Seminar Detail

Coding & Billing in Healthcare: Apply the Latest Updates & Prevent Costly Errors
Coding & Billing in Healthcare: Apply the Latest Updates & Prevent Costly Errors


When:  Wednesday, February 20, 2019 at 8:00 AM - 3:30 PM

This event is not currently available for purchase.

For more information: Call (800) 844-8260
Course Description:

The Departments of Justice and Health are committing increased resources to weed out fraud, waste, and abuse in health care. In 2017 false and fraudulent billing of Medicare and Medicaid claims amounted to $1.2 billion, resulting in criminal charges for 400 individuals. The Department of Health has also announced it will be increasing the number of Medicaid audits performed each year to prevent fraud and improper payments.

Committing fraud in health care billing does not necessarily require an intent to do so. Improper coding and submission of a claim due to a lack of knowledge and understanding is all that is necessary to land you and your doctor’s office in hot water. With changes on the horizon in ICD-10, new telehealth billing protocols, and new codes relating to psychiatric care in certain primary care settings, it is more important than ever to ensure you and your staff are up to date.

In addition to avoiding claims of fraud, ensuring proper coding and submission of claims from the start will see your doctor’s office reimbursed the correct amount faster and easier. In an era where providers are forced to do more with less, it is essential for a practices’ survival to receive appropriate reimbursements in a timely fashion. You really can’t afford to miss this one-day event!

  1. Maximize your reimbursement through knowledgeable code selection.
  2. Analyze the 2019 changes to the ICD-10-CM and CPT codes to determine how they affect your practice.
  3. Recommend when to use attachments.
  4. Explain telehealth billing, with correct modifiers and POS.
  5. Develop the best course of action for medical necessity denials.
  6. Analyze the most common ICD-10-CM denials to put in to place the proper approach on the front end.
  7. Evaluate the best steps to ensure optimal and timely reimbursement.
  8. Examine bundling to know when it is best to unbundle codes.
  9. Illustrate proper submission of incident-to claims.
  10. Recognize strategies to avoid down coding.

A First Look At The 2019 Changes
  • ICD-10 CM code update effective 10/01/2018
  • New guidelines for ICD-10 CM
  • Psychiatric Collaborative Care Management for the family practice, pediatrics, internal medicine, OB/GYN or other general practice office
  • Telehealth – modifiers, place of service, and the difference between telehealth and phone visits and who reimburses
  • Proper use of prolonged time codes – how this can help your practice immediately!
Expert Tips To Master The Claims Submission Process
  • Understand how the diagnosis drives the claim
  • Recognize what a mutually exclusive diagnosis rejection is telling you
  • The elements of an incident-to claim
  • Discuss modifiers and how they can assist a claim
  • When should documentation be submitted with the claim
  • Know how and when to unbundle a code
Documentation Strategies
  • What to do if you’ve been down coded?
  • Tools to analyze and solve difficult billing problems
  • Learn how to prevent a medical necessity denial
  • Acceptable use of unspecified diagnostic codes
  • What should you locate in the documentation to support an appeal or correction
Improved Billing Processes
  • Avoid costly and common errors
  • Know when to query the provider
  • When should you appeal and when should you “write it off”
  • What information are you communicating through the coding – to understand the potential impact
Target Audience

  • Coding and Billing Staff
  • Medical Records Staff
  • Office Managers
  • Physicians
  • Physician Assistants
  • Nurse Practitioners
  • Nurse Managers
  • Chiropractors
  • Dentists
  • Physical Therapists
  • Occupational Therapists


Debra Mitchell, MSPH, CPC-H, is a coding and compliance consultant and auditor, drawing from 30 years of experience in the field. She also shares her expertise through nationally presented continuing education events to benefit those working in various coding and billing roles. Debra has contributed to the development of a coding certification program and supervised a statewide Medicaid “peer review” program. Her commitment to the specialty is reflected as Debra maintains active membership in the American Academy of Professional Coders and is certified in hospital coding.

Speaker Disclosures:

Financial: Debra Mitchell receives a speaking honorarium from PESI, Inc.

Non-financial: Debra Mitchell is a member of the American Academy of Professional Coders.
Credits listed below are for full attendance at the live event only. After attendance has been verified, pre-registered attendees will receive an email from PESI Customer Service with the subject line, “Evaluation and Certificate” within one week. This email will contain a link to complete the seminar evaluation and allow attendees to print, email or download a certificate of completion if in full attendance. For those in partial attendance (arrived late or left early), a letter of attendance is available through that link and an adjusted certificate of completion reflecting partial credit will be issued within 30 days (if your board allows). Please see “live seminar schedule” for full attendance start and end times. NOTE: Boards do not allow credit for breaks or lunch.

If your profession is not listed, please contact your licensing board to determine your continuing education requirements and check for reciprocal approval. For other credit inquiries not specified below, or questions on home study credit availability, please contact or 800-844-8260 before the event.

Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

PESI, Inc. offers continuing education programs and products under the brand names PESI, PESI Healthcare, PESI Rehab and Psychotherapy Networker.

This program has the prior approval of the American Academy of Professional Coders (AAPC) for 6.0 continuing education hours. Granting of prior approval in no way constitutes endorsement by the AAPC of the program content or the program sponsor. AAPC approval good thru .

BOC LogoThis activity is offered for 6.0 credit hours.

Nurses, Nurse Practitioners, and Clinical Nurse Specialists
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PESI, Inc. is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Nurses in full attendance will earn 6.0 contact hours. Partial contact hours will be awarded for partial attendance.

Occupational Therapists & Occupational Therapy Assistants
PESI, Inc. is an AOTA Approved Provider of continuing education. Provider #: 3322. Full attendance at this course qualifies for 6.0 contact hours or .6 CEUs in the Category of Domain of OT and Occupational Therapy Process. Partial credit will be issued for partial attendance. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA. Course Level: Intermediate.

Physical Therapists & Physical Therapist Assistants
This activity consists of 6.0 clock hours of instruction that is applicable for physical therapists. CE requirements for physical therapists vary per state/jurisdiction. Please retain the certificate of completion that you receive and use as proof of completion when required.

Tennessee Physical Therapists & Physical Therapist Assistants: 6.0 contact hours have been approved by the Tennessee Physical Therapy Association.

PESI, Inc. is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

PESI, Inc. designates this live activity for a maximum of 6.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Physician Assistants
AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1™ from organizations accredited by ACCME such as PESI. Physician assistants may receive a maximum of 6.0 hours for completing this program.

PESI, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. PESI, Inc. designates this live activity for a maximum of 6.0 AMA PRA Category 1 Credit(s)™.

Other Professions
This activity qualifies for 360 minutes of instructional content as required by many national, state and local licensing boards and professional organizations. Save your course outline and certificate of completion, and contact your own board or organization for specific requirements.

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