NCCI Edits and Modifier 59 Changes
Please join us as Gawenda Seminars & Consulting, Inc. presents “2019 NCCI Edits and Changes to Appending Modifier 59″ webinar conference on June 19, 2019 from 1:00PM – 2:30PM eastern daylight time. The Centers for Medicare and Medicaid Services (CMS) updates the National Correct Coding Initiative (NCCI) edits every quarter. Effective with dates of service on and after July 1, 2019, CMS is changing how modifier 59 is appended to a CPT code(s) on the claim form. Continue reading below for the full webinar description and objectives.
One registration allows as many people to watch and listen to the webinar on one computer and/or phone line and each participant would be eligible to print off a certificate of attendance that may be eligible for 1.5 CEUs from your state board or national association. If your computer has no speaker or you unable to be at a computer, you can still call in to the phone number provided to hear the audio portion and follow along with the handout in pdf format.
Can’t Listen Live on June 19th? Not a problem. Register for the webinar, email us after the webinar stating no one from your organization logged in or called in to listen live, we will verify, and then send you a playback link of the actual live presentation along with the handouts. The playback link can be viewed on your computer as many times as you would like and audio comes through your computer speakers. Playback link is emailed 72 business hours after the completion of the webinar.
National Correct Coding Initiative (NCCI) edits are used by the Medicare program, state Medicaid programs as well as some commercial insurance carriers and workers compensation carriers to combat abusive and fraudulent billing practices in outpatient therapy as well as other services. NCCI edits were first implemented in 1996 by the Medicare program and applied only to private practices. In 2000, the Medicare program expanded NCCI edits to hospital outpatient departments and in 2006; NCCI edits were expanded to all other outpatient settings (i.e. skilled nursing facilities, CORF’s rehabilitation agencies, and home health agencies providing Part B services) under the Medicare program.
Modifier 59 is used by outpatient therapy providers to bypass certain NCCI edits and allow the payment of more than 1 CPT code billed on the same day that an insurance carrier may consider should be bundled and separate payment should not be made. Because of this, modifier 59 is not only the most commonly used modifier, it is also the most commonly abused modifier. In addition, the need to use modifier 59 is not only within the same discipline but may also be required when a patient is receiving multiple disciplines from the same provider on the same date of service.
On July 1, 2019, the Centers for Medicare & Medicaid Services (CMS) will implement version 25.2 of the NCCI edits and will change how modifier 59 is appended to the CPT code(s) on the claim form. This 1.5-hour webinar program will explain NCCI edits, the use of modifier 59 and what code(s) to append modifier 59 to on the claim form. In addition, the webinar will provide detailed and realistic examples when providers of outpatient therapy services would utilize modifier 59. Examples will include all 3 disciplines as well as how speech therapy billing impacts the physical and occupational therapy codes billed the same day. Lastly, participants will receive Gawenda Seminars & Consulting NCCI Version 25.2 “cheat sheet” to assist them in knowing when to apply modifier 59 to a CPT code on the claim form.
At the conclusion of this webinar presentation, participants will:
1. Describe and understand NCCI edits and the use of modifier-59 for outpatient therapy services
2. Describe and understand column 1/column 2 NCCI edits and which CPT code(s) requires modifier 59
3. Be able to use the NCCI edit “cheat sheet” to append modifier-59 to the correct CPT code(s) on the claim form
4. Recite how one discipline’s billing may cause another discipline’s billing to require modifier 59
5. Understand the documentation that must be present in the medical record to support the use of modifier 59
ABOUT THE SPEAKER:
Rick Gawenda, P.T., graduated in 1991 with a Bachelor of Science in Physical Therapy from Wayne State University, Detroit, Michigan. Mr. Gawenda is currently the President and founder of Gawenda Seminars & Consulting, Inc. and Director of Finances for Kinetix Advanced Physical Therapy Inc., a private practice located in southern California. He has provided valuable education and consulting to hospitals, rehabilitation agencies, private practices, nursing homes, and his peers in the areas of CPT and ICD-10 coding, billing, documentation, reimbursement, and compliance as it pertains to outpatient therapy services as well as denial management and the appeals process for Medicare denied claims. Mr. Gawenda’s website, www.gawendaseminars.com, provides a valuable source of information on rehabilitation rules and regulations, coding, documentation, and reimbursement.
Mr. Gawenda is a member of the American Physical Therapy Association (APTA) and Michigan Physical Therapy Association (MPTA). Mr. Gawenda is the Past President of the Section on Health Policy & Administration of the APTA as well as Past President of the Michigan Association of Medical Rehabilitation Program Administrators.
