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Digital Seminar

Coding and Billing for Mental Health Services 2018 Code Updates: CPT, ICD, DSM-5, and HCPCS Level II Code


Average Rating:
Not yet rated
Faculty:
Sherry Marchand CPMA
Duration:
5 Hours 51 Minutes
Format:
Audio and Video
Copyright:
Jul 12, 2018
Product Code:
POS020156
Media Type:
Digital Seminar


Description

Coding and Billing Strategies for Optimal Reimbursement

Comprehending the requirements for procedure code and policy changes have further complicated the reimbursement process for all psychiatrists, psychologists, social workers, therapists, counselors, and clinical nurse specialists.

This recording will provide training on the major elements of coding and billing for mental health services and consolidate all of the new requirements with existing code rules and proven billing techniques in a comprehensive course, taught by an expert speaker and a veteran reimbursement analyst and coding and billing specialist. The areas of psychiatry for evaluation and management services and medication management, psychotherapy services, health and behavioral assessments and psychological and neuropsychological testing will be covered, along with specifics such as Inpatient Psychiatric services, Partial Hospitalizations, Detox coding, Intensive Outpatient and Outpatient services. Learn with the most current and accurate coding procedures coupled with documentation tips and complete definitions to ensure prompt and optimal payment for future insurance claims.

Credit


**

NOTE: Tuition includes one free CE Certificate (participant will be able to print the certificate of completion after completing the on-line post-test (80% passing score) and completing the evaluation). 

Continuing Education Information:  Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Please note, your state licensing board dictates whether self-study is an acceptable form of continuing education, as well as which credit types are acceptable for continuing education hours. Please refer to your state rules and regulations. If your profession is not listed, please contact your licensing board to determine your continuing education requirements and check for reciprocal approval. For other credit inquiries not specified below, please contact cepesi@pesi.com or 800-844-8260 before the event.

Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of your profession.  As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your profession's standards.  

For Planning Committee disclosures, please statement above.  For speaker disclosures, please see the faculty biography.


Counselors

This self-study activity consists of 5.75 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please save the course outline, the certificate of completion you receive from the activity and contact your state board or organization to determine specific filing requirements.


California Counselors

The California Board of Behavioral Sciences accepts CE programs that are approved by other approval agencies, including several that approve PESI and its programs.  A full list of approval agencies accepted by the BBS can be found at www.bbs.ca.gov/licensees/cont_ed.html under “Where to find CE Courses.” This intermediate level self-study activity consists of 5.0 clock hours of continuing education instruction.


Florida Counselors

PESI, Inc. is an approved provider with the Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling. Provider Number 50-399. This self-study course qualifies for 5.75 continuing education credits.


Missouri Counselors

CE credit is available. This self-study course consists of 5.75 continuing education clock hours for Missouri Counselors. The Missouri Committee for Professional Counselors accepts continuing education programs relevant to counseling that are provided by organizations recognized by national social worker associations. PESI, Inc. is recognized by a national social worker association. Please see social work approvals for this program.


Montana Counselors

The Montana Board of Behavioral Health no longer pre-approves any courses or sponsors. Each licensee is responsible for taking courses which contribute to their competence and directly relate to their scope of practice as defined in board statute (MAR 24-219-32). Licensees must keep CE documentation for three years in case of an audit. This intermediate level self-study activity consists of 5.75 clock hours of instruction.


New York Counselors

PESI, Inc. is recognized by the New York State Education Department's (NYSED) State Board for Mental Health Practitioners as an approved provider of continuing education for Licensed Mental Health Counselors. #MHC-0033. This self-study activity will qualify for 7.0 contact hours. Full attendance is required; no partial credits will be offered for partial attendance


Ohio Counselors

PESI, Inc. is an approved provider with the State of Ohio Counselor, Social Worker and Marriage & Family Therapist Board. Provider approval #:RCST071001. Full attendance in this self-study course meets the qualifications for 5.75 clock hours of continuing education credit. 20-647797


Pennsylvania Counselors

The Pennsylvania State Board of Social Workers, Marriage and Family Therapists and Professional Counselors accepts many national association CE approvals, several of which PESI offers. For a full list, please see your State Board regulations at https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/. This intermediate level self-study activity consists of 5.75 clock hours of continuing education instruction.


South Carolina Counselors

This self-study program has been approved for 5.5 continuing education hours by the South Carolina Board of Examiners for Licensure of Professional Counselors, Marriage and Family Therapists, and Psycho-Educational Specialists. Provider #4540.


Texas Counselors

This self-study activity consists of 5.5 clock hours of continuing education instruction. Texas State Board of Examiners of Professional Counselors no longer approves programs or providers. PESI activities meet the continuing education requirements as listed in Title 22 Texas Administrative Code, Chapter 681, Subchapter J, Section 681.142 Acceptable Continuing Education. Please retain the certificate of completion that you receive and use as proof of completion when required.


