Outpatient Therapy Billing & Documentation

Gawenda Seminars provides educational courses in Outpatient Therapy on the following topics:

Outpatient Therapy CPT Coding, Billing, and Documentation for Rehabilitation Reimbursement

This one day seminar discusses Medicare and other 3rd party payer
policies for rehab therapy services. This course is appropriate for
OT’s, COTA’s, PT’s, PTA’s, SLP’s, rehab directors, rehab managers,
billers and coders responsible for therapy billing, coding, and
documentation for outpatient therapy services provided in private
practice, hospital outpatient departments, rehab agencies, comprehensive
outpatient rehabilitation facilities (CORF), home health agencies
providing therapy not under a home health plan of care, and skilled
nursing facilities (SNF).

Course Description: Outpatient Therapy CPT Coding,
Billing & Documentation for Rehabilitation Reimbursement covers the
correct use of CPT codes, as well as G & L Health Care Financing
Administration Common Procedure Coding System (HCPCS) Level II codes.
Modifiers used by Physical, Occupational, and Speech Therapists will be
discussed with emphasis on Modifier-59 due to CCI edits. This course
also covers ICD-9-CM coding guidelines and provides participants with
the most widely utilized ICD-9 codes in outpatient therapy. Billing
scenarios are discussed and reviewed to ensure therapists and assistants
are accurately charging patients correctly for their services. We also
examine the most common reasons claims are denied and thoroughly review
Medicare Part B and other 3rd party payer documentation
guidelines for initial evaluations, re-evaluations, progress reports,
daily notes, certifications/re-certifications, plan of care, and
physician orders required for outpatient therapy reimbursement.
Resources and references are provided so that therapists and assistants
may keep up to date with the ever-changing reimbursement guidelines and
regulations.

Course Objectives:

  • Define service-based versus timed-based CPT codes
  • Understand and effectively use CPT codes and G & L HCPCS Level II codes
  • Define, identify, and understand CCI edits
  • Recognize when it is appropriate to use modifier-59 and how to document to support the use of modifier-59
  • Apply and comprehend ICD-9-CM coding guidelines to outpatient therapy services
  • Understand how various insurance payers utilize ICD-9 codes in determining medical necessity
  • Be able to charge correctly for the services you provide–Understanding Medicare’s “8 minute rule”
  • Identify reasonable and necessary criteria for skilled therapy services
  • Describe and implement the necessary components of documentation to support skilled therapy services for reimbursement
  • Develop and write short and long term function-based goals based on the patient’s functional deficits
  • Identify and understand plan of care and certification/re-certification requirements for Medicare Part B therapy services

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Outpatient Therapy CPT Coding & Billing For Rehabilitation Reimbursement

This half day seminar discusses Medicare and other 3rd party payer
policies for rehabilitation therapy services. This course is appropriate
for OT’s, COTA’s, PT’s, PTA’s, SLP’s, rehab directors, managers,
billers and coders responsible for therapy billing and coding for
outpatient therapy services provided in private practice, hospital
outpatient departments, rehab agencies, comprehensive outpatient
rehabilitation facilities (CORF), home health agencies providing therapy
not under a home health plan of care, and skilled nursing facilities
(SNF).

Course Description: Outpatient Therapy CPT Coding
& Billing for Rehabilitation Reimbursement covers the correct use of
CPT codes, as well as G & L Health Care Financing Administration
Common Procedure Coding System (HCPCS) Level II codes. Modifiers used by
Physical, Occupational, and Speech Therapists will be discussed with
emphasis on Modifier-59 due to CCI edits. This course also covers
ICD-9-CM coding guidelines and provides participants with the most
widely utilized ICD-9 codes in outpatient therapy. Billing scenarios are
discussed and reviewed to ensure therapists and assistants are
accurately charging patients correctly for their services. Resources and
references are provided so that therapists and assistants may keep up
to date with the ever-changing reimbursement guidelines and regulations.

Course Objectives

  • Define service-based versus timed-based CPT codes
  • Understand and effectively use CPT codes and G & L HCPCS Level II codes
  • Define, identify, and understand CCI edits
  • Recognize when it is appropriate to use modifier-59 and how to document to support the use of modifier-59
  • Identify and comprehand 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–Understanding Medicare’s “8 minute rule”