Mr. Gawenda is also the author of “The How-To Manual for Rehab Documentation: A Complete Guide to Increasing Reimbursement and Reducing Denials” and “Coding and Billing For Outpatient Rehab Made Easy: Proper Use of CPT Codes, ICD-9 Codes and Modifiers”.
WHO SHOULD LISTEN:
Physical therapists, physical therapist assistants, occupational therapists, occupational therapy assistants, speech-language pathologists, private practice owners and practice administrators, coders and office managers at private practices, as well as directors, managers, supervisors, compliance officers, risk managers, and billers in skilled nursing facilities, hospital outpatient therapy departments, schools, rehabilitation agencies, home health agencies, and comprehensive outpatient rehabilitation facilities.
INCLUDED IN YOUR MATERIALS PACKET:
In addition to the expertise and advice presented during this webinar conference, you’ll also receive a handout (in PDF format) that will include related reference links as well as Gawenda Seminars & Consulting NCCI Edit Version 25.2 “Cheat Sheet” for use of modifier 59 in outpatient therapy.
Audio – phone connection required only if your computers do not have speakers or you will not be at a computer.
Webinar – Computer and internet connection required. Participants will be provided a url link where they can log in and follow the presentation on their computer as the speaker provides the presentation. If your computer has speakers, you will be able to hear the audio portion through your computer speakers and will not require a phone connection. If no speakers on your computer or unable to be at a computer, participants will need to call in to the phone number provided to them to hear the audio portion. You will need adobe flash.
This webinar has not been submitted to any state board or national organization for CEU approval. A certificate of attendance will be available upon completion of the webinar for each participant and may be adequate for credit in some states; you will need to contact your state licensing regulatory body to determine whether or not credit will be granted for this webinar conference.
HOW THE WEBINAR CONFERENCE WORKS
Register for the event on or before 11:30am EDT on June 19, 2019.
When you register, you’ll receive a confirmation e-mail that serves as your receipt . Approximately 5 days before the webinar conference, you will receive a separate email that provides you with instructions for accessing the call and handouts. If you register within 5 days of June 19, 2019, instructions will be emailed the evening of the day you registered (after 6:00PM pacific time).Please make sure that your email system will accept messages from the webinar conference host: firstname.lastname@example.org. The easiest way to do this is to add this email address to the contacts list in your email software.
Gather your staff and listen to this webinar conference via your computer speakers or a speaker phone, follow along with the session handout on your computer, and participate in a live, interactive Question and Answer session.
PLEASE NOTE: ONE REGISTRATION PROVIDES YOU WITH ONE PHONE AND/OR COMPUTER CONNECTION FOR THE WEBINAR CONFERENCE. You may pay for additional locations where indicated on the registration form.
Written requests for refunds received on or before June 5, 2019, will receive a refund less a $60 processing fee; fees are nonrefundable after this date. There are no refunds for no shows or any other reasons after June 5, 2019. We are not responsible for organization fire walls or computer software issues that may interfere and/or prohibit your connection to the webinar portion of the presentation. Email your request for a refund to the conference coordinator: email@example.com.
PLAYBACK LINK or AUDIO RECORDINGS
Playback link or CD recordings (audio only) are NOT included with registration, but registrants have an option to purchase a playback link for $49.95 or CD recording (audio only) for $69.95 prior to completing online registration or send in the additional payment with your registration and check. Playback link is best option as you are able to view and listen to the webinar live on your computer as many times as you would like and the playback link is emailed 72 business hours after the completion of the webinar where CD’s will take 10-14 days for delivery.
TelSpanWeb System Requirements to View Webinar:
• Windows XP, Windows Vista, Windows 7, Windows 8
• MAC OS X v10.4 or Higher
• Internet Explorer 7 or Higher (Windows)
• Firefox 4 or Higher
• Safari 4 or Higher
• Google Chrome 2 or Higher
Stable Internet Connection, DSL or Above:
• 100 kbps for Video Transmission
• 300kbps for Screen Sharing and Remote Control
• Recommended 500kbps to ensure fluidity of all Services
Flash Player 10.3 or Newer: http://get.adobe.com/flashplayer
Disabled pop-up blockers
Computer speakers for participants listening over the computer
In order to ensure successful connection to your upcoming meeting, please take a moment to conduct a system test by clicking this link: http://web.telspan.com/systemcheck
If you have questions about registration or logistics for this webinar conference, please contact the Webinar Conference Manager:
Michelle Gawenda • Gawenda Seminars & Consulting, Inc. • 661.350.6187
If you wish to contact Rick Gawenda directly, you may fill out our contact form.
REGISTER ONLINE WITH A CREDIT CARD: Click HERE
If you want to pay by check, complete the Printable Registration Form and submit with your payment to the address listed at the bottom of the registration form.