This lesson 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 0.50 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 0.50 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: Christina A. Johnson, CPC, CPB
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 declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Christina Johnson, CPC, CPB is a Certified Professional Coder and Biller that holds a certificate in instructional design and eLearning development. With over 15 years of experience, Christina understands the cycle of a medical billing claim and the importance of patient access staff. She has served in multiple aspects of physician office management with hands-on responsibility for claims preparation, resolution of claim denials, and maintenance of patient accounts within a specialty office for gastroenterology.
In her most recent role, she worked with authors and subject matter experts to design and develop adult online continuing education courses included in an extensive revenue cycle coding and clinical nursing curriculum.
Disclosure: Christina A. Johnson, CPC, CPB has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
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