Outpatient Coding and Coverage Issues: Medicare B Therapy Services

Hours: 0.50
# Course Code: REL-RCC-REV-CCI-A06

This lesson explains the basics of the documentation and billing requirements for outpatient therapy (OPT) services that deal with physical therapy (PT), occupational therapy (OT), and speech-language pathology (SLP) that are provided under Medicare Part B. Documentation, coding, and billing requirements are covered. 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 lesson explains the basics of the documentation and billing requirements for outpatient therapy (OPT) services that deal with physical therapy (PT), occupational therapy (OT), and speech-language pathology (SLP) that are provided under Medicare Part B. Documentation, coding, and billing requirements are covered. 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 (3 Match)

American Health Information Management Association

0.5 HOURS

“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.”

American Academy of Professional Coders

0.5 HOURS

This activity is approved for 0.5000 contact hours.

American Health Information Management Association

0.5 HOURS

Course Details

Course Code: REL-RCC-REV-CCI-A06

Hours: 0.5

Type: Online Course

Content Expiration Date: 1/31/2023

Learning Objectives:
Recall the key terms that apply to OPT services.
Identify the conditions of coverage that are necessary for OPT.
Identify the requirements of a plan of care.
Recall and select the requirements for certification.
Identify billing issues such as the use of modifiers, timed codes, and units of service.

Outline:
Section 1: Introduction

About This Course

Learning Objectives

Coverage Policies

Provider Definitions

Review

Section 2: Certification

Conditions of Coverage Certification

Orders/Referrals and Need for Care

Review

Plan of Care

Sample Therapies

Revision of Goals

Section 3: Payment and Reporting

Payment Caps and Medical Necessity

Modifiers

Review

Section 4: Time

Untimed Codes and Units of Service

Clarification of Time

Review

Section 5: Conclusion

Course Summary

Course Contributors

Resources

Bibliography

References

Instructor: Deborah Neville, RHIA, CCS-P

Deborah is responsible for Elsevier's online solution of education and tools to improve employee performance for Revenue Cycle, Coding, CDI, and Compliance professionals. Deborah has earned BS degrees in Management/Human Resources and Social Psychology. She is a Registered Health Information Management Administrator (RHIA) and is a Certified Coding Specialist, Physician-Based (CCS-P). Prior to joining Elsevier, Deborah held positions such as Revenue Cycle Analyst for Mayo Clinic; Compliance Officer; educator; coding manager; and senior consultant. Deborah actively participates on projects important to the healthcare industry. As an active member of AHIMA, she has participated in the Quality Initiatives & Secondary Data Practice Council, was Chair of the Coding Policy and Strategy Committee and Board member for the Society of Clinical Coding. She has authored journal articles, been a presenter of audio-conferences and a speaker at national and state conventions. Deb was a member of the AHA Editorial Advisory Board for ICD-9-CM Coding Clinic and AHA Editorial Advisory Board for HCPCS.
Disclosure: Deborah Neville, RHIA, CCS-P has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.

Expert Reviewer: Jean C. Russell, MS, RHIT

Jean Russell has over thirty years of healthcare and information system experience. Her areas of expertise include the Medicare outpatient prospective payment systems (APCs, and APGs), as well as ICD-10-CM/PCS training, Charge Description Master (CDM), admission status reviews, and outpatient coding and compliance. She is a frequent speaker at the national, state and local levels for HFMA and AHIMA professional groups. Jean has her Masters from the University of Houston in Biomedical Engineering; her Bachelors from Colgate University in Biology; and her RHIT from the independent study program through the American Health Information Management Association.
Disclosure: Jean C. Russell, MS, RHIT 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.
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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: Medicare B Therapy Services

$ 35.0 $35.00 $35.00

American Health Information Management Association

American Academy of Professional Coders

American Health Information Management Association

$ 35.0 $35.00

$35.00