Wednesday, October 30th at 11:30 AM - 12:30 PM

1 CEU
Domain IV. Revenue Cycle Management

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Coding and Billing staff at Hospitals are increasingly responsible for interpreting Medicare and Medicaid edits and determining when a modifier is appropriate. This presentation will summarize the key Medicare edits (OCE, MUE and CCI) as well as common hospital-outpatient modifiers and their application. We will review and summarize some of the issues surrounding the reporting of modifiers. Case examples will be utilized for the training.

Program Objectives:

• Understand the background and interaction of common Medicare edits
• Learn how NY Medicaid has initiated the application of some of the same edits
• Relate to some of the regulatory pressures for accurately reporting modifiers to bypass these edits
• Provide a platform on which Management and staff can build as they move forward with applying modifiers to line-items on outpatient claims