Unlocking the Secrets in Medicare’s Physician Fee Schedule for Ob/Gyn Services

Event Information
Product Format
Prerecorded Event
Presenter(s)
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, CDIP, COBGC, AHIMA approved ICD-10-CM/PCS trainer
Length
60 minutes
Product Description

Utilizing the Medicare Physician Fee Schedule to Reduce Claims Denials and Increase Appropriate Reimbursements

Understanding the codes that allow bilateral modifiers, multiple surgeons and multiple procedure code reductions can be tricky. The Medicare fee schedule database includes all that valuable information and more.

Join this session by expert speaker Lori-Lynne A. Webb, who will discuss how to utilize the information in the fee schedule to reduce claims denials and receive appropriate reimbursement. Lori will explain how to navigate the Medicare fee schedule database and how each of the columns relates to coding and reimbursement. The session will also discuss the relative value formulas in the clinic vs. outpatient setting, which affect overall physician reimbursement and have appeared on the OIG list of common errors for several years.

Session Highlights

  • Utilize the information in the fee schedule to reduce claim denials and receive appropriate reimbursement
  • Identify global periods and professional/technical component services
  • Use co-surgeon and assistant surgeon modifiers appropriately
  • Identify services that are most commonly performed in the office setting vs. facility services
  • Identify radiological services that may have payment reductions when performed at the same encounter

Session Agenda

  • CMS Physician Fee Schedule overview
  • What is resource-based relative value scale
  • Physician work component
  • Practice expense component
  • Fee schedule lookup tool
  • 2017 GPCI value table
  • Adjustments made to the RVUS
  • Formula to determine reimbursement
  • Claim denials - prevention and improvement
  • Appealing your claim denial
  • Global period definition and indicators
  • Modifiers used with CMS physician fee schedule tool
  • MOD 26 physician interpretation only
  • MOD TC technical component only
  • MOD 53 overview
  • Office vs. facility
  • OIG implications

Who Should Attend

  • Office managers
  • Coders
  • Reimbursement managers and providers

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About Our Speaker

Lori Lynne - ICD 10 Training Expert

Lori-Lynne A. Webb - CPC, CCS-P, CCP, CHDA, CDIP, COBGC, AHIMA approved ICD-10-CM/PCS trainer, is an independent coding, compliance, and auditing specialist. She has 20+ years of multi-specialty coding experience and teaches coding, compliance, auditing and billing skills for clinical and clerical staff, utilizing AMA and AHIMA curriculum. She specializes in women’s ob-gyn services, maternal fetal ultrasound services, urology and general surgical procedures, to include physician based and...   More Info
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