Social Workers - National ASWB ACE

PESI, Inc., #1062, is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: January 27, 2023 - January 27, 2026. Social workers completing this course receive 5.75 Clinical  continuing education credits.

 

Course Level: Intermediate  Format: recorded asynchronous distance. Full attendance is required; no partial credits will be offered for partial attendance.

 

Canadian Social Workers: Canadian provinces may accept activities approved by the ASWB for ongoing professional development.


California Social Workers

The California Board of Behavioral Sciences accepts CE programs that are approved by other approval agencies, including several that approve PESI and its programs.  A full list of approval agencies accepted by the BBS can be found at www.bbs.ca.gov/licensees/cont_ed.html under “Where to find CE Courses.” This intermediate level self-study activity consists of 5.0 clock hours of continuing education instruction.


Colorado Social Workers

PESI, Inc. is an approved provider with the Colorado Chapter of the National Association of Social Workers. Provider #1413. This self-study course has been approved for 5.9 continuing education hours. 

 

COLORADO PARTICIPANTS ONLY: If you did not answer YES to be reported to the Colorado Chapter of the NASW on the evaluation, please contact cepesi@pesi.com and provide the full title of the webcast, speaker name, date of live broadcast, your name and your license number in the email.


Florida Social Workers

PESI, Inc. is an approved provider with the Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling. Provider Number 50-399. This self-study course qualifies for 5.75 continuing education credits. 


Illinois Social Workers

PESI, Inc. is an approved provider with the State of Illinois, Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 159-000154. Successful completion of this self-study activity qualifies for 5.5 contact hours.


Kansas Social Workers

PESI, Inc. is an approved provider with the Kansas Behavioral Sciences Regulatory Board. Provider #14-006. This self-study course has been approved for 5.5 continuing education hours.


Minnesota Social Workers

PESI, Inc. is an approved provider with the State of Minnesota, Board of Social Work. Provider #: CEP-140. This self-study package has been approved for 5.5 continuing education hours. This certificate has been issued upon successful completion of a post-test.


Montana Social Workers

The Montana Board of Behavioral Health no longer pre-approves any courses or sponsors. Each licensee is responsible for taking courses which contribute to their competence and directly relate to their scope of practice as defined in board statute (MAR 24-219-32). Licensees must keep CE documentation for three years in case of an audit. This intermediate level self-study activity consists of 5.75 clock hours of instruction.


New York Social Workers

PESI, Inc. is recognized by the New York State Education Department's (NYSED) State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0008. This self-study activity will qualify for 7.0 contact hours. Full attendance is required; no partial credits will be offered for partial attendance. 


Ohio Social Workers

PESI, Inc. is an approved provider with the State of Ohio Counselor, Social Worker and Marriage & Family Therapist Board. Provider approval #:RCST071001. Full attendance in this self-study course meets the qualifications for 5.75 clock hours of continuing education credit. 20-647797


Pennsylvania Social Workers

The Pennsylvania State Board of Social Workers, Marriage and Family Therapists and Professional Counselors accepts many national association CE approvals, several of which PESI offers. For a full list, please see your State Board regulations at https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions. This intermediate level self-study activity consists of 5.75 clock hours of continuing education instruction.


Canadian Psychologists

PESI, Inc. is approved by the Canadian Psychological Association to offer continuing education for psychologists. PESI, Inc. maintains responsibility for the program. This program is approved for 5.5 self-study continuing education hours. Full credit statement at: www.pesi.com/cpa-statement


Florida Psychologists

PESI, Inc., is an approved provider with the Florida Board of Psychology.Provider Number #50-399.This product qualifies for 5.9 self-study continuing education credits.


Psychologists

This self-study activity consists of 5.75 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please save the course outline, the certificate of completion you receive from this self-study activity and contact your state board or organization to determine specific filing requirements.


Illinois Psychologists

 

PESI, Inc is an approved provider with the State of Illinois, Department of Professional Regulation. License #: 268.000102. Full attendance at this self-study course qualifies for 5.5 contact hours.


Kentucky Psychologists

PESI, Inc. is approved by the Kentucky Board of Examiners of Psychology to offer continuing education for psychologists, approved provider #202312H. PESI maintains responsibility for this program and its content. This self-study activity will qualify for 5.75 contact hours.


Ohio Psychologists

PESI, Inc. is approved by the Ohio Psychological Association, Provider #263896894, to sponsor continuing education for psychologists. PESI, Inc. maintains responsibility for this program and its content. PESI is offering this self-study activity for 5.75 Standard hours of continuing education credit.


