NCCI Edits and Modifier 59: Version 27.0
Please join us as Gawenda Seminars & Consulting, Inc. presents “Understanding NCCI Edits and Modifier 59: Version 27.0” webinar conference on January 6, 2021 from 1:00PM – 2:00PM eastern standard time. The Centers for Medicare and Medicaid Services (CMS) updates the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits every quarter. This webinar will provide participants with information on NCCI Edits Version 27.0 that became effective with dates of service beginning on January 1, 2021 and lasting through March 31, 2021. CMS has deleted many of the NCCI PTP edits that they had reinstated on October 1, 2020 and this will have positive changes for providers of outpatient physical, occupational and speech therapy services, not only for Medicare, but also for insurance carriers like Anthem BC, Aetna, and Humana.
To register online with a credit card, purchase a ticket at the bottom of this page. Due to the short time period, the only way to register is online with a credit card. We do not take Purchase Orders (PO’s) from any organization!
One registration allows as many people to watch and listen to the webinar on one computer and each participant would be eligible to print off a certificate of attendance that may be eligible for 1.0 CEUs from your state board or national association. This webinar is NOT being submitted for CEUs by Gawenda Seminars & Consulting, Inc. to any national or state association. We do not provide any agenda or other material that you may need if you want to submit to your state or national association.
Can’t Listen Live on January 6th? Not a problem. Register for the webinar below, 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 within 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. 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.
Version 27.0 becomes effective with dates of service between January 1 – March 31, 2021. This 1-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 as well as provide the participants with the significant changes to the procedure-to-procedure (PTP) edits effective beginning on January 1, 2021 that will impact outpatient physical, occupational and speech therapy services. One of the major changes involves the billing and payment of a physical or occupational therapy evaluation or re-evaluation on the same date of service the hospital bills for an emergency room visit on a Medicare beneficiary.
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 27.0 “cheat sheet” to assist them in knowing when to apply modifier 59 to a CPT code on the claim form.
In addition, the webinar will explain how the reinstated NCCI edits will impact the billing of outpatient therapy services to commercial insurance carriers such as Aetna, Anthem BC, Humana and many others.
At the conclusion of this webinar presentation, participants will be able to:
- Describe and understand column 1/column 2 NCCI edits and which CPT code(s) requires modifier 59
- Be able to use the NCCI edit “cheat sheet” to append modifier-59 to the correct CPT code(S) on the claim form
- Recite how one discipline’s billing may cause another discipline’s billing to require modifier 59
- Understand the documentation that must be present in the medical record to support the use of modifier 59
- Identify at least 5 changes to NCCI edits as they pertain to outpatient physical, occupational and speech therapy services with Version 27.0 compared to Version 26.3
- Summarize the current payment status of a physical or occupational therapy evaluation or reevaluation when billed on the same date of service as an emergency department visit
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 27.0 “Cheat Sheet” for use of modifier 59 in outpatient therapy.
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. No phone lines will be available for this webinar.
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. We provide no additional information for CEU approval.
HOW THE WEBINAR CONFERENCE WORKS
Register for the event on or before 12:45pm EST on January 6, 2021.
When you register, you’ll receive a confirmation e-mail that serves as your receipt. You will receive an email the day prior to the webinar that will provide you instructions on how to access the webinar, test your computer and download the handouts. If you register the day of the webinar, instructions are emailed every half hour beginning at 10:00am EST. Please make sure that your email system will accept messages from the webinar conference host: email@example.com. 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 COMPUTER CONNECTION FOR THE WEBINAR CONFERENCE. You may pay for additional locations where indicated on the registration form.
Due to the short registration period, there are no refunds for no shows or any other reasons once you register and payment is received. We are not responsible for organization firewalls 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: firstname.lastname@example.org.
Playback link is NOT included with registration, but registrants have an option to purchase a playback link for $49.95 prior to completing online registration or send in the additional payment with your registration and check. Playback link allows you to view and listen to the webinar live on your computer as many times as you would like and the playback link is emailed 48-72 business hours after the completion of the webinar.
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Stable Internet Connection, DSL or Above:
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Testing 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: PURCHASE A TICKET ON THIS PAGE
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