Simplifying Pain Management Coding and Compliance

Event Information
Product Format
Prerecorded Event
60 minutes
Product Description

Tips, Strategies and Guidelines for Accurately Coding Pain Management Procedures in 2016


Pain Management Practices are seeing continued decreases in reimbursement and increase in scrutiny over compliance issues. 2016 changes, challenge of prior authorization requirements, coding changes, OIG scrutiny over POS (place of service), and billing correctly for supplies and services, while providing medical necessity makes pain management billing a real pain for providers.

Join this session by expert speaker Trish Bukauskas to learn how to capture all relevant reimbursement and avoid costly denials by streamlining your claims management process. This session will help you to streamline your billing and help you realize the importance of monitoring your EOBs (Explanation of Benefits) more closely than ever.

Trish will also provide a sample authorization form, fee schedules and tips on how to hold payers “accountable.”  You’ll be able to review Medicare and payer’s policies in advance. CPT® coding changes and proper billing of multiple procedures will be discussed along with an overview of spinal anatomy.  The session’s focus will be primarily on the changes and upcoming trends in 2016 and future changes due. Medicare is proposing a value based payment system where physicians will get paid on quality and this session will provide guidance on getting practices on the right path towards a quality-based practice.

Additional Handouts:

  • Prior Authorization Form
  • New Patient Visit Form
  • New Patient Hx Form
  • Follow-Up Template
  • Member Advance Notice Form
  • Claim Reconsideration Reference Guide

Session Highlights:

  • “Prior Authorization” for pain management and musculoskeletal procedures: Learn what codes UHC now want authorized along with a sample authorization form.
  • Billing tips to help providers avoid common billing problems.
  • Common bill denial reasons and what to do about them.
  • How to request an adjustment/overpayments
  • How does Dx coding affect pain management billing?
  • What do insurance companies want?
  • Challenges of ICD-10: Coding pain services related to workers’ compensation claims.
  • Easy crosswalks and tips to avoid denials due to “nonspecific diagnosis.”
  • Learn the key components carriers want see in the documentation of E/M services.
  • 2016 pain management changes and upcoming trends.
  • Modifiers are necessary in getting claims paid.  Learn how to use them correctly.
  • Claims follow up for reimbursement and compliance made easy.
  • Implementing and streamlining the claims follow up process to improve revenue and compliance.
  • Importance on reports and statistics.

Session Snapshots:

  • HCFA 1500 Problematic Fields
  • CPT®/HCPCS procedure codes and modifiers
  • Top Denials for Medicare Claims
  • Facet Joint Injections
  • Facet CPT® Codes
  • Industry Changes
  • Specific Documentation Requirements
  • Knowing your LCDs
  • Commonly used modifiers in pain management
  • Steps to avoid denials
  • Effective follow up guidelines
  • Reports to help monitor payments

Who should attend?

Medical coders, medical billers, physician office managers and personnel and pain physicians

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About Our Speaker

Trish Bukauskas

Trish Bukauskas is both an administrator and management consultant with over 25 years of successful coding, management and training in varied healthcare practices. From a practice consulting business to continuing on-site management, Trish's experience is unique and comprehensive. Attendees will have the opportunity of learning solutions to their insurance billing problems from "real world" experience. Ms. Bukauskas is committed to assisting specialty practices in taking back control and...   More Info
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