Download
1 / 10
100 likes | 113 Views
In recent years, there have been new codes added to CPT® related to coordination of care and transition care, but when can these be used in Orthopaedics, and what is included in a patient’s Skilled Nursing Facility residency that will affect the reimbursement of orthopedic surgeons? This webinar will look at both of these lines of service and help practices decide if and when they will report these services.<br><br>Areas covered In the Session:<br><br>The expectations of this conference are that the attendee upon the completion of the conference should have an understanding of the newer CPT® codes related to coordination of care and the rules and guidelines related to consolidated billing for patients in a skilled nursing facility.<br><br>Why Should You Attend:<br><br>Billing for home care certifications and re-certifications<br>Reporting prolonged service codes without direct patient contact.<br>When you can report care management services<br>What is transitional care management?<br>Managing to bill for skilled nursing facilities related to consolidated billing.<br><br>E-mail us at cs@onlineaudiotraining.com or Call 1-800-935-3714 to buy full webinar.
E N D
Keys to Billing Care Coordination and Consolidated Billing Rules Lynn M. Anderanin, CPC, CPMA, CPC-I,CPPM, COSC
Agenda • Coordination Care – Chronic Care Management – Transitional Care Management – Care Plan Oversight – Home Health Certification/Recertification • Consolidated Billing Rules – Radiology – DME
CPT- Surgical Package Definition • Evaluation and Management (E/M) service(s) subsequent to the decision for surgery on the day before and/or day of surgery (including history and physical) • Local infiltration, metacarpal/metatarsal/digital block or topical anesthesia • Immediate postoperative care, including dictating operative notes, talking with the family and other physicians or other qualified health care professionals • Writing orders • Evaluating the patient in the post anesthesia recovery area • Typical postoperative follow-up care
CPT-Care Management Services • Patient has two or more chronic continuous or episodic health conditions that are expected to last at least 12 months, or until the death of the patient, and that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline.
CPT-Care Management Services • 99487- Complex chronic care management service – 60 minutes of clinical staff time in a calendar month – Establishment or substantial revision of a comprehensive care plan – Moderate or high complexity medical decision making
CPT-Care Management Services • +99489- Complex chronic care management service – each additional 30 minutes of clinical staff time in a calendar month – Management of a comprehensive care plan – Moderate or high complexity medical decision making
CPT- Care Management Services • 99490- Chronic care management service – At least 20 minutes per calendar month – Management of comprehensive care plan
Chronic Care Management CMS Fact Sheet • https://www.cms.gov/Outreach-and-Education/Medicare- Learning-Network- MLN/MLNProducts/Downloads/ChronicCareManagement.pdf
CMS-Chronic Care Management • Practitioner Eligibility – Physicians and the following non-physician practitioners may bill CCM services: – Certified Nurse Midwives – Clinical Nurse Specialists – Nurse Practitioners – Physician Assistants • Not within the scope of practice of limited license physicians and practitioners such as clinical psychologists, podiatrists, or dentists. • Not a NCCI edit to surgery with 90 day global
CMS- Chronic Care Management • Examples of chronic conditions include, but are not limited to, the following: – Alzheimer’s disease and related dementia – Arthritis (osteoarthritis and rheumatoid) – Asthma – Atrial fibrillation – Autism spectrum disorders – Cancer – Cardiovascular Disease – Chronic Obstructive Pulmonary Disease – Depression – Diabetes – Hypertension – Infectious diseases such as HIV/AIDS
