This course will explain the importance of and distinction between coding and charging for other, non-evaluation and management, hospital services, and procedures that are payable separately under the Outpatient Prospective Payment System (OPPS). The lesson includes information on charging through the Charge Description Master (CDM), surgical and non-surgical procedures, and radiology services. This lesson may feature information on the use of medical and procedural codes, including CPT codes as they relate to the subject matter presented.
“This program has been approved for 0.5000 continuing education unit(s) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor.”
This activity is approved for 0.5000 contact hours.
Section 1: Introduction
About This Course
Section 2: Charging
Reporting Separately-Reportable Services
Example: Status Indicators
Charge Description Master
Charge Description Master Example
Section 3: Procedures
Diagnostic and Nonsurgical Procedures
Surgical or Procedural Services
Section 4: Radiology
Interventional Radiology Packaged Procedures and Status Indicators
Key Points for Radiology Services
Issues That May Affect Payment for Radiology Services
Section 5: Drugs
Drugs, Biologicals, and Radiopharmaceuticals
Status Indicator K
Section 6: Conclusion
Expert Reviewer: Veronica Ziac, MBA
Richard has more than eighteen years in healthcare consulting. He has developed an expertise in hospital outpatient and inpatient coding, including professional split billing and E/M coding, admission criteria, reimbursement and compliance, and charge master reviews. His areas of expertise include Medicare reimbursement for the Medicare Outpatient Prospective Payment System (OPPS), Medicaid Ambulatory Payment Groups (APGs), as well as commercial payers, and professional reimbursement. He is a certified coder with AHIMA (CCS). Richard earned his Bachelors from Hobart College.Disclosure: Richard R. Cooley, BA, CCS has no Relevant Financial or Non-Financial Relationship with ineligible companies to disclose.
Veronica Ziac, MBA has over twenty years of healthcare administration experience. Her areas of expertise include revenue cycle, information systems, population health and physician practice management. Most recently, she was the Director of Revenue Cycle Integrity at Cobleskill Regional Hospital. Prior to that, Veronica was the Chief Operating Officer for a large multispecialty hospital-based physician practice based in New York. Veronica has an MBA in Healthcare Administration from Union College and a bachelor’s degree from the University at Albany. She is a member of HFMA and MGMA and has been Certified in Healthcare Compliance (CHC) by the Healthcare Compliance Association.Disclosure: Veronica Ziac, MBA has no Relevant Financial or Non-Financial Relationship with ineligible companies to disclose.
Access to over 1,450 courses! Access to 1,450+ courses for one low price.