Pennsylvania Psychologists

PESI, Inc. is approved by the Pennsylvania State Board of Psychology to offer continuing education for psychologists. Provider #PSY000211. PESI maintains responsibility for the program(s). This self-study program qualifies for 5.75 continuing education hours.


Marriage & Family Therapists

This self-study activity consists of 5.75 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please save this course outline, the certificate of completion you receive from this self-study activity and contact your state board or organization to determine specific filing requirements. 


California Marriage & Family Therapists

The California Board of Behavioral Sciences accepts CE programs that are approved by other approval agencies, including several that approve PESI and its programs.  A full list of approval agencies accepted by the BBS can be found at www.bbs.ca.gov/licensees/cont_ed.html under “Where to find CE Courses.” This intermediate level self-study activity consists of 5.0 clock hours of continuing education instruction.


Florida Marriage & Family Therapists

PESI, Inc. is an approved provider with the Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling. Provider Number 50-399. This self-study course qualifies for 5.75 continuing education credits.


Illinois Marriage & Family Therapists

PESI, Inc. has been approved as a provider of continuing education by the State of Illinois, Department of Professional Regulation. Provider #:168-000156. Full attendance at this self-study activity qualifies for 5.5 credits.


Montana Marriage & Family Therapists

The Montana Board of Behavioral Health no longer pre-approves any courses or sponsors. Each licensee is responsible for taking courses which contribute to their competence and directly relate to their scope of practice as defined in board statute (MAR 24-219-32). Licensees must keep CE documentation for three years in case of an audit. This intermediate level self-study activity consists of 5.75 clock hours of instruction.


New York Marriage & Family Therapists

PESI, Inc. is recognized by the New York State Education Department's (NYSED) State Board for Mental Health Practitioners as an approved provider of continuing education for Licensed Marriage and Family Therapists. #MFT-0024. This self-study activity will qualify for 7.0 contact hours. Full attendance is required; no partial credits will be offered for partial attendance


Ohio Marriage & Family Therapists

PESI, Inc. is an approved provider with the State of Ohio Counselor, Social Worker and Marriage & Family Therapist Board. Provider approval #:RCST071001. Full attendance in this self-study course meets the qualifications for 5.75 clock hours of continuing education credit. 20-647797


Pennsylvania Marriage & Family Therapists

The Pennsylvania State Board of Social Workers, Marriage and Family Therapists and Professional Counselors accepts many national association CE approvals, several of which PESI offers. For a full list, please see your State Board regulations at https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/. This intermediate level self-study activity consists of 5.75 clock hours of continuing education instruction.


South Carolina Marriage & Family Therapists

This self-study program has been approved for 5.5 continuing education hours by the South Carolina Board of Examiners for Licensure of Professional Counselors, Marriage and Family Therapists, and Psycho-Educational Specialists. Provider #4540.


Texas Marriage & Family Therapists

This self-study activity consists of 5.5 clock hours of continuing education instruction. Texas State Board of Examiners of Marriage and Family Therapists no longer approves programs or providers. PESI activities meet the continuing education requirements as listed in Title 22 of the Texas Administrative Code, Chapter 801, Subchapter K, Section 801.264 Types of Acceptable Continuing Education. Please retain the certificate of completion that you receive and use as proof of completion when required.


Nurses, Nurse Practitioners, and Clinical Nurse Specialists

This self-study activity consists of 5.75 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please save the course outline, the certificate of completion you receive from this self-study activity and contact your state board or organization to determine specific filing requirements.


California Nurses

PESI, Inc. is a provider approved by the California Board of  Registered Nursing, Provider #: 17118 for 5.75 self-study contact hours. 

** You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.


Florida Nurses

PESI, Inc. is an approved provider by the Florida Board of  Nursing. Provider #: FBN2858. These materials qualify for 5.5 self-study contact hours.

CE Broker


Iowa Nurses

PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 5.9 self-study contact hours. Please email cepesi@pesi.com with your license number, include the title, speaker name and date. PESI must have this number on file in order for your hours to be valid.


California Licensed Educational Psychologists

The California Board of Behavioral Sciences accepts CE programs that are approved by other approval agencies, including several that approve PESI and its programs.  A full list of approval agencies accepted by the BBS can be found at www.bbs.ca.gov/licensees/cont_ed.html under “Where to find CE Courses.” This intermediate level self-study activity consists of 5.0 clock hours of continuing education instruction.


South Carolina Psycho-Educational Specialists

This self-study program has been approved for 5.5 continuing education hours by the South Carolina Board of Examiners for Licensure of Professional Counselors, Marriage and Family Therapists, and Psycho-Educational Specialists. Provider #4540.


Other Professions

This self-study activity qualifies for 5.75 continuing education clock hours as required by many national, state and local licensing boards and professional organizations. Save your activity advertisement and certificate of completion, and contact your own board or organization for specific requirements.



