage the Change to ICD-10-CM without Jeopardizing Medical Necessity Documentation

Medical Necessity is one of the biggest challenges healthcare professionals face because the Medicare’s definitions of medical necessity varies depending on who you are – physician, coder, biller, payer. In addition, denials related to medical necessity have increased enormously even for legitimate services because of the burdensome appeal claims. 

This session by expert speaker Kim Garner-Huey, MJ, CHC, CPC, CCS-P, PCS, CPCO will explore and apply the definitions of Medical Necessity to your medical practice. From helping your physicians document appropriately to support why they did, what they did, to assigning the right codes and modifiers, to appealing to receive the payment deserved.  You will learn how to manage the change to ICD-10-CM and maintain medical necessity documentation.

Additionally, you will get links and advice on ABN forms and waivers; tips on appeal language; and how to manage the change to ICD-10-CM without jeopardizing medical necessity documentation.

Session Highlights

  • Medical Necessity documentation guidelines and how they may change in ICD-10
  • How the definition of medical necessity has changed - and will continue to change in ICD-10
  • ICD-10: Is it okay to use unspecified?
  • Keys for using the medical necessity modifiers -GA, -GY, -GZ
  • 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 (ABN) - for Medicare and other payers
  • Links and advice on ABN forms and waivers
  • How to teach your providers—respectfully
  • Tips on appeal language

 Session Agenda:

  • Medical Necessity Definition
  • CMS-1500 Claim Form Language
  • Diagnosis Coding
  • ICD-10-CM Specificity with Examples
  • ICD-10-CM in Payer Policy with Examples
  • ICD-10-CM Changes
  • Evaluation and Management
  • Medical Necessity vs. Medical Decision-Making
  • Balancing Medical Necessity and Meaningful Use
  • Other EMR Issues

Who should attend?

Physicians, coders, billers, office managers, practice managers, revenue cycle managers, administrators

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

You can also order through:
Phone

1-866-458-2965

Fax

1-919-287-2643

About Our Speaker

Kim Garner Huey - Health Care Management Expert

Kim Garner-Huey, MJ, CHC, CPC, CCS-P, PCS, CPCO, COC, 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...   More Info
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