Clinical Provider Documentation & Coding Training Focus

Join ARCHPRO Coding from 9:00pm – 1:00pm MST for a billing and coding workshop catered to Colorado Rural Healthcare RHC Providers.

General Overview of Main Sections:

• Overview of RHC principles and the HIPAA-approved code set guidelines for CPT, HCPCS-II, ICD-10-CM
• RHC Billing Basics and Key CMS Resources
• Value-based Care and Quality Reporting Overview (ex. HEDIS, HCC, ACO Shared Savings, CPT-II)
• Evaluation & Management (E&M) Documentation and Coding
• Documenting and Reporting Preventive Medicine Services
• Review of Monthly Chronic Care Management Options
• Compare/Contrast Telehealth & Virtual Communication Services

Target Audience:

ARCHPRO Coding strongly believes team-based training is key. Though the primary focus is to educate health care providers who document in medical records, please include facility leadership and revenue support staff as deemed necessary and appropriate (e.g., coders and billers) so everyone is organizationally aligned.

Objectives:

1. Deliver an overview of AMA, CMS, and ICD-10-CM documentation, coding, reporting, and reimbursement issues that impact health providers related to CPT, HCPCS-II, and ICD-10-CM codes.
2. Outline the vital distinctions between clinical documentation protocols vs. professional coding rules vs. varying requirements of insurance payers vs. reporting accurate quality metrics (if required by payers).
3. Identify solutions to the inherent limitations of EHRs, templates, and billing software with a goal to increase revenue, facilitate quality reporting, and decrease audit risk.
4. Review the AMA’s E&M documentation guidelines with a focus on selecting the proper level of service based on time vs. medical decision making (MDM) and the distinction between proper reporting of “Sick” and “Well” visits.
5. Identify the CMS-covered Preventive Services including the Initial Preventive Physical Exam, Annual Wellness Visits, and additional covered preventive services Medicare and other payers will cover on a periodic basis.
6. Review key areas of the “ICD-10-CM Official Guidelines for Coding and Reporting” in the context of the revenue cycle and quality care reporting.
7. Outline Care Management revenue options including Principal/Chronic Care Management, Transitional Care Management, Behavioral Health Integration, and the Psychiatric Collaborative Care Model.
8. Compare/contrast traditional Telehealth vs. Virtual Communication Services.
9. Understand the impact Medicare’s fee schedule (RBRVS) may have on RHCs and the unique global surgery rules that effect RHCs.