ICD-9 Coding & OASIS: What You Need to Know for Assured Accuracy

In the past 3 years, home health has seen many changes and new regulations, and there are still more to come in 2011. Most of these changes and new regulations affect not only an agency's policies and procedures, but can also affect its reimbursement. Some of these are out of the agency's control but others can be controlled with ongoing staff education. Join us as Jennifer provides the ICD-9 and OASIS-C information agencies need to know in order to assure accuracy of clinical records and reimbursement. She will provide detailed information that every clinical staff member should be using every day. She will also allow time for answering your most pressing questions and provide sample scenarios.

ICD-10: The Good, The Bad, and The Ugly

All health care entities must transition from ICD-9 CM to ICD-10 CM in 2013. It is important for the home health industry to realize there are processes that should be occurring right now to prepare for the conversion. For example, in preparation for the transition to ICD-10CM, the conversion to HIPAA 5010 is happening this year. The webinar will provide an overview of the new coding system, describe HIPAA timelines, discuss staff educational needs and how to prepare now to lessen the transition’s impact on your agency.

Defeating Orthopedic & Therapy Coding Dilemmas

Objective 1: Identify official coding rules and guidlines
1. General coding guidelines
2. M2200 and it's relationship to coding
3. OASIS-C considerations

Objective 2: Assess frequently used coding conventions in Orthopedic conditions
1. Using 781.2 (abnormality of gait) as a symptom or a etiology code
2. Use of 719.7 (difficulty in walking)
3. Weakness and other symptom codes
4. Etiology or symptom code

Objective 3: Recognizing when to use V57 codes appropriately
1. Current guidelines for V57 codes
2. Therapy only cases
3. Multiple disciplines and V57 codes
4. Aftercare code or V57 code

Objective 4: Apply lessons learned to practice scenarios
1. Practice Scenarios

Focused Medical Review & ADR's

Why the increase nationwide?
Why will you be probed electronically during the next 18 months?
Who really owns NGS, CAHABA, and Palmetto and why they are under new scrutiny from CMS?
Data triggers, Documentation deficiencies
Probe edit process
Focused medical review processes
Referral to the Benefit integrity group by the medical review teams

Medicare home health has changed in many ways, OASIS-C, Face to Face, and therapy thresholds have kept all of us so busy with minutia we have forgotten the most important relationship of all: the one we share with our RHHI. State and accreditation surveyors can force you to write plans of correction and reorganize. Within 5 minutes your billing can be audited by 50% on pre-pay basis. Within 5 minutes it can be turned off. Which one deserves the greatest attention?

Agencies accross the country pass accreditation surveys and department of health surveys everyday just to loose hundreds of thousands of dollars in medical review. RAD readiness seminars have supposedly protected agencies but no one has presented the inside story as of yet and how to audit using the same tools the RHHI and BI groups use. Now is the time to be informed as preparations thus far seem not to have provided the protection expected.