Conference Materials (Password Required)
We will discuss the NCCI Edit manual. We will review the entity responsible for creating and maintaining the manual and what entities use the NCCI manual. We will define the edits and the methodology behind the edits. We will discuss the history of the edits, when it was created and when it gets updated. We will go over how to locate the edits for Medicare, Medicaid, and Commercial payers. We will discuss why these edits exist and how to use them. We will review some specific examples of using the NCCI edits.
Learning Objective:
- To review the overall development of the NCCI edits
- To have knowledge of the NCCI edit coding policy manual
- To carefully review the definition of the modifier
- To review the operational use of the National Correct Coding Initiative edits
- To appreciate how physicians and hospital should use modifiers in connection with the NCCI edits
- To review the general and specific policies inherent in the NCCI guidelines
- To identify the differences in coding policies between physicians and hospitals
- To appreciate the compliance issues surrounding physician and hospital use of the modifier 55 and 59 modifier
- To review policies relative to specific service areas as delineated in CPT
- To appreciate possible RAC and other audit activities in conjunction with the NCCI coding policies
Areas Covered in the Session:
- Who: creates, maintains, uses
- What: edit, methodology
- When: history of, created, updated
- Where: locating
- Why: do these edits exist
- How: using the edits
- Live Q&A session
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Suggested Attendees:
- Coders
- Revenue Cycle staff and managers
- Auditors
- Compliance Officers
- Billers/ Revenue Cycle Managers
- Consultants
- Physicians
- Nurses
- Claim Officers
- Healthcare administrator and providers
Presenter Biography:
Beth Schleeper, COC, CPC, CDEO, CPB, CPPM, CPCO, CPMA, CRC, CPC-I, CANPC, CEMC, CEMA has more than 25 years of experience in medical billing and coding. She owns and operates T&T Consulting Firm, a medical billing service, and Advanced Coding Services, a coding school using the AAPC curriculum. Mrs. Schleeper started her career as a front desk receptionist at an internal medicine physician practice and worked her way up to practice manager. She has experience in durable medical equipment, pediatrics, obstetrics/gynecology, infertility, home health, PT and OT, and family practice. Schleeper has been Chapter President, Vice President, & Member Development, officer. She served on the AAPC National Board of Directors as Region 7 AAPC Chapter Association representative.
Snippet From Our Previous Session
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“Jim Sheldon-Dean’s insights on privacy and security were very much helpful to our team, it was great to learn from an instructor like him. Appreciate!” –CHRISTINE JACOB MD, CDI SPECIALIST
“This program on HIPAA did a great job providing actionable concepts in a way that updated our team and me, I now know how I will implement the concepts because I already did it in their online seminar, it was easy to ask questions from the speaker at the end of my 60 minutes course.” –MELISSA PRESTON, HEALTH INFORMATION MANAGEMENT STAFF
“The workshop was very insightful and made absolute sense in terms of the regulations and their compliance. I am thankful for having the opportunity to attend.”–BARBARA CAPRIOTTY, REHABILITATION DIRECTOR