Handouts

Faculty

Sherry Marchand CPMA Related seminars and products


SHERRY MARCHAND, CPMA, is a reimbursement analyst and a billing, collection, and chart-auditing consultant with more than 25 years of experience in the health care industry, including hospital and physician group billing, and collection management. She has served as an expert witness/consultant in Medicare, Medicaid, ALJ hearings, and criminal fraud cases. Her vast knowledge of the practice management process has come from working in various levels of health care accounting, including the management of international hospital billing. As a certified, self-employed practice management consultant and chart auditor, Ms. Marchand has helped numerous medical offices take control of their cash flow through implementation of billing and documentation processes. Her specialties include Internal Medicine, Obstetrics, Mental Health, Physical Therapy, Cardiology, ENT, and Surgical Specialties. Ms. Marchand is skilled in installation training and implementation of hardware and software systems that are right for the health care arena. Ms. Marchand has many tips and tools to assist your office on the road to healthy patients and insurance collections.

 

Speaker Disclosures:

Financial: Sherry Marchand is the owner of Advanced Physician Services. She receives a speaking honorarium from PESI, Inc.

Non-financial: Sherry Marchand is a member of the American Academy of Professional Coders.


Additional Info

Access for Self-Study (Non-Interactive)

Access never expires for this product.


Objectives

  1. Explore strategies to prepare for 2018 ICD-10-CM
  2. Answer the question why are Insurance Companies not paying for ICD-10-CM Codes
  3. Identify and use all current and new procedure codes for mental health services
  4. Discuss problem areas of documentation for mental health services
  5. Inform how MACRA will change the way providers documentation
  6. Evaluate MIPS measures and gain access to resources
  7. Explore Advancing Care Information and Improvement Activities
  8. Document correctly and learn what is necessary to support reimbursement
  9. Discuss reimbursement strategies for inpatient and partial hospital services
  10. Outline procedures for conducting an internal review of coding and documentation

Outline

CPT/HCPCS PROCEDURE CODES
  • New charts by program of most common used CPT/HCPCS level II codes
  • Codes for diagnostic assessments
  • Codes and guidelines for psychotherapy
  • Codes and guidelines for psychotherapy with E/M
  • Codes and guidelines for psychotherapy for crisis
  • How to code medication management, use of evaluation, and management codes
  • Code and guidelines for interactive complexity
  • Group therapy
  • Family therapy
  • Health and behavior assessment/intervention services
  • How to code and document psychological testing
  • How and when to code evaluation and management services
  • History, exam, and medical decision making vs. billing based on time
  • How to code RN/LPN services
DIAGNOSTIC CODING
  • 2018 code changes and online tools to prepare for ICD-10-CM
  • DSM-5 structure
  • DSM-5 diagnostic criteria for initial evaluations and treatment plans
FEDERAL REGULATIONS AND MEDICARE'S BILLING RULES
  • Explore free online tools for access to federal and payer rules
  • Affordable Care Act changes that impact mental health
  • Fines have doubled in the False Claims Settlement Practice Act
COMPLIANCE WITH CODING AND DOCUMENTATION STANDARDS
  • Gain systematic steps for implementation of new DSM-5 for diagnostic criteria medical necessity
  • CMS MAC, RAC, ZIP, and CERT program guidelines
  • OIG audit focus on behavioral health services
  • Insurance companies and the focus on audits for psychiatric, psychological, and evaluation and management (E/M) services
  • Medicare's "incident to" guidelines
  • Definition of "incident to" services
  • Supervision requirements
  • Documentation of initial assessments and treatment plans
  • Components necessary in psychotherapy documentation and progress notes
  • Common problem areas of documentation
UNDERSTANDING THE REIMBURSEMENT PROCESS
  • Coding for maximum reimbursement by payer type
  • Links to major payer websites: Medicare, Medicaid, Blue Cross/Blue Shield, and other payers
  • Payment methodologies, PPS, and fee schedules
PROVIDER TYPES AND SCOPE OF COVERED SERVICES
  • Psychiatrists
  • Physician Assistants
  • Certified Registered Nurse Practitioner
  • Psychologists
  • Social Workers
  • Psychotherapists
  • Professional Counselors
  • Marriage and Family Therapists
  • Outpatient clinic and hospital
  • Consultation definition and appropriate use
  • Inpatient hospital
  • Partial hospital program
  • Nursing facility
  • Discharge day management
CLAIMS PROCESSING
  • CMS1500
  • UB-04
  • Modifiers
THE APPEAL PROCESS
  • Systematic steps of the appeal
  • Understanding reasons for denials

Target Audience

  • Coding
  • Billing
  • Finance Personnel
  • Psychiatrists
  • Psychologists
  • Social Workers
  • Psychotherapists
  • Counselors
  • Marriage and Family Therapists
  • Nurse Practitioners

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