CAH Coding Workshops

MT Flex Coding Education

Education for billing office and coding staff is offered each summer with topics chosen based on input from MT CAHs.

Registration is now open for two coding webinars sponsored and supported by the MT Medicare Rural Hospital Flexibility (Flex) grant which assists Montana’s Critical Access Hospitals.   Eide Bailly will be presenting on two timely coding topics for MT CAHs.  Continuing education credits have been submitted to AAPC for approval.

These webinars are free to MT Critical Access Hospital staff.   If you work for a larger hospital that provides billing and coding for MT CAHs, register as a MT CAH.

Register here by August 11: https://www.surveymonkey.com/r/6TLXBXY

Operationalizing Hierarchical Condition Categories HCC: How to implement and be successful in your organization
August 15                      11:00 a – 12:00 p

With increased movement to value based reimbursement across the market, the ability to accurately report patients’ complex needs to account for their resource and cost utilization is becoming increasingly important.  Multiple Medicare programs utilize Hierarchical Condition Category coding (HCC) as a means of communication of a patient’s diagnosis history, current health status, and projected resource utilization. A lack of understanding of HCC and how their resulting Risk Adjusted Factor (RAF) scores are used to provide reimbursement to organizations, leaves you at risk of causing an unintentional negative impact to your organization’s financial health.

In this session, we will address the following objectives:

  • Provide general understanding of Hierarchical Condition Categories (HCC), including the impact they can have on your organizations financial health.
  • Assess common challenges encountered in organizations as they implement workflows to support HCC scoring
  • Provide feedback on next steps for your organization to be prepared and successful in HCC scoring

RHONDA QUAST, DIRECTOR OF REVENUE CYCLE, EIDE BAILLY : Rhonda has more than 21 years of health care industry experience, including 13 years of experience as a Licensed Practical Nurse with clinical and claims review experience. She has eight years of experience in Revenue Cycle leadership, including patient access related to scheduling, registration, and prior authorization.  Rhonda has experience in ACO and Electronic Health Record implementations and Revenue Cycle operations related to population health and value based reimbursement models.

 

Observation: Refresher on Inpatient v. Obs. Status, Medical Necessity, & Billing Compliance
August 17                    11:00 a – 12:00 p

Regulations abound throughout every health care setting.  Observation is one of the more complex services to accurately assure compliance with documentation, coding, and billing.  The organization may be at risk for reporting errors, or may be leaving money on the table for which they are entitled.

In this session we will address the following objectives:

  • Observation versus Inpatient status – what are the “criteria”?
  • What is Observation?
  • Calculating Observation hours – orders, carve outs, and calculations
    • Differences in PPS versus CAH settings
  • Documentation requirements
  • Provider and clinical staff documentation is the key to accurate reimbursement
  • Communication is the key
    • Admission through discharge
    • Provider to patient
    • Provider and clinical staff

SUSAN ROEHL, RHIT, CCS, HEALTH CARE CONSULTING MANAGER, EIDE BAILLY
Knowledge and Experience

  • More than 30 years of health care experience, with an emphasis in health information and quality management.
  • Provide ICD-9-CM and CPT coding support for inpatient and outpatient accounts.
  • Provide ICD-10-CM and PCS documentation and coding assessments.
  • Specialize in assisting hospital medical records coding staff, physicians, business services and ancillary departments with appropriate reimbursement.
  • Provide educational sessions and coding validation studies to determine if providers are assigning correct diagnosis and procedure codes for reimbursement and compliance.
  • Assess daily workflow methods and operations.
  • Review policies and procedures to ensure compliance with Federal, State and HIPAA requirements.
  • Provide physician education on appropriate documentation for medico-legal and reimbursement compliance.

Archived Coding Education by Topic

Many sessions are recorded and available for viewing by clicking on the link provided. Presentations contain links to valuable educational resources. Basic coding education programs are also available. See the list below for available programs. If you have having trouble viewing the linked videos, right-click on the link and save the file to your computer. You may then play the file directly from your computer.

Click the topic name to go directly to those presentations.

General Coding Information

Body Systems and Conditions

Presentations

Coding Compliance

CPT

Earning a Coding Credential

ICD-9

ICD-10 & ICD 10 PCS

Outpatient Coding

Brain

Cardiovascular System

Diabetes Mellitus

Integumentary System

Musculo-Skeletal System

Respiratory System