Documentation for Accurate Coding and Billing
Overview:
Learn specific examples how to document for services and procedures accurately and effectively. With the coming implementation of ICD-10, proper documentation will be more important than ever. This sixty-minute Webinar will provide a wealth of information concerning documentation for a wide variety of procedures and environments.
Why should you attend: This is most important for providers and mid-level clinical professionals. Also, it is appropriate for auditors and coders responsible for translating the medical record to accurate codes.
Areas Covered in the Session:
- Basic
- What to avoid
- Acronyms and abbreviation rules and guidelines
- Organizational tips
- Illustrations
- Bilateral indications (especially for ICD-10)
- Documenting lesions
- Skin Grafting
- Burns
- Changes in the medical record
- Establishing policy concerning bad outcomes
- Referrals
- Counseling and Coordination of care
- Medical vs financial information
- SOAP and SNOCAMP
- History
- Exam
- Medical Decision Making
- Surgical procedures
- Documenting for complicated procedures.
- Surgical operative report checklist
- Radiological services
- Pathology / Lab
- Coding and Documentation Audit Checklist
- Examples and scenarios
- Compliance Plan
Who Will Benefit:
- Providers
- Mid - Levels
- Coders
- Coding Manager
- ICD-10 Implementation Team