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Syllabus Coding Course CODING COURSE SYLLABUS June 28, 2013 The Breakers | Palm Beach, Florida www.ophmasters.com Sponsored by the Florida Society of Ophthalmology AGENDA Friday, June 28 7:00‒8:00 AM REGISTRATION AND BREAKFAST South Ballroom Foyer 8:00‒10:00 AM Medicare Update Physician Fee Schedule Changes ASC Fee Schedule Changes CPT and ICD-9 Changes QUESTIONS & ANSWERS 10:00‒10:15 AM BREAK West Ballroom Foyer 10:15 AM ‒12:00 PM OIG Work Plan Update Issues affecting Ophthalmology - New and Ongoing Issues Requiring Special Attention Modifiers Surgeries E&M vs. Eye Codes Co-Management QUESTIONS & ANSWERS 12:00‒1:00 PM LUNCH Gold Room 1:00‒2:30 PM ICD-10 Update Implementation and Training Coding scenarios Medicare Audit Contractor Concerns CMS Onsite Audits Clinic Optical Compliance Issues QUESTIONS & ANSWERS 2:30 PM ADJOURN OBJECTIVES/ACCREDITATION TARGET AUDIENCE This program has been designed for physicians, coders, technicians and administrators with a basic understanding of CPT and ICD-9. LEARNING OBJECTIVES Upon completion of the educational activity, participants should be able to: Upon completion of the educational activity, participants should be able to: Appropriately select the level of Evaluation and Management or Eye code Describe updates to the OIG work plan that affect ophthalmology Implement the CPT and ICD-9 updates into the practice Recognize changes that will come with the implementation of ICD-10 Discuss Medicare Audit Contractor concerns Identify practical application techniques to appropriately code for proper reimbursement in all specialties within ophthalmology ACCREDITATION CME/CE Credit provided by AKH Inc., Advancing Knowledge in Healthcare Physicians This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of AKH Inc. and the Florida Society of Ophthalmology. AKH Inc. is accredited by the ACCME to provide continuing medical education for physicians. AKH Inc. designates this live for a maximum of 5.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Physician Assistants NCCPA accepts AMA PRA Category 1 Credit™ from organizations accredited by ACCME. Nursing AKH Inc. is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s COA. AKH Inc. designates this educational activity for 5.25 contact hours. Accreditation applies solely to educational activities and does not imply approval or endorsement of any commercial product by the ANCC-COA. FL Nursing AKH Inc. is an approved provider for nursing continuing education by the Florida Board of Nursing #50-2560. AKH Inc. designates this educational activity for 5.2 contact hour (.52 CEU). Criteria for Success Statements of credit will be awarded based on the participant's attendance and submission of the activity evaluation form. A statement of credit will be available upon completion of an online evaluation/claimed credit form at www.ophmasters.com/cme. If you have questions about this CME/CE activity, please contact AKH Inc. at [email protected]. Commercial Support No commercial support was received for this course. FACULTY E. Ann Rose Owner/President Rose and Associates Duncanville, TX Ann Rose, owner and president of Rose & Associates, is a Medicare reimbursement and compliance consultant who has been associated with the health care industry for 30+ years. Rose & Associates specializes in Medicare coding, billing, documentation, and training for physician practices with medical record auditing being their main focus. Ann’s professional experience began as a member of the Medicare acquisition team at Blue Cross and Blue Shield of Texas shortly after they were awarded the Medicare contract in 1966. She was instrumental in helping develop the HCFA 1500 claim form (now known as the CMS-1500 claim form) and served as a team member in developing the paperless claims processing system known today as electronic billing. For the past 30 years Ann has been devoted to assisting ophthalmologists with coding and reimbursement issues for maintaining compliance with government regulations. She is a member of the American Society of Ophthalmic Administrators (ASOA), the Medical Group Management Association, the American Academy of Ophthalmic Executives (AAOE), and the American Academy of Professional Coders. She is also editor and publisher of The Messenger, a newsletter written and developed specifically for the specialty of ophthalmology and serves on the editorial board of the reimbursement section of Ocular Surgery News. FACULTY/PLANNERS/STAFF