CPT & MEDICARE CHANGES FOR RHEUMATOLOGY

CPT & MEDICARE CHANGES FOR RHEUMATOLOGY

PRESENTOR: Candice Fenildo, CPC, CPMA, CPB, CENTC, CPC-I

Presented in Partnership with NORM and Crescendo Bioscience Developed & Hosted by Acevedo Consulting Incorporated

The Mission of NORM is to be a forum by which we promote and support education, expertise, and advocacy for rheumatology practices

and their patients.

~ ~ ~ NORM is a diverse community of rheumatology managers with a common goal.

NORM provides educational opportunities through webinars and during our annual conference.

NORM supports rheumatology practices, managers and staff by offering unique educational opportunities specific to rheumatology.

Visit to learn more and join NORM!

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Crescendo Bioscience focuses on enabling more effective management of autoimmune and inflammatory diseases by

providing quantitative, objective molecular tests (such as Vectra? DA) and disease information services to rheumatologists and patients.

Vectra-

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About the Speaker:

Candice Fenildo, CPC, CPMA, CPB, CENTC, CPC-I Associate Consultant

Candice Fenildo holds an Associate's Degree in Health Sciences and numerous national coding certifications through the AAPC. She is also an AAPC certified Instructor. Candice has over 15 years combined experience in coding, billing and A/R management for Multi-Specialty Physicians; including Rheumatology.

Candice is currently serving as the 2016 Chair for the AAPC Chapter Association Board of Directors (AAPCCA).

About the Firm:

Acevedo Consulting Incorporated is a nationally recognized firm known for its expertise with:

Coding and Chart Reviews HIPAA Appeals and ADRs

Compliance Education Credentialing

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Upcoming Webinars

Eastern Daylight Saving Time

PQRS for Rheumatology

Tuesday, April 12, 2016 12-1 EST

ICD-10 Documentation and Coding Tips for Rheumatology

Tuesday, May 24, 2016 12-1 EST

Infusion Coding for Rheumatology: How to Appropriately Document

Tuesday, July 26, 2016 12-1 EST

Chronic Care Management for Rheumatology Tuesday, October 4, 2016 12-1 EST

Pacific Daylight Saving Time

Thursday, April 14, 2016 12-1 PST Thursday, May 26, 2016 12-1 PST Thursday, July 28, 2016 12-1 PST

Thursday, October 6, 2016 12-1 PST

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Agenda

? New & Revised Payment Policies

? Advance Care Planning ? Transitional Care Management ? LCD for SNF/NF Visits

? Other Areas Needing Your Attention

? Medicare deductible, therapy cap, etc. ? Incident-to guidelines clarifications ? Reporting requirements for 10- and 90-day global periods

? Pay for Performance programs

? ....in brief

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Disclaimer

The information enclosed was current at the time it was presented. Medicare and other payer policies change frequently. This presentation was prepared as a tool to assist providers and is not intended to grant rights or impose obligations.

Although every reasonable effort has been made to assure the accuracy of the information within these pages, the ultimate responsibility for the correct submission of claims and response to any remittance advice lies with the provider of services. Acevedo Consulting Inc. employees, agents, and staff make no representation, warranty, or guarantee that this compilation of information is error-free and will bear no responsibility or liability for the results or consequences of the use of this information.

This presentation is a general summary that explains certain aspects of the Medicare Program and other reimbursement and compliance information, but is not a legal document. The official Medicare Program provisions are contained in the relevant laws, regulations, and rulings.

THIS PRESENTATION CONTAINS ABBEVIATED CODE DEFINITIONS, IS NOT A SUBSTITUTE FOR YOUR CODE BOOKS, AND DOES NOT INCLUDE ALL CHANGES YOU MAY NEED TO KNOW TO CODE AND BILL ACCURATELY.

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Evaluation and Management

? +99415: Prolonged clinical staff service (the service beyond the typical service time) during an E&M service in the office or outpatient setting, direct patient contact with physician supervision; 1st hour (list separately in addition to code for outpatient E&M service) (~$9.47 Medicare allowable)

? Use with 99201-99215

? +99416: ....each additional 30 minutes (List separately in addition to code for prolonged service) (~$0.98 Medicare allowable)

? Use in conjunction with 99201-99205, 99211-99215

? Do not report 99415/16 in conjunction with 99354/55

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