MedLearn Coding Guide Resources 2022

Three Proven Resources — Ideal for These High-Risk Times

Designed to address unprecedented threats to your revenues, these how-to resources are essential tools for the respiratory therapy, pulmonary function testing, sleep studies/polysomnography and cardiopulmonary departments. The books and webcast will provide complete guidance to coding, billing, documentation and reimbursement and offer clear insights, analysis and action steps.

2022 Respiratory Therapy Reimbursement & Compliance Update Webcast

MedLearn 2022 Respiratory Therapy Reimbursement & Compliance Update Webcast

Achieve financial stability at a time of declining payments and increasing audit risks.

Can you achieve financial stability during uncertain, tumultuous times? The answer is “yes” … if you have the right guidance. As a provider of respiratory therapy services, you can count on Robin Miller Zweifel and this on demand MedLearn Publishing webcast to guide you to the full legal payment for services rendered, which is critically important at a time of declining reimbursements and increasing audit risks.

You’ll get much more than just an update on what’s new with codes, coding and documentation requirements, and payments for 2022. With her clear, concise delivery, reinforced by case examples, Robin will walk you through areas of confusion and common problem areas that can sabotage payments and compromise your regulatory compliance. Here’s a taste of what’s covered in this popular webcast:

  • Understanding the 2022 OPPS final rule and its impact on RT providers
  • Correct CPT®/HCPCS coding for a full range of RT/pulmonary function services
  • New remote therapeutic monitoring (RTM) codes and their application
  • Commonly missed revenue opportunities
  • “Medical indications” vs. “medical necessity” and why the difference is so important
  • Approved for 1.5 hours of CRCE credit
  • Much, much more!

Available at the AARC Store

Coding Essentials

MedLearn 2022 Respiratory Therapy Reimbursement & Compliance Update Webcast

Maximize revenue while avoiding risky practices with this unique resource as your guide.

Facilities strive to maximize revenue, but, with respiratory therapy services, it’s also about avoiding risky practices — because auditors, regulators and payers are watching closely! This unique resource will guide you through charge capture and coding while helping you avoid noncompliant practices for a full range of respiratory therapy, pulmonary function testing and sleep study services.

Count on our trusted RT experts to guide you step by step through the intricacies of coding, charging, billing and documentation for this very challenging area of healthcare. Along the way, you’ll discover a wealth of dos and don’ts, equipping you to protect your compliance and revenue. We address many potential pitfalls, including insufficient documentation, unbundled coding, modifier misuse, and the inappropriate coding of services.

Features and Benefits

Updated and expanded content, including:

  • Explanation of new, deleted, and revised CPT®/HCPCS codes — including two new codes and the elimination of the longstanding G-codes for outpatient pulmonary rehab
  • Guidance with all RT-specific HCPCS code changes and National Correct Coding Initiative (NCCI) updates
  • Comprehensive information including clarification of supervision requirements for pulmonary rehab, an audit topic that poses serious consequences for noncompliance
  • Updated billing tips and expanded guidance for common problem areas such as inhalation treatments (94640) and ventilation management, including coding guidelines and clarification of confusing NCCI rules
  • Expanded information and guidance specific to inhaled nitric oxide and remote monitoring services—including new codes for remote therapeutic monitoring (RTM)
  • FAQ section addressing some of the most commonly asked questions and challenges observed by our experts across the country
  • Special guidance with services that should not be reported, such as evaluation and management (E&M) and recreational therapy, as well as testing provided per protocol —this is a growing area of noncompliance for RT departments that focus on counting productivity
  • New appendices on the COVID-19 public health emergency (PHE) and the latest OIG audits regarding coverage requirements for outpatient cardiac and pulmonary rehabilitation services

Our experts address common questions, concerns, and problem areas:

  • High-risk practices inherent with polysomnography and other sleep studies, such as insufficient prior authorization and incorrect coding for home sleep study tests
  • Billing issues with breathing treatments — a prime RAC target — and billing sequence or date of service
  • Unbundling of codes and groups of CPT/HCPCS codes that are inappropriately reported together
  • Incorrectly billing for routine monitoring, oxygen, and services not specifically ordered by a physician
  • Medicare medical necessity coverage policies and frequency limitations
  • Lack of documentation to support medical necessity

Clear, step-by-step guidance through the tasks you perform every day:

  • Coding, documentation, and billing for a full range of respiratory therapy services and pulmonary function testing, plus polysomnography and other sleep studies, EEGs, home sleep testing, and penile studies
  • Covers code assignments by both hospital (technical) and physician (professional) entities
  • A proven quick-reference approach for busy professionals

Easy to navigate; each section contains:

  • Descriptions and intended uses of services provided
  • Listings of the corresponding CPT/HCPCS and revenue codes, along with explanations of intended code usage
  • Modifier usage, where appropriate
  • Documentation and medical necessity requirements
  • Billing tips
  • Clinical examples

Complete and current payment information, including:

  • Hospital Outpatient Prospective Payment System (OPPS) rates
  • Procedures with APCs, status indicators and at-a-glance tables showing CPT/HCPCS codes included in APCs, plus prior year and current payment rates
  • National and local coverage determinations (LCDs/NCDs)
  • Advance beneficiary notices (ABNs)
  • NCCI, including procedure-to-procedure (PTP) and Medically Unlikely Edits (MUEs)

Available at the AARC Store

Medicare Payment Guide for RT/Cardiopulmonary Services

Medicare Payment Guide for RT/Cardiopulmonary Services

Quick, practical, and convenient access to current and complete payment information.

With the fast-paced world of healthcare and the struggles of everyday operations, we know your time is valuable. The busier your schedule, the more you’ll appreciate this convenient reference! It provides the easiest, fastest pathway to current Medicare payment information for a full range of respiratory therapy and cardiopulmonary services: EKGs, stress tests, EEGs and many more. You don’t have time for the inconvenience and hassle of searching through multiple Medicare files to dissect APC and payment information. In one resource, you’ll find the detail you need — payment information and ambulatory payment classifications (APCs) — to determine whether you’re receiving the full appropriate reimbursement while complying with regulatory requirements.

Features and Benefits

Updated with the latest information, including:

  • New codes for outpatient pulmonary rehab and remote therapeutic monitoring (RTM), plus all RT-specific HCPCS code changes and NCCI updates
  • Payment changes with the most current conversion factors
  • Updated status indicators

A proven quick-reference approach for busy professionals:

  • Provides Medicare payment information for all services performed in your RT/pulmonary function, cardiopulmonary and sleep study departments

Divided into two main sections:

  • APCs for typical procedures
  • CPT®/HCPCS codes included in the APCs, with current payment rates and status indicators
  • At-a-glance tables with crosswalks compare the prior year payment rate to the current rate giving you instant detail on the changes
  • Key to status indicators at the bottom of every other page, guiding you through Medicare payment policies

Available at the AARC Store

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