Understanding the Complex World of Therapy Services: Documentation, Coding & Billing

Course overview

Physical and occupational therapy services continue to be on the medical record review radar for various Medicare Administrative Contractors and private insurance carriers medical review entities for documentation, coding and billing issues. This seminar will teach participants the necessary components of documentation for the initial evaluation, reevaluation, progress reports, daily notes, discharge reports and the Medicare Part B certification and recertification process that will help participants document the key points in supporting medical necessity and the skilled nature of outpatient therapy services not only for insurance carriers, but for their respective state practice act. The seminar will teach participants what interventions, techniques and procedures are included within the CPT codes most commonly used by physical therapists, physical therapist assistants, occupational therapists, and occupational therapy assistants. The seminar will teach participants the national correct coding initiative NCCI edits and the proper use of Modifier 59 as well as Medicare's 8-minute rule, definition of substantial per the American Medical Association, and provide billing scenarios to ensure therapists bill correctly to all insurance carriers, including the Medicare program. Finally, the seminar will teach participants the latest on the Medicare therapy threshold, use of the KX modifier, claims exceeding 3,000 dollars in a calendar year, and the new PTA and OTA modifiers the Medicare program will begin using in calendar year 2020 when services are provided in whole or in part by a physical therapist assistant or occupational therapist assistant.