Course Provider
Learning Objectives
Describe the governments rules and regulations related to the design and operation of Medicares inpatient prospective payment system (IPPS) for short-term acute care hospitals
Understand the most significant aspects of and recent changes to Medicares inpatient prospective payment system (OPPS)
Describe the rules and regulations that must be followed to ensure correct patient assignments
Identify how to proceed when a physician incorrectly assigns a patient to inpatient status
Discuss National and Local Coverage Determinations and coverage with evidence development
Discuss CMS process in identifying coding changes and explain the importance of compliance with the National Correct Coding Initiative edits
Describe the role of the charge description master in revenue integrity and recognize ways to ensure accurate charges for specific departments and services
Articulate strategies for a comprehensive audit system that reviews charges, denials, external reports, and regulatory changes
Identify challenges related to drug administration billing and coding, both inpatient and outpatient
Discuss the importance of complying with claims submission requirements, ensuring billing accuracy, and selecting proper revenue and HCPCS codes