Provided by MHA Health Institute
Date & Location
Thursday, Dec. 5
Courtyard by Marriott
1500 North East Coronado Dr.
Blue Springs, Mo.
Register on or before Wednesday, Nov. 20.
MHA-member — $299
Nonmember — $399
The registration fee includes continental breakfast, refreshments, lunch and electronic access to program materials. This seminar is being offered at a reduced registration fee to MHA-member hospitals thanks to a generous contribution from MHA Management Services Corporation. This seminar also is eligible for use of the MHA Health Institute coupon. Coupons were mailed to MHA-member hospital CEOs on Dec. 17.
This seminar is for individuals responsible for ambulatory payment classifications, billing, revenue cycle management and chargemaster maintenance, including coders, chargemaster/APC coordinators, revenue cycle managers, perioperative services directors, health information/medical records managers, directors of patient financial services, billing office/business office managers, pharmacy directors, supply chain and purchasing managers, ancillary departments, nurse auditors, and compliance auditors.
The Centers for Medicare & Medicaid Services promised another transformative year for health care facilities by issuing significant revisions that impact hospital operations and processes. This program will review the important components specific to ambulatory payment classifications, chargemasters, current procedural terminology codes, pharmacies and pass-throughs.
Upon completion of this program, participants will be able to:
- incorporate 2020 codes to individual facility’s chargemasters
- describe scenarios for reporting new CPT codes
- identify the affect of new reimbursement levels for APC payments
- prepare for the health care common procedure coding system’s code revisions, changes and additions beginning Jan. 1, 2020
- discuss the affect of status indicator changes for 2020
- discuss packaging concepts impacting Medicare APC payments
- review the 2020 coding changes for drugs, radiopharmaceuticals and contrast, including the impact on reimbursement
- discuss how to improve new product implementation processes
- discuss the importance of correctly billing add-on inpatient prospective payment systems’ for new technology devices
- discuss how to provide department-specific guidance in the proper reporting and utilization of the new codes
- review CMS' instructions regarding accurate units of service
- explain the importance of accurate revenue code assignment
- discuss the affect of accurate and complete reporting of supply/device costs and future payments
- discuss the payment for new drugs not yet assigned a specific drug HCPCS code and the risk of billing nonformulary drug changes
7:30 a.m. — Registration/Continental Breakfast
8 a.m. — Introduction to 2020 Coding and APC Updates
- significant payment impacts for 2020
- status indicator revisions
- anticipated operational challenges relative to new CMS reporting guidelines
- charging concepts versus reimbursement opportunities
Review Changes for Supplies, Devices, Biologicals and Pharmaceuticals
Pharmaceutical Reimbursement Impacts
- payment changes and financial forecasts
- HCPCS changes — pharmacy
- self-administered versus supply drugs
- billing/documentation for discarded products
- contrast updates
- radiopharmaceutical updates
- modifier — JW modifer, chargemaster versus manual assignment
10:30 a.m. — Break
10:45 a.m. — Supplies and Biologicals
- procedure-to-device/device-to-procedure edits
- new technology and pass-through payments
- chargemaster-required revisions for CY 2020
- durable medical equipment, prosthetics, orthotics and supplies updates
- incorporating new biological products into the chargemaster
New Updates Affecting Chargemaster
Laboratory — Another Exciting Year
- chemistry, immunology, pathology and microbiology revisions
- molecular pathology
- new, revised and deleted codes review
- consolidation of more radiology procedures
- review of surgical section revisions relative to the chargemaster
11:45 a.m. — Lunch (provided)
12:30 p.m. — New Category III Codes
- discussion and review of the new category III codes for 2020
Observation Challenges in 2020
- operational challenges
- review OPPS reimbursement updates
- two-midnight rule
Infusions and Injections
- chemotherapy/therapeutic administration
Wound Therapy and Hyperbaric Oxygen Therapy
- effects on improper reporting of services by providers
Transitioning of More Surgical CPT Codes From Inpatient Only
- payment for use of modifier (CA)
- review inpatient only list, and construction design and management regulations requirements
2 p.m. — Break
2:15 p.m. — Rehabilitation Services
- review of new CPT/HCPCS coding requirements for 2020
Evaluation and Management Codes
- new chargemaster challenges
- review of E/M codes for emergency departments
- anything new for critical care?
- impact on operations and reimbursement based on proposed/final CMS revisions
3 p.m. — Adjournment
Glenda J. Schuler, RHIT, CPC, CPC-H
Vice President of Revenue Cycle Solutions
HealthCare Consulting Solutions
Shawnee Mission, Kan.
With more than 39 years of experience, Schuler has an extensive background in coding and hospital CPT-4 coding. Her expertise encompasses all areas of medical records, as well as utilization review and patient business services. She has extensive knowledge of third-party reimbursement, electronic submission of claims, and billing and collection issues.
As a health care consultant, her areas of expertise include ICD-9-CM/DRG coding, hospital CPT coding and APC, as well as chargemaster coding and reimbursement, and charge capture. She has developed and conducted coding and reimbursement seminars, and has been a featured speaker nationwide on Medicare APC groups and their impact on hospital operations. Schuler is an active member of the American Health Information Management Association and the American Academy of Professional Coders.
Participants must attend the program in its entirety to receive a certificate of completion and continuing education contact hours.
Coders — This program has prior approval of the American Academy of Professional Coders for 6 continuing education units. Granting of this approval in no way constitutes endorsement by the academy for the program, content or program sponsor.
All Other Participants — A certificate of attendance for 6 clock hours will be awarded.