Principles of Practice; Documentation, Compliance & Diagnosis Coding

Diagnosis

• ICD10 – You have the conversions, now learn proper application and documentation
• Understanding the use of specified, other specified and unspecified codes
• Personal injury and proper use of trauma codes and use of A, D, and S extensions
• Diagnosis hierarchy

CPT & Documentation

• Updated coding and policies for laser reimbursement
• Evaluation and management guidelines, use and documentation. Know and understand what is needed for each level of E&M coding
• Forms that easily and completely document E&M compliance for all levels
• Acupuncture & Physical Medicine coding and documentation
• Constructing a treatment plan with appropriate goals and outcomes
• Document & demonstrate medical necessity and how to use ADL & functional assessments
• Specific state acupuncture laws relating to scope and documentation
• Know the common pitfalls that cause audits and refunds

Insurance

• Acupuncture policy and protocols for medical necessity, documentation and reimbursement.
• Major insurance carrier (Aetna, BCBS, CIGNA, United Health Care et al) diagnosis requirements and allowance for acupuncture reimbursement
• Veterans Administration and the role of acupuncture
• Managed care contracts – The Good, the Bad and the Ugly
• Utilizing the equality non discrimination provision of the Affordable Care Act section 2706 to be paid for services within scope
• Sample billing for insurance and how to properly file a 1500 claim for or electronic claim

Cash Practice

• Legalities of offering cash, pre-pay or time of service discounts
• How to set up and utilize a “super-bill”
• Medical necessity and documentation of the cash patient, can there be a difference?

HIPAA

• Privacy and compliance requirements for the small office

Workers’ Compensation

• Acupuncturist role in the workers’ compensation system
• Which states do and do not require ICD10
• 2016 fee schedule updates