Outpatient Coding and Coverage Issues: Non-E/M Services

Hours: 0.50
# Course Code: REL-RCC-REV-CCI-A05

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.

Course Description

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.

Certificates

Certificates provided by accrediting body (2 Match)

American Health Information Management Association

0.5 HOURS

“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.”

American Academy of Professional Coders

0.5 HOURS

This activity is approved for 0.50 contact hours.

Course Details

Course Code: REL-RCC-REV-CCI-A05

Hours: 0.5

Type: Online Course

Content Expiration Date: 1/31/2023

Learning Objectives:
Differentiate between “hard–coded” and “HIM-coded” activities.
Recall the use of a charge description master and understand its function.
Identify the types of services that are paid through separate Ambulatory Payment Category (APC) payments.

Outline:
Section 1: Introduction

About This Course

Learning Objectives

Section 2: Charging

Reporting Separately-Reportable Services

Example: Status Indicators

Charge Description Master

Charged Services

Charge Description Master Example

Review

Section 3: Procedures

Diagnostic and Nonsurgical Procedures

Surgical or Procedural Services

Review

Section 4: Radiology

Interventional Radiology

Interventional Radiology Packaged Procedures and Status Indicators

Review

Key Points for Radiology Services

Issues That May Affect Payment for Radiology Services

Section 5: Drugs

Drugs, Biologicals, and Radiopharmaceuticals

Status Indicator K

Vaccines

Review

Section 6: Conclusion

Course Summary

Course Contributors

Resources

References

Instructor: Richard R. Cooley, BA, CCS

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.

Expert Reviewer: Veronica Ziac, MBA

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 declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.

Target Audience:
The target audience for this course is: Coding Specialists; in the following settings: Acute Care Facility.

Relias will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.

Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
If you require special accommodations to complete this module, please contact Relias Support by completing the web form (https://www.relias.com/help) or by using the chat functionality.
All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.

Accommodations
If you require special accommodations to complete this module, please contact Relias Customer Support here.

Outpatient Coding and Coverage Issues: Non-E/M Services

$ 35.0 $35.00 $35.00

American Health Information Management Association

American Academy of Professional Coders

$ 35.0 $35.00

$35.00