DISCLOSURES DISCLOSURE DECLARATION It is the policy of AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The faculty must disclose to the participants any significant relationships with commercial interests whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflicts of interest are resolved by AKH prior to accreditation of the activity and may include any of or combination of the following: attestation to non-commercial content; notification of independent and certified CME/CE expectations; referral to National Faculty Initiative training; restriction of topic area or content; restriction to discussion of science only; amendment of content to eliminate discussion of device or technique; use of other faculty for discussion of recommendations; independent review against criteria ensuring evidence support recommendation; moderator review; and peer review. AKH/FSO planners and reviewers have no relevant financial relationships to disclose. DISCLOSURE OF UNLABELED USE AND INVESTIGATIONAL PRODUCT This educational activity may include discussion of uses of agents that are investigational and/or unapproved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. DISCLAIMER This course is designed solely to provide the healthcare professional with information to assist in his/her practice and professional development and is not to be considered a diagnostic tool to replace professional advice or treatment. The course serves as a general guide to the healthcare professional, and therefore, cannot be considered as giving legal, nursing, medical, or other professional advice in specific cases. AKH Inc. specifically disclaims responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through participant's misunderstanding of the content. FACULTY DISCLOSURES NAME RELATIONSHIP COMPANY E. Ann Rose Consultant Heidelberg Engineering, Inc. (2) PLANNER DISCLOSURES AKH & FSO Staff/Planners N/A Nothing to disclose *Compensation Range per 1= $0-$1,000 2= $1,001- 3= $10,001- 4= ≥$50,001 Company $10,000 $50,000 Medicare Coding Update 2013 Masters in Ophthalmology 2013 Coding Program Palm Beach, Florida June 28, 2013 Presented by: E. Ann Rose Financial Interest E. Ann Rose is President of Rose & Associates and also provides consulting services for: Alcon Surgical, Inc. Heidelberg Engineering Physician Fee Schedule • 2013 Physician Fee Schedule Final Rule – Called for 26.5% reduction in physician fees • At 11th hour, Congress approved legislation halting fee cuts through 12/31/13 – SGR remains flawed and ASCRS still fighting to get payment mechanism changed • U.S. House of Representatives expected to vote on proposal for permanent fix by August 3 Rose & Associates 1-800-720-9667 1 Physician Fee Schedule – Medicare Sequestration (spending) cuts • 2% cut to Medicare physician payments effective April 1, 2013 – Also applies to ASC, DME and Incentive bonus payments • Cuts scheduled to last through 2021 – Co-pays should be collected on actual 2013 fee schedule allowable, not the 98% payment – 1.000 GPCI floor extended through 2013 • Good news for physicians practicing in areas with normally low GPCIs 4 Physician Fee Schedule • Some fees increased due to RVU changes • Some fees decreased Procedures with RVU Reductions Code Description % 66982 Complex Cataract w/IOL -21% 66984 Cataract w/IOL -13% 67028 Intravitreal Injection -9% 92235 Fluorescein Angiography - 6% 92286 Endothelial Cell Counts -69% 5 Physician Fee Schedule – Survey conducted jointly by ASCRS and ASOA found time to perform cataract surgery has dropped 30% in past 8 years – Also fewer post-op visits performed • Cataract cuts would have been greater without survey • Final conversion factor for 2013 • $34.0230 – Included budget neutrality reduction – 2012 CF was $34.0376 6 Rose & Associates 1-800-720-9667 2 Physician Fee Schedule National Fee Schedule Payment Amounts Through December 31, 2013 CPT Code 2012 2013 66170 – Trabeculectomy $1,178.72 $1,238.44 66821 – YAG - Office $ 326.08 $ 344.99 66821 – YAG - Facility $ 307.70 $ 325.26 66982 – Complex Ct w/IOL $1,054.48 $ 828.46 66984 – Cataract w/IOL $ 760.74 $ 667.87 67028 – Intravitreal Injection - Office $ 115.73 $ 105.13 67028 – Intravitreal Injection - Facility $ 104.16 $ 103.43 67036 – Vitrectomy $ 948.97 $ 990.41 67108 – Repair Detach. Retina $1,589.56 $1,656.58 7 Physician Fee Schedule National Fee Schedule Payment Amounts Through December 31, 2013 CPT Code 2012 2013 92004 - Comp, New patient $144.66 $151.40 92012
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