How PPS Changes Will Turn Coding on its Ear: What every coder must know to ensure accurate reimbursement

Friday, October 26, 2007 . 1:00- 2:30 p.m. ET

Home Care Outcomes present:

How PPS Changes Will Turn Coding on its Ear:
What every coder must know to ensure accurate reimbursement
Audio Conference • Friday, October 26, 2007 • 1:00- 2:30 p.m. ET

Coders will no longer have the luxury of a tidy list of case-mix codes to guide their pursuit of coding accuracy. Come January 1, you’ll step into a maze of new case-mix calculation rules that will lead you through some tricky turns. For starters: A case-mix code won’t always be a case-mix code in 2008!

Your coding accuracy and OASIS assessments will even be more essential than ever – your agency’s proper reimbursement literally hangs in the balance!

Consider this: A faulty OASIS assessment on an MS patient’s functionality could cost your agency 18 points in the clinical domain, diminishing a case-mix diagnosis code’s value to zero points. To make matters worse, this could throw a wrench into your sequencing if a V code is placed in M0230!

But don’t worry, coding expert and trainer Trish Twombly RN, BSN, HCS-D, CHCE, has been through every nook and cranny of CMS’156-page PPS final rule to develop strategies for navigating all of its many twists and turns.

Tune into this live 90-minute audio conference and you’ll learn what to be wary of, how to prepare and how to code so that your agency collects every Medicare dollar to which it’s entitled. You’ll learn:

The ins and outs of the nearly two-dozen case-mix categories you’ll have to contend with in 2008. Careful: Only 12 categories will be clear-cut case-mix codes that can be used in all episodes.
The rest will require you to determine the answers to a complex variety of questions in order to calculate each code’s point value.
How to reap points from V codes. That’s right -- for the first time, V codes will be worth case-mix points, but only under very strict conditions.
Why accurate coding will hinge on the quality of the OASIS assessment – Your sequencing will be way off if clinicians fail to accurately score each patient’s severity.
How the same code could be worth 18 case mix points for one patient, and just three – or even zero! – points for another. And it all hinges on the answers to four key OASIS items that coders will have no control over!
When you’ll be able to add up the points of all case-mix codes placed in M0230 and M0240b and M0246a and M0246b. Hint: It involves comorbidities and must include codes from different categories.
When it’ll be necessary – and permissible – to include the same diagnosis code more than once in M0246. The zinger? It could happen up to six times! Find out whether you can also reap points for these odd repetitions.

EXAMPLE

A patient experiencing gait abnormality due to late effect of an old fracture is being admitted for physical therapy only. Under the current PPS regulations it would be coded:

M0230: V57.1 Physical therapy
M0240b: 781.2 Abnormality of gait
M0240c: 905.4 Late effect of fracture of lower extremity
M0245a: 781.2 Abnormality of gait
Worth 11 points from the ortho case mix list

After January 2008 using the new PPS regulations the same scenario would be coded:

M0230: V57.1 Physical therapy
M0240b: 781.2 Abnormality of gait
M0240c: 905.4 late effect of fracture of lower extremity
M0246 (3): blank
Worth no additional case mix points

In this example, 781.2 ‘abnormality of gait’, does not meet criteria for case mix points even though it is listed on the new case mix list in its own case mix category. Under the new system, this code would only be a case mix when M0460 was marked yes for a pressure ulcer in the first or second episode with 0 to 13 therapy visits. Since this patient does not have a pressure ulcer, abnormality of gait does not have case mix status for this patient.

One registration fee lets your entire staff listen in!
Save money - no travel expenses!

Your Expert Speaker:

Trish Twombly RN, BSN, HCS-D, CHCE, is director of coding at Foundation Management Services, in Denton, Texas.

Sponsors

Diagnosis Coding Pro for Home Health provides you and your coding staff with ICD-9-CM coding and training answers for accurate OASIS, 485 and UB-92 completion to ensure full reimbursement for home health services.

DecisionHealth®, publisher serving the business and regulatory needs of health care practitioners, providers and their administrative staff nationwide by offering more than 50 independent newsletters, magazines, books, web sites and loose-leaf services that help readers make the best business decisions.

4 Ways to Register

1. Register online
2. Call (866) 620-5939 or (301) 287-2642
3. E-mail conf@decisionhealth.com
4. Mail registration to:

Conference Department - A1393
11300 Rockville Pike
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Make checks payable to: DecisionHealth - A1393 (TIN: 52- 05881)
Payment must be received by the day of the conference

Audio Conference	Audio CD	Conference & CD
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Important Information

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If this audio presentation doesn’t give a better understanding of how the PPS changes for 2008 will affect your coding practices, let us know and we’ll refund every penny of your registration fee. Guaranteed!

Cancellation Policy
Cancellations made within 3 business days of the conference are subject to a $50 service fee. Registrants who do not dial in and who do not cancel before the conference date are liable for the full conference fee. Cancellations must be made by fax or email. Fax to the conference department at 301-287-2535 or email to conf@decisionhealth.com.
Telephone cancellations are not accepted.

We reserve the right to substitute a speaker, reschedule or cancel an audio conference.