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West Virginia Overview of Clinical Documentation, Coding, and Billing for Community Health Clinical Providers
Friday, April 26, 2024, 8:30 AM - 12:30 PM EDT
Category: Rural or Community Health Coding & Billing Bootcamp
ENROLL Now
Event Overview: Please join the WVPCA and ArchProCoding, who have partnered to deliver a training, Overview of Clinical Documentation, Coding and Billing for Community Health Clinical Providers, which will focus on medical documentation, coding and Billing. Topics covered, but not limited to are updated E/M documentation guidelines, 2024 ICD-10-CM Official Guidelines for Coding and Reporting, minor procedures, reporting quality measures via CPT Category II codes, Evaluation and Management documentation guidelines, preventative vs. sick visits vs covered-CMS preventative services, behavioral health services and modifiers specifically for FQHCs. This session is designed to provide foundational knowledge on the key topic areas on the unique rules and regulations facing FQHCs/RHCs/CAHs. 

This training will be provided from the perspective of a provider documenting in a medical record and will provide valuable perspective on how facility leaders, professional coders, and billing staff use the information in the medical record to extract data related to what services are documented (CPT and HCPCS-II codes) and why they were done (ICD-10-CM codes) and how their health center may need to adjust the codes on a claim to meet various payer rules. 

This training class provides a complete overview of key resources, references, and responsibilities related to proper medical records documentation capture and proper reporting of the HIPAA mandated CPT, HCPCS-II, and ICD-10-CM code sets with a focus on Medicare since they serve as foundation for billing to many payers.  Medicaid is unique to each state, and it is difficult to provide accurate Medicaid billing advice.

Tentative Agenda/Topics: 
  • Deliver an overview of the documentation, coding, reporting, and reimbursement issues that impact providers in and HHS-certified Federally Qualified Health Centers related to the CPT, HCPCS-II, and ICD-10-CM.
  • Outline the vital distinctions between clinical documentation protocols vs. professional coding rules vs. varying requirements of insurance payers vs. reporting accurate quality metrics (if required by payers).
  • Identify solutions to the inherent limitations of EHR and billing software with a goal to increase revenue, facilitate quality reporting, and decrease audit risk.
  • Provide detailed instruction on the AMA’s and CMS Evaluation & Management documentation guidelines and the distinction between proper reporting of “Sick” and “Well” visits and when they can both be reported on the same encounter.
  • Identify the CMS-covered Preventative Services including the initial Preventative Physical Exam, Annual Wellness Visits, and other covered preventative services Medicare will cover on a periodic basis. 
  • Review key areas of the “ICD-10-CM Official Guidelines for Coding and Reporting” in the context of the revenue cycle and quality care reporting including the Social Determinants of Health.
  • Identify how different payers may want a health center to bill for minor surgical procedures using different definitions of the “global surgical package.”
  • Compare/contrast traditional Telehealth versus Virtual Communication Services.
  • Outline Care Management revenue options including Principal/Chronic Care Management, Transitional Care Management, Behavioral Health Integration, and the Psychiatric Collaborative Care Model.
  • Injections and Infusions
  • Risk Adjustment, HCC, UDS reporting, Quality Measures

CEUs: 4 hours of Category 1 CMEs will be provided with this training

Event Date: April 26th, 2024 8:30 AM - 12:30 PM

Target Audience: Providers who create clinical documentation in medical records and need training on the AMA's CPT documentation guidelines, HCPCS-II coding, and ICD-10-CM diagnosis codes. 

Cost: This event is being offered at only $250 per participant!

This training is only available to Community Health Center staff!