Course Faculty: Jon Hathaway, MD and Mitch Schuster, MD

Course Description:

This postgraduate course is designed to educate and update the gynecologic surgeon on the current landscape of coding and billing for surgically based services.  Accurate coding and documentation are critically important to the sustained health of any physicians practice.  Insurers and CMS are aggressively creating initiatives that are focused on identifying improper billing practices and are focusing on performance measures. 

Over the course of four hours, participants will engage in a series of lectures and discussions, led by experienced faculty in both urogynecology and gynecologic surgery.  The curriculum covers the fundamental basis for coding and reimbursement, the rules related to surgical billing including services both included and excluded from the global surgical package, and how to appropriately use surgical modifiers.  Lastly, the faculty will explain how to use documentation to support complex services including multiple surgical procedures, and discuss how surgeons can best manage and divide their time between the operating room and their office practice.

There will also be adequate time dedicated to answering questions, and addressing common misconceptions related to both billing and reimbursement. 

Overall Course Learning Objectives:

 At the conclusion of this course, participants will be able to:

1. Understand how CMS/RUC establishes relative value for each professional service
2. Understand Global Surgical Package.
3. Concepts of surgical bundling and the rules of NCCI.
4. Construct documentation that supports complex surgical service billing.

Agenda & Session Details

1:00 – 1:10 PM — Welcome & Course Overview (10 minutes)

1. Introduction of faculty and participants.
2. Outline of course structure and interactive elements.
3. Coding Resources. 

1:10 - 1:30 PM -Principles of Surgical Coding (Toglia) 

1:30 - 2:00 – Session 2:  Relative Value Unit (Hathaway)

1. The process of how work is valued
2. RVS Process 

2:00 - 2:30 – Session 3 – Understanding NCCI Edits, Surgical Bundling, and Coding for Multiple Procedures  (Schuster)

2:30 – 3:00  – Session 4 – Understanding the Global Surgical Package (Toglia)

1. Describe the 3 types of global surgical packages recognized by Medicare
2. Understand what pre and post-operative services are included (‘pre-paid”) in our compensation for surgery
3. Identify professional services that fall outside the global package and are separately billable

 3:00 - 3:15      BREAK

 3:15 - 3:45      Session 5:  The Proper use of Surgical Modifiers (Hathaway)

 3:45 - 4:15      Session 6:   How do I code for that? Examples of surgical procedures (Schuster)

 4:15 - 4:45      Understanding Value of Time and Relationship to Reimbursement

                        Intro – Toglia

                        Panel Discussion/Questions (Hathaway, Schuster, Toglia)

 4:45 - 5pm      Wrap Up