Outpatient Infusion Coding & Documentation

Outpatient Infusion Coding & Documentation:

Take Your Skills to a Higher Level

Presented by

Robin Zweifel, BS, MT(ASCP)

Marta Kramer, MBA, CCS-P

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June 27, 2014

Disclaimer

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MedLearn Publishing has prepared this seminar using official Centers for Medicare and Medicaid Services (CMS)

documents and other pertinent regulatory and industry resources. It is designed to provide accurate and authoritative

information on the subject matter. Every reasonable effort has been made to ensure its accuracy. Nevertheless, the

ultimate responsibility for correct use of the coding system and the publication lies with the user.

MedLearn Publishing, its employees, agents and staff make no representation, warranty or guarantee that this

information is error-free or that the use of this material will prevent differences of opinion or disputes with payers. The

company will bear no responsibility or liability for the results or consequences of the use of this material. The

publication is provided ¡°as is¡± without warranty of any kind, either expressed or implied, including, but not limited to,

implied warranties or merchantability and fitness for a particular purpose.

The information presented is based on the experience and interpretation of the publisher. Though all of the

information has been carefully researched and checked for accuracy and completeness, the publisher does not

accept any responsibility or liability with regard to errors, omissions, misuse or misinterpretation.

Current Procedural Terminology (CPT ?) is copyright 2013 American Medical Association. All Rights Reserved. No

fee schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for

the data contained herein. Applicable FARS/DFARS restrictions apply to government use.

CPT? is a trademark of the American Medical Association.

Copyright ? 2014 by MedLearn Publishing. All rights reserved.

¨C No part of this presentation may be reproduced in any form whatsoever without written permission from the

publisher

¨C Published by MedLearn Publishing, 287 East Sixth Street, Suite 400, St. Paul, MN, 55101

? 2014 MEDLEARN PUBLISHING / A DIVISION OF PANACEA HEALTHCARE SOLUTIONS

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Today¡¯s Agenda

? 2014 CPT Coding Guidelines and Updates for reporting outpatient infusion

services

¨C Overview of CPT Codes

¨C Review of Coding Hierarchy Rules

¨C Documentation Components

¨C Translation of Time to Billable Unit of Service

? Resolving Claim Edits

¨C Review of Documentation for Claim Comparison

? Case Studies

? Questions and Answers

? 2014 MEDLEARN PUBLISHING / A DIVISION OF PANACEA HEALTHCARE SOLUTIONS

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Today¡¯s Challenges

? What are our biggest challenges?

¨C Understanding the coding guidelines for injections, IV push, IV infusion.

¨C Documenting and billing according to AMA CPT coding hierarchy.

¨C Providing complete & accurate documentation in the patient record of all

infusion times, mode of administration and line flushes.

¨C Realizing that medical record documentation will determine which

outpatient procedures are separately billable and payable versus those that

are bundled.

¨C Assuring consistent charge capture of administration procedure as well as

drugs, fluids or substances.

? 2014 MEDLEARN PUBLISHING / A DIVISION OF PANACEA HEALTHCARE SOLUTIONS

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