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Who should attend Outpatient Therapy CPT Coding, Billing and Documentation for Rehabilitation Reimbursement
Physical Therapists, Occupational Therapists, Speech Language Pathologists, Physical Therapy Assistants, Certified Occupational Therapy Assistants, Rehab Directors and ManagersRehab Billers and Coders, NursesNurse PractitionersNursing Home Administrators
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Outpatient Therapy CPT Coding, Billing and Documentation for Rehabilitation Reimbursement  

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Physical Therapists, Occupational Therapists, Speech Language Pathologists, Physical Therapy Assistants, Certified Occupational Therapy Assistants, Rehab Directors and ManagersRehab Billers and Coders, NursesNurse PractitionersNursing Home Administrators

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Seminar Summary:

Stay current with the ever-changing reimbursement guidelines and regulations as they pertain to outpatient therapy services!  (see full course description)

 
 

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Training Course Syllabus:


PROGRAM DETAILS

Insurance payers are increasingly reviewing therapy claims to ensure that the therapy provided to the beneficiary required the skills of a therapist, was billed appropriately and the required documentation was present in the patient's medical record. The Centers for Medicare and Medicaid Services continue to focus their efforts on reducing inappropriate payments to providers of therapy services in all settings as outlined in the Office of the Inspector General's 2007 workplan.

Outpatient Therapy CPT Coding, Billing and Documentation for Rehabilitation Reimbursement covers the correct use of CPT codes, G, and L Level II codes, and modifiers used by Physical, Occupational and Speech Therapists in all outpatient settings including private practice, hospital-based, rehab agencies, comprehensive outpatient rehabilitation facilities, skilled nursing facilities and in a patient's home. The course also covers ICD-9-CM coding guidelines as they pertain to outpatient therapy services. Billing scenarios are discussed and reviewed to ensure therapists can accurately charge patients correctly for their services. This course also examines the most common reasons claims are denied for all payers and thoroughly reviews Medicare Part B and other third party payer documentation guidelines for initial evaluations, re-evaluations, progress reports, daily notes, certifications/recertifications, plan of treatment and physician orders. Resources and references are provided to assist therapists to stay current with the ever-changing reimbursement guidelines and regulations as they pertain to outpatient therapy services.

WHAT YOU WILL LEARN

  • Learn and understand use of CPT, G, and L codes
  • Charge correctly for the services you provide
  • Understand the Medicare Automatic and Manual Process Exceptions
  • Identify and avoid the main reasons for denials
  • Master all the necessary components of documentation
  • Define service-based vs. time-based CPT codes
  • Describe the rationale for the use of CPT, G, and L codes in all outpatient settings
  • Define and distinguish between mutually exclusive edicts and column 1/column 2 edits
  • Be able to read the CCI edit chart and appropriately append modifier -59 to the correct CPT code(s)
  • Be able to document appropriately to support the treatments provided and the use of modifier -59
  • Learn and understand the ICD-9-CM coding guidelines as they pertain to outpatient therapy services
  • Understand how ICD-9 codes support medical necessity by the various insurance payers
  • Be able to charge correctly for the services you provide under outpatient therapy benefits
  • Identify the most common reasons for denials of outpatient therapy services by all providers
  • Delineate the specific requirements for physician orders for outpatient therapy services
  • Identify reasonable and necessary criteria for skilled therapy services
  • Describe and implement the necessary components of documentation to support skilled therapy services for reimbursement
  • Be able to write function-based short- and long-term goals based on the patient's functional deficits
  • Provide the definitions and requirements for developing plan of care and the certification/recertification process

 

ABOUT THE SPEAKER

Rick Gawenda, PT, graduated in 1991 with a Bachelor of Science in Physical Therapy from Wayne State University, Detroit, Michigan. Mr. Gawenda is currently Director of Physical Medicine and Rehabilitation at Detroit Receiving Hospital overseeing all PM&R services provided in both the inpatient and outpatient setting and owner of Gawenda Seminars.

