Coding and Billing for the PDPM and PDGM

As we continue to navigate the biggest change in Medicare in over 20 years, there is much confusion and doubt about the value of therapy in establishing the case mix groups that determine payment under the PDPM and PDGM. Many therapists feel ill-prepared and unsure of the most effective way to manage patient billing and coding practices for the new payment models. It is critical that therapists selectthe most appropriate ICD-10 Medical and treatment diagnoses Codes and function scores to align with patient clinical categories and overall condition. Additionally, many therapists are unsure about best practice guidelines for thevarious modes of therapy; especially when therapy students are utilized. This timely course will provide much needed clarification of the do's and don'ts of billing and coding for the PDPM and PDGM as well as practical application of coding and billing through case study examples. Last but not least,this course will feature FAQs to reveal answers to those burning billing questions like when to use certain CPT codes, how to incorporate and bill for point-of-service documentation, therapeutic rest breaks, and other common uncertainties.

Highlights

• Understand how and why to select the most appropriate ICD-10, CPT codes, modifiers, and Function scores to align with the Clinical Categories for the PDPM and PDGM
• Identify appropriate billing practices for individual, group, concurrent co-treatment, and to ensure that legal and ethical guidelines are met
• State guidelines for billing procedures with the addition of therapy students
• Application of coding and billing concepts through real- life case study examples

Target Audience: Physical Therapists, Physical Therapist Assistants, Occupational Therapists, Occupational Therapy Assistants, Speech-Language Pathologists