Fisher-Titus Medical Center Rehab Gawenda Course

Rick Gawenda from Gawenda Seminars & Consulting will be leading a seminar in the Fisher-Titus Jennings Auditorium on rehab documentation & billing. Completion of this course is good for 7 CEUs for PT, OT, & Speech. 35 Spots Available

Course Description:

Physical, occupational, and speech therapy services for pediatrics, adults, and geriatrics continue to be on the medical record review radar for Medicaid, Medicare, and private insurance carriers medical review entities for documentation, CPT coding, and billing issues. This seminar applies to therapists and assistants who treat pediatrics, adults, and geriatrics in all outpatient and Medicare part B therapy settings.

This seminar will teach participants the necessary components of documentation for the initial evaluation, reevaluation, progress reports, daily notes, discharge reports and the Medicare Part B certification and recertification process that will help participants document the key points in supporting medical necessity and the skilled nature of outpatient therapy services not only for insurance carriers, but for their respective state practice act.

The seminar will teach participants what interventions, techniques and procedures are included within the CPT codes most commonly used by physical therapists, physical therapist assistants, occupational therapists, occupational therapy assistants, and speech-language pathologists. The seminar will teach participants about the caregiver training services (CTS) CPT codes, documentation required to bill the CTS codes, and how to bill the CTS codes. These new CTS codes are very applicable to the pediatric population for all 3 disciplines.

The seminar will teach participants the national correct coding initiative (NCCI) edits and the proper use of Modifier 59 for Medicare, Medicaid and commercial insurance carriers. Lastly, the seminar will teach participants Medicare's "8-minute rule", definition of substantial per the American Medical Association, and provide billing scenarios to ensure therapists bill correctly to all insurance carriers, including the Medicare and Medicaid programs.

Course Objective:

· Describe and implement the necessary components of an initial evaluation to support the need for skilled therapy services

· Identify when a reevaluation is appropriate to perform on a patient and bill to an insurance carrier

· List the required and necessary components of a progress report to support the therapy already provided and the need for continued skilled therapy services

· Apply strategies to more effectively support medical necessity and skilled services in your daily notes

· Describe and implement the necessary components of a discharge report to demonstrate the nature of skilled services provided to support why you should be paid for those services

· Understand the certification and recertification process for Medicare Part B therapy services

· Distinguish between therapeutic exercise, neuromuscular reeducation & therapeutic activities

· Identify how to select the correct CPT code(s) based on interventions and techniques provided and documentation in the medical record

· Describe the requirements to bill the caregiver training services CPT codes

· Recite when to append modifier 59 to a CPT code on the claim form

· Explain how to charge correctly for the services you provide under outpatient therapy benefits for Medicare and private insurance carriers

Course Agenda:

08:00AM – 10:00AM – Documentation requirements for evaluations and reevaluations

10:00AM – 10:15AM – Break

10:15AM – 10:45AM - Documentation requirements for Progress Reports

10:45AM – 11:30AM – Documentation requirements for daily notes and discharge reports

11:30AM – 11:45AM – Medicare Part B certification & recertification requirements

11:45AM – 12:00PM - CPT codes most commonly utilized by PT and OT

12:00PM – 1:00PM – Lunch

1:00PM – 2:30PM – CPT codes most commonly utilized by PT and OT (cont.)

2:30PM – 2:45PM – Break

2:45PM – 3:15PM – CPT codes most commonly utilized by SLP

3:15PM – 3:45PM – NCCI edits and use of Modifier 59

3:45PM– 4:00PM – Medicare “8-minute rule” and definition of substantial per the American Medical Association

4:00PM – 4:30PM – Post-Test Billing Scenarios for Medicare, Medicaid, & commercial insurance carriers

4:30PM – Conclusion