WEBINAR: APCs In-Depth: Cardiovascular Coding and Payment

Cardiovascular Interventional Radiology (CVIR) is a significant growth area as demands continues to ramp up with the Baby Boom generation. CVIR also represent some major coding and billing challenges.

Coding is often accomplished by coding through the Chargemaster using charge entry.  Modifiers must be used for a number of services in this area.  Also, the development of proper charge mechanisms is a challenge particularly with expensive implantable devices such as stents.  The coding structure for CVIR at both the CPT and HCPCS levels continues to evolve.  

Additionally, there are a number of NCCI edits in this area.  CMS through APCs (Ambulatory Payment Classifications) has been significantly increasing the bundling of certain CVIR services starting in 2008 through 2017.  This increased bundling from different perspectives has created concern about properly charging, even for services and items that will be packaged.

Webinar Objectives: 
review coding, billing and reimbursement for cardiovascular interventional radiology services in general
appreciate the extreme complexity of coding, billing and reimbursement in the cardiovascular interventional radiology area
review several case studies to illustrate the complexities of coding and billing and the need to carefully design the charge capture interface to the chargemaster
review CPT coding and coding directive changes in the cardiovascular areas
understand the multi-year changes from 2008 through 2017 for coding that continue to occur in CPT, HCPCS, NCCI edits along with APC packaging and their impact on hospitals
discuss pricing strategies for expensive catheters and stents used for interventional radiology services for both inpatient and outpatient services
review chargemaster techniques and associated coding and billing flow
appreciate how charge structures must be adjusted relative to coding inclusions in the cardiovascular area
examine how APCs are being changed in the cardiovascular interventional radiology areas through increased packaging
understand compliance concerns that arise with correlating physician and facility component coding
appreciate that by using different documentation approaches there may be inconsistencies generated

Webinar Topics:
Cardiovascular Overview
o Interventional Cardiovascular Services
o Cardiovascular Monitoring and Devices
o Electrophysiological Procedures
Interventional Radiology Overview
o Component Coding
o Diagnostic versus Therapeutic Services
o Stents and Stent Placement
o Angioplasties and Atherectomies
o APC and DRG Payment Processes
Coding and Coding Directive Changes
o Coronary and Vascular Catheterization Procedures
o Monitoring and Cardiac Devices
o Electrophysiological Procedures
o CPT Coding and Coding Guidance Changes
o Impact on Charges and Payments
Chargemaster Issues
o Basic Design Process for Cardiovascular and CVIR Services
o Professional versus Technical Component Coding/Billing
o Proper Charging for CVIR Services
o Modifier Challenges
Payment Issues for CVIR Services
o Increased Packaging for APCs
o Device Dependent Concept for APCs and DRGs
o Multi-Year Changes in APC Grouping
o Changes in Reimbursement
? Physicians vs. Hospitals
Alternative Revenue Cycle Flows
o Static Coding in the Chargemaster
o Dynamic coding Outside the Chargemaster
o Hybrid Methodologies
o Assessing Claim Accuracy
o Tracking Reimbursement
o Costs versus Reimbursement
Compliance Issues
Sources for Further Information

Target Audience:
Coding Personnel, Billing and Claims Transaction Personnel, CVIR Personnel, Chargemaster Coordinators, Financial Analysts, Compliance Personnel, Auditors, Cardiovascular Service Area Staff, Physicians and Other Interested Personnel

Faculty: Duane C. Abbey

Duane Abbey is a management consultant and president of Abbey & Abbey Consultants, based in Ames, Iowa. For over twenty years Abbey & Abbey, Consultants, Inc. has provided superior healthcare consulting services to hospitals, hospital systems, physicians, medical clinics and integrated delivery systems.
Abbey & Abbey, Consultants, Inc. specializes in healthcare consulting primarily in the areas of: 
Payment systems - reimbursement consulting
Delivery systems - organization of healthcare delivery
Compliance - developing compliance programs - emphasis in the coding, billing and reimbursement areas
In addition to his consulting, Dr. Abbey has been an invited presenter for hospital associations, medical societies, and other groups. He has also published both articles and books on health care topics. Dr. Abbey earned his graduate degrees from the University of Notre Dame and Iowa State University.

Contact Hours: 
All participants: Must attend the entire Webinar and complete a Webinar critique to receive a 1.5 Hour Attendance Certificate.
6/15/2017 10:00 AM - 6/15/2017 11:30 AM
United States


Thursday, 15 June 2017

6/15/2017 10:00 AM
10:00 AM - 11:30 AM
6/15/2017 10:00 AM
10:00 AM - 11:30 AM
6/15/2017 10:00 AM
10:00 AM - 11:30 AM
6/15/2017 10:00 AM

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