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Format: On-Demand Webinar
Presenter: Shellie Sulzberger, LPN, CPC, CT-CM
Time: You can access the webinar anytime
Duration: 60 minutes
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During this Webinar, we will discuss Coding and Documentation for Behavioral Health Services. We will review the qualified providers for Medicare. We will also review the G codes and qualifying codes. During this session, we will outline the importance of medical necessity. By the end of the session, participants will understand the documentation requirements for initial diagnostic evaluations, psychotherapy, crisis and interactive complexity. We will also spend time on the requirements of the treatment plan as this is a key and required element for behavioral health services. We will review the ICD-10 coding of signs/symptoms related to behavioral health.

Learning Objectives:

  • The attendees will be able to identify which providers are considered qualified providers for Medicare.
  • The attendees will be able to determine if a CPT/HCPCS code is considered a qualified code for Medicare.
  • The attendees will understand the documentation requirements for the initial diagnostic evaluation and psychotherapy.
  • The attendees will learn the requirements and importance of a treatment plan.
  • The attendees will learn ICD-10 codes for signs/symptoms

Areas Covered in the Session

  • Qualified Providers for Medicare
  • G codes and Qualifying Codes
  • Initial diagnostic evaluation
  • Psychotherapy
  • Interactive Complexity
  • Medicare
  • FQHC Services
  • Medicare G codes
  • Qualifying Codes
  • Behavioral Health Services and Documentation
  • Medical Necessity
  • Assessment
  • 90791 and 90792 – template for documentation
  • Initial Diagnostic Exam – Template Example
  • Psychiatric diagnostic evaluation
  • Treatment Plan Development
  • Treatment Plan with Examples
  • Findings from an OIG review in New York
  • Discharge Summary
  • Therapy
  • Psychotherapy Additional Documentation Requirements
  • Technical Documentation Elements
  • Documentation highlights
  • Progress Notes
  • Group Psychotherapy
  • Family Psychotherapy
  • Psychotherapy for Crisis
  • ICD-10
  • ICD-10 Diagnosis – All care must have a diagnosis
  • Common Z codes
  • Signs/Symptoms – R codes

Suggested Attendees

  • Coders
  • Billers
  • Coding
  • Billing
  • Providers
  • Healthcare Providers
  • Medical Assistants
  • Auditor
  • Billing Specialists
  • Claims Processor and adjuster
  • A/R Staff
  • Office managers
  • Denial managers
  • Administrators
  • Managers
  • Claims Adjusters
  • Reimbursement Staff

About the Presenter

Ms. Sulzberger is a Licensed Practical Nurse and a Certified Professional Coder. She received her Bachelor of Science degree in Business Administration from Mid America Nazarene University. Ms. Sulzberger received her nursing license in 1994 and was a practicing clinician at Saint Luke’s Health System for several years before transferring to the internal compliance/audit area. She became credentialed as a Certified Professional Coder in 1996 and assisted the Saint Luke’s Health System with performing medical record chart audits to verify the accuracy of the internal coding and claims processing.

Ms. Sulzberger spent approximately six years as a coding/billing consultant with National accounting and consulting firms (BKD, Grant Thornton) before becoming the President of Coding & Compliance Initiatives, Inc. (CCI) in April 2003. Ms. Sulzberger assists her clients with improving their operational performance in a variety of critical outcome areas, including coding/billing, corporate compliance, charge capture processes, etc. Ms. Sulzberger works with a variety of healthcare providers including hospitals, physician practices, and rural health clinics in their daily compliance and operational activities.

A substantial amount of Shellie’s time is spent providing education to the physicians and internal coding staff regarding opportunities for the clinic to improve its current documentation and coding practices, which impact both the revenue and compliance risk of the facility.

Shellie works extensively with federally qualified health centers across the country (along with physician practices, rural health clinics, and hospitals) serving as an independent auditor and compliance resource to improve documentation quality, coding accuracy, workflow, and revenue cycle performance. She works collaboratively with the National Association of Community Health Centers (NACHC) and State Primary Care Associations (PCA).

She assists legal counsel with research, investigation, and her expert opinion. She also provides clinical education in the areas of patient management and medical record documentation. She attends many physicians and other staff meetings to offer updates and to act as a liaison for the health care provider.

Ms. Sulzberger presents locally and nationally on coding topics as well as develops specialized training programs to meet the needs of her clients.

Shellie works with the front-office and back-office revenue cycle team members, focusing on education regarding E/M and ICD-10 coding and billing guidelines and coding/billing-related processes that improve compliance and cash flow. She emphasizes communication between the billing team and the providers and clinicians about the “downstream” impacts of incorrect coding.

Shellie personally works with 10+ health centers annually regarding documentation, coding, and billing processes and serves as an educational resource for several State PCAs every year.

Shellie is credentialed through the American Institute of Healthcare Compliance as a Certified ICD-10 Trainer.

Professional Affiliations:

  • American Academy of Professional Coders (AAPC)
  • Greater Kansas City Medical Managers Association (GKCMMA)

Course Content

You can access all the webinar materials after successful payment

  • Webinar Link + Handouts PDF
    00:00
  • Course Key
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