Observation: Coding, Billing and Financial Impacts
Thursday, March 30, 12 to 1:30 p.m., CDT
Content
• Differentiate between observation and inpatient
This workshop is devoted to the observation services
with an emphasis on coding, billing and financial
impacts with the development of the observation C-APC
(Comprehensive APC) under the Medicare Outpatient
Prospective Payment System (OPPS). Observation
continues as a problem area relative to proper coding,
billing and documentation, particularly in relationship
with the propriety of inpatient admissions. CMS through
the OPPS has developed a packaged payment process
using a C-APC that makes a blanket payment of
observation services. Whether hospitals even recover
their costs under this packaged approach is problematic
given the extreme variability of services and the host of
challenges with determining proper inpatient admissions.
The reimbursement differences between a short
inpatient stay versus observation will also be discussed.
•
Speaker
Schedule
Duane Abbey, Ph.D., CFP, president, Abbey & Abbey
Consultants
• Thursday, March 30, 12 to 1:30 p.m., CDT
Who should attend
This session is recommended for physicians and
non-physician practitioners; outpatient nursing staff;
medical/surgical nursing personnel and managers;
ED nursing staff; health care compliance personnel;
utilization review and quality assurance teams; billing,
coding and claims transaction personnel; chargemaster
coordinators; compliance personnel; and other interested
staff.
Learning objectives
At the completion of this program, participants will be
able to:
• Discuss the concept of observation and associated
•
services.
Explain how documentation must support the
coding and billing process.
•
•
•
•
•
•
admissions.
Describe the medical decision-making relative to
the Two-Midnight rule.
Define the use of standard observation protocols or
care paths.
Identify use of C-APC 8011 in payment for
observation under the OPPS.
Discuss how Medicare reimbursement is affected
by a procedure performed after observation.
Compare reimbursement between a short stay
inpatient encounter and an observation encounter.
Explain how private payers view and use
observation services.
Identify the requirements in the NOTICE Act.
Dr. Duane Abbey is a management consultant and
president of Abbey & Abbey Consultants. For more
than 20 years, Dr. Abbey has provided health care
consulting services to hospitals, physicians and medical
clinics. The focus of his consulting has been in the
areas of compliance, payment and delivery systems. In
addition to his consulting, Duane is an invited presenter
for hospital associations, medical societies and other
groups. He has also published articles and books on
health care topics.
Requirements to participate
You will need a phone (preferably a speaker phone) and
an internet connection. Please note: this call will not be a
toll-free call; long-distance charges will apply.
Fee
• MHA members: $200 per connection
• Non-members: $300 per connection
The registration fee provides you with one phone
number, one computer connection and a downloadable
version of the presentation slides.
Numerous people at your site are encouraged to
participate in this web conference through one
registration (utilizing the same computer and telephone
connection). If participants at your site require more
than one computer and telephone connection, additional
registration is necessary.
Prior to the program you will receive an email that
contains instructions on how to connect to the web
conference. This email will also contain codes to access
the website and conference call. Advance registration is
required to ensure delivery of instructional materials.
If you do not receive an email from Cari
Kronschnable prior to the program with web
conference details, please contact her at
[email protected] or 651-641-1121 to confirm
that your registration has been received.
Registration deadline
In order to schedule the appropriate number of lines for
the call, all registrations must be received in our office by
5 p.m. on March 28. Once the deadline has passed we
will no longer be able to accept registrations.
Cancellation
Registration fees, less a $25 cancellation fee, are
refundable if notice is received five working days before
the program date.
7317/200/300
(GHA - T4022)
Web Conference Registration Form
Registrant/s Information
Name __________________________________________________________________________________________
Title ___________________________________________________________________________________________
Facility _________________________________________________________________________________________
Address ________________________________________________________________________________________
City, State, Zip ___________________________________________________________________________________
Phone _________________________________________________________________________________________
Email __________________________________________________________________________________________
To Register
You may register for this program in any of the following ways:
• Mail the completed form and check to:
Minnesota Hospital Association
2550 University Ave. W., Ste. 350-S
St. Paul, MN 55114-1900
• Fax this form to (651) 659-1477
• Online at www.mnhospitals.org; Click on “Education,” select program title and log-in to register.
Method of Payment
 Check
 Bill Me (Members Only)
 Visa
 MasterCard
 American Express
Credit Card # __________________________________ Exp. Date______________
Signature _________________________ Sec. Code
(3 digits on back of card) __________
More Information
For more information, please contact MHA’s Education Department at (651) 641-1121 or (800) 462-5393.