Coding & Billing for HIV & STI Testing and Preventative ...

[Pages:50]Coding & Billing for HIV & STI Testing and Preventative Services

November 19, 2018

Presented by Dr. Lisa L Campbell, PhD, MHA, MPH RHIA, CDIP, CCS, CCS-P, CPC, COC, CPC-I

Speaker Biography

26 Years Experience

Medical Assistant

Certified Coding Specialist

Medical Biller

Educator

Volunteer

Consultant

Clinical Documentation Improvement

Specialist

Health Information Administrator

Healthcare Administrator

Disclaimer

The information presented and responses to the questions posed are not intended to serve as coding or legal advice.

Many variables affect coding decisions and any response to the limited information provided in a question is intended only to provide general information that might be considered in resolving coding issues.

All coding must be considered on a case-by-case basis and must be supported by appropriate documentation in the health record.

Therefore, we recommend consulting directly with payers to determine specific payers' guidance regarding appropriate coding and claim submission.

CPT Disclaimer

? CPT? copyright 2018 American Medical Association

? The CPT codes that are utilized in coding claims are produced and copyrighted by the American Medical Association (AMA). Specific questions regarding the use of CPT codes may be directed to the AMA.

? CPT? is a registered trademark of the American Medical Association

Objectives

? Understand how proper documentation and coding supports compliant billing practices and efficiencies.

? Understand relevant ICD, CPT and modifier terminology and codes. ? Become familiar with common HIV/STI ICD codes. ? Apply knowledge learned by identifying which codes would be

assigned to a patient scenario.

The Billing Process

Paint

Identify

Discuss

Identify

Follow

Paint a picture of the visit by your documentation

Identify all services you provided today?

CPT / HCPCS

Discuss why you performed the services?ICD-10-CM

Identify any special circumstances? Modifiers

Follow established coding rules and

regulations

Documentation Basics

Improves compliance

Improves patient care

Improves clinical data for research

and education

Protects the legal interest of the

patient, facility and clinician

Enables proper reimbursement for services performed

If it isn't documented ? it can't be coded and ultimately billed!

Ensure your documentation supports

the codes billed for services and captures the essential elements needed

by your payers

Be careful to not cut and paste documentation

without individualizing the notes to the specific patient visit

More is not better ? quality vs. quantity

Documentation Basics

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