Risk Adjustment Documentation and Coding Boot Camp
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- Delbert Collins
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1 Risk Adjustment Documentation and Coding Boot Camp *** LIMITED TIME OFFER: FREE $100 AMAZON GIFT CARD! *** REGISTER TODAY! Course Overview Risk adjustment requires coding and CDI professionals to work together as one team to ensure the capture of the most appropriate risk score for each patient. If you re looking for ways to expand your CDI department into outpatient settings and services all of which can impact risk scores you ll find it in therisk Adjustment Documentation and Coding Boot Camp. The Risk Adjustment Documentation and Coding Boot Camp reviews both inpatient and outpatient coding guidelines and their application to the CMS-Hierarchical Condition Category (HCC) methodology, and includes detailed instruction on the individual HCCs and identification of opportunities for improved documentation. Clinical scenarios are used to demonstrate concepts and validate learning. This Boot Camp goes beyond just knowing how to code for a condition. It explores where coding information may be obtained as well as where to look for documentation deficiencies to improve overall risk scores. Similar to how implementing clinical documentation improvement (CDI) departments improves documentation for DRG assignment, this Boot Camp uses the same principles to improve documentation for risk adjustment. The Risk Adjustment Documentation and Coding Boot Camp will take you all the way from tackling the concept of risk adjustment and how it is calculated, to focusing on specific diagnoses and conditions that may affect overall risk scores. It will ensure you understand all facets of risk adjustment and help you position your organization to make the best decisions. It will also offer strategies to reduce your facility s vulnerability to Risk Adjustment Data Validation audits (RADV). This three-day course can also help prepare you for the Certified Risk Adjustment Coder (CRC) examination offered through the AAPC. Who should attend? CDI specialists CDI managers and directors HIM managers and professionals Inpatient and outpatient coding managers and professionals Medicare Advantage payers Quality professionals Physicians and nonphysician healthcare professionals Physician practice managers Learning Objectives At the conclusion of this educational activity, participants will be able to: Discuss predictive modeling and the concept of risk adjustment Explain how risk adjustment is applied to reimbursement in healthcare Explain how risk adjustment is applied to CMS quality measures Identify the different models used in risk adjustment Discuss the process of computing the Risk Adjustment Factor (RAF) score for individuals Describe the process of Risk Adjustment Data Validation (RADV) audits Identify elements within a medical record that can be used to support code assignment Define what is considered a reportable diagnosis
2 Identify the most common conditions found within the Hierarchical Condition Categories (HCC) risk adjustment methodology Apply the Official Guidelines for Coding and Reporting when assigning codes to these common conditions Identify query opportunities related to documentation deficiencies that would likely impact HCC assignment and RAF score Apply the process of record review for HCC risk adjustment to clinical examples Outline/Agenda Module 1: CMS Reimbursement: IPPS, OPPS, and Medicare Advantage Quality Incentives Summary of Medicare Parts A D Inpatient Prospective Payment System (IPPS) Outpatient Prospective Payment System (OPPS) Medicare Advantage Plans Prescription Drug Coverage Module 2: ICD-10-CM Diagnosis Coding: Documentation Sources, Diagnosis Selection, and Official Guidelines Sources of Authority for ICD-10-CM Coding Documentation Sources Diagnosis Coding Inpatient Services Diagnosis Coding Outpatient/Professional Services Uncertain Diagnoses Signs/Symptoms Comparative/Contrasting Diagnoses Acute and Chronic Conditions Combination Codes ICD-10-CM Conventions Excludes notes Laterality Module 3: Introduction to Risk Adjustment: Review of Risk Adjustment Methodologies Risk Adjustment Models HHS-HCCs Adjusted Clinical Groups CDPS DRGs CMS-HCCs Demographic Variables Hierarchical Condition Categories Applicable settings Approved providers Medicare Advantage Plans Prescription Drug Coverage Module 4: Hierarchical Condition Categories and the Hierarchies Review of Key Diagnoses From Each HCC
3 Module 5: Disease Interactions and Disabled Disease Interactions Roles of Disease Interactions in Risk Adjustment Module 6: Risk Adjustment Validation: RADV Audits Please contact the event manager Marilyn ) below for: - Multiple participant discounts - Price quotations or visa invitation letters - Payment by alternate channels (PayPal, check, Western Union, wire transfers etc) - Event sponsorships NO REFUNDS ALLOWED ON REGISTRATIONS Service fees included in this listing BUSINESS & LEGAL RESOURCES-BLR - New York Events List JOA190429CEV
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