This comprehensive webinar explores the latest CMS rules and top billing issues related to the ever-changing ‘ three day window’ rule and offers practical advice on key CMS definitions, and proper application of the 72-hour rule to assure you are reimbursed for services.
In just 75 minutes, you will learn:
- The latest changes/updates/CMS guidance for the “three-day” window rule
- Suggested action items for compliance
- Why 72 hours does not always equal three (3) days
- Explanation of CMS’ s definition of ‘ wholly-owned’
- How CMS defines the two critical time frames defined under preadmission services rule
- Billing nuances for ‘ excluded’ and ‘ related’ services
- How to apply the rule for diagnostic & non-diagnostic services
- Proper billing protocols for cases when the inpatient stay is not ‘ reasonable and necessary’
- Best practices for reviewing claims to avoid high-risk errors
- Review of real life non-compliance cases
Product ID: 5834
MHA, RHIA, CCS, CDIP, CPHM
Sharon Easterling began her career as a coder over 20 years ago and since that time has evolved into a HIM professional who has directly touched and understands all aspects of the revenue cycle. Choosing to grow and learn wherever she works, some of her experiences include inpatient and outpatient coding, payment validation, medical staff coordination, utilization review, and serving as a director of HIM and coding departments. While working in these areas, Sharon assisted with health information system development as well as documentation improvement initiatives.
Mary D. Gregory
Mary Gregory began her coding career over 20 years ago with Carolinas Medical Center (formerly Charlotte Memorial Hospital) as an inpatient coder and she has not looked back. Soon after beginning her career at Carolinas Medical Center, she left to work for the Metrolina Medical Foundation and was introduced to the world of IPPS (Inpatient Prospective Payment System and DRGs.) At Metrolina, she soon discovered her passion for coding and the IPPS/DRG payment system. Mary’s love for coding soon lead her into academia as an ICD-9-CM/CPT coding instructor at Central Piedmont Community College.
Thomas W. Coons
Principal, Ober|Kaler's Health Law Group
Thomas W. Coons is a principal in Ober|Kaler's Health Law Group. His practice concentrates on health care issues involving Medicare payment, coverage and compliance. Tom provides legal counsel and litigates on behalf of academic medical centers, community hospitals, skilled nursing facilities, physicians, home health agencies, laboratories, independent diagnostic testing facilities, dialysis facilities and other health care providers and their associations. He also advises manufacturers and suppliers of health care products regarding coverage, payment and compliance laws.