Mr. Gawenda is on the editorial advisory boards for Advance for Directors in Rehabilitation and Briefings on Outpatient Rehab Reimbursement and Regulations. Mr. Gawenda is the consulting editor for Outpatient Physical Therapy Coding Alert and Eli's Rehab Report. Mr. Gawenda is a member of the American Physical Therapy Association (APTA), Michigan Physical Therapy Association (MPTA), MPTA Insurance Relations Committee, MPTA Director #1 overseeing the Legislative and Bylaws Committees, and President of the Section on Health Policy & Administration of the APTA. Mr. Gawenda serves as the liaison between the MPTA and United Government Services, who is the Medicare Fiscal Intermediary for the State of Michigan.

Mr. Gawenda has provided his expertise for many articles in Briefings on Outpatient Rehab Reimbursement and Regulations and Eli's Rehab Report, on various topics such as Advance Beneficiary Notice, Medicare certification/recertification, utilization of "L" codes as they relate to therapy, reimbursement and documentation, and the use of aides in therapy. In addition, Mr. Gawenda has written articles for Advance for Directors in Rehabilitation on CPT coding, Modifier 59, The Medicare Appeals Process, and has a monthly Q&A column where he answers questions submitted by the readers. Mr. Gawenda is also the author of The How-To Manual for Rehab Documentation: A Complete Guide to Increasing Reimbursement and Reducing Denials as well as Coding and Billing for Outpatient Rehab Made Easy: Proper Use of CPT codes, ICD-9 codes, and Modifiers.

TESTIMONIALS

"Very impressed with the presenter's knowledge of this topic." - Glen McBride, SLP-CCC, Kansas City, Missouri

 

WHO SHOULD ATTEND

  • Physical Therapists
  • Occupational Therapists
  • Speech Language Pathologists
  • Physical Therapy Assistants
  • Certified Occupational Therapy Assistants
  • Rehab Directors, Managers and Supervisors
  • Rehab Billers and Coders
  • Physicians
  • Nursing Home Administrators

 

CREDITS

Cross Country Education is a Preferred Provider of professional continuing education with the National Association of Boards of Examiners of Long Term Care Administrators (NAB) and has approved this program for the number of clock hours listed under their sponsor agreement with NAB/NCERS. This program is approved for 6 continuing education clock hours Approval #2822007-24144-6. State licensure boards, however, have final authority on the acceptance of individual courses.

This program has prior approval by the American Academy of Professional Coders for 6.0 Continuing Education Units (Index #CCE0613070352A). Granting of prior approval in no way constitutes endorsement by AAPC of the program content nor the program sponsor. Full attendance is required to receive credit for Coders; variable credit for partial attendance may not be awarded based on the AAPC guidelines.

Cross Country Education is approved by the Continuing Education Board of the American Speech-Language-Hearing Association (ASHA) to provide continuing education activities in speech-language pathology and audiology. This program is offered for .6 CEUs Introductory level; Related area. ASHA CE Provider approval does not imply endorsement of course content, specific products, or clinical procedures.

Cross Country Education is an approved provider of continuing nursing education by the Tennessee Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation. Provider #044013109, this course is offered for 6.0 contact hours.

Cross Country Education is an approved provider with the Iowa Board Of Nursing, approved provider #328. This course is offered for 7.2 contact hours.

Cross Country Education is an approved provider by the Florida Board of Nursing, provider #50-466. This course is offered for 7.2 contact hours.

Cross Country Education is approved by the California Board of Registered Nursing, Provider #CEP 13345, for 7.2 contact hours.

Cross Country Education is an AOTA Approved Provider of continuing education. This course is offered for .6 AOTA CEUs. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA. AOTA Educational level Intermediate, Category 3: Professional Issues

This program has been approved for 6 CEUs by the Ohio Physical Therapy Association for Physical Therapists and Physical Therapy Assistants (Approval #07S1110).

This seminar qualifies for 6 continuing education hours 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 filing requirements.
 

SEMINAR CLASS TIME

Seminar Check-In:  7:30 AM   Seminar Class 8:00 AM - 3:30 PM

Seminar Summary:

Stay current with the ever-changing reimbursement guidelines and regulations as they pertain to outpatient therapy services!  (see full course description)

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