Product Detail

1. Maximize your reimbursement by emphasizing proper coding
2. Outline the 2019 changes to ICD-10-CM and CPT codes and how they affect your practice
3. Identify when to use attachments
4. Explain how to treat medical necessity denials
5. Assess what ICD-10-CM denials are most popular common
6. Discuss tips and techniques to obtain optimal and timely reimbursement
7. Examine bundling and how or when to unbundle codes
8. Illustrate proper submission of incident-to claims
9. Recognize what downcoding is and how to fight it and avoid it

FIRST LOOK AT 2019

• The coding process
• What to expect for 2019
• The OIG Work Plan
• Proper use of prolonged time codes - how this can help your practice, immediately

THE CODING PROCESS IN THE CHANGING HEALTHCARE ENVIRONMENT

• 2019 ICD-10-CM codes—a closer look
• OIG work plan issues for physician billing
• An overview of CPT changes
• Modifiers and which ones can enhance reimbursement
• Unraveling the complexities of Medicare, Medicaid, and Third Party Insurance

NAVIGATING THE INS AND OUTS OF THE CLAIMS SUBMISSION PROCESS

• Know when documentation must be submitted with the claim
• The elements of an incident-to claim
• Recognize CCI edits (bundling) and understand how and when to unbundle

DOCUMENTATION, DOCUMENTATION

• What to do if you have been downcoded
• How to analyze and solve difficult billing problems
• What to look for with a denial for medical necessity
• Understand what to use from the documentation for an appeal or correction

EFFECTIVE TECHNIQUES FOR BETTER BILLING

• How to avoid the most common errors
• Know when to appeal and when to "write it off"
• Understanding the importance of physician profiling
• News from the CMS front that may impact your billing

Save time and $10 off the price of other submission methods – purchase & take the CE test online for $9.99 USD per participant. Additional processing fees apply for other submission methods (i.e. mail, fax, etc.). Please contact our Customer Service at 1-800-844-8260 for more details.

Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Please note, your state licensing board dictates whether self study is an acceptable form of continuing education. Please refer to your state rules and regulations.

Certificates of Successful Completion are available for email, download and/or printing from your online account immediately following the successful completion of the post-test/evaluation.

**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.

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners. For speaker disclosures, please see the faculty biography.

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Nurses/Nurse Practitioners/Clinical Nurse Specialists - Credit Expired: 9/19/2021
No CE available for this board.

California Nurses: PESI, Inc. is a provider approved by the California Board of Registered Nursing, Provider #:17118 for 5.5 self-study contact hours.

You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

Florida Nurses: PESI, Inc. is an approved provider by the Florida Board of Nursing. Provider #: FBN2858. These materials qualify for 5.5 self-study contact hours.

Iowa Nurses: PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 5.9 self-study contact hours.

Copies of the evaluation may be sent to the IBON. You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

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Other Professions
This self-study activity qualifies for 5.75 clock hours of instructional content as required by many national, state and local licensing boards and professional organizations. Retain your certificate of completion and contact your board or organization for specific filing requirements.

Disclaimer: **Information obtained in this course should be used within your scope of practice.
**It is your ethical responsibility to report accurate hours to your licensing board.
**All self-study participants must complete and pass (80% or better) a post-test and evaluation prior to receiving a certificate of completion. If you require a copy of the test/evaluation for CE purposes, please print at the time you take the test. Or you may call our customer service department and a copy of your test/evaluation will be emailed to you. Please allow 30-45 days.

• Coding and Billing Personnel
• Medical Records Personnel
• Office Managers
• Physicians
• Medical Assistants
• Nurse Practitioners
• Nurse Managers and Nurses