Health Information Management

Learn strategies to reduce the burden of Part B rebilling

APCs Insider, May 1, 2015

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By Steven Andrews
New regulations allow hospitals to bill Part B services for inpatient cases that are internally reviewed and “self-denied” within one year of the date of service. Utilization review staff have to determine when to use the old condition code 44 process and when to opt for the new process using condition code W2, which can have an impact on which outpatient services may be covered and on which bill types to report them.
Operationalizing these rules has proved challenging, causing recoding, rebilling, and expensive slow-downs in the revenue cycle.
Part B rebilling using condition code W2 can be challenging for organizations—but with appropriate guidance and an understanding of the regulations, it doesn’t have to be. Expert speaker Kimberly Anderwood Hoy Baker, JD, CPC, director of Medicare and compliance for HCPro, a division of BLR, in Danvers, Massachusetts, will present a 90-minute webcast Wednesday, May 6, to teach strategies for implementing a rebilling method at your organization that streamlines the utilization review, billing, and coding processes.
Bring your entire team to this program as she discusses the difference between condition codes W2 and 44, how to bill under the regulations, and how to think smarter about billing with condition code W2, sooner rather than later. She will also discuss strategies for operationalizing the use of condition code W2 to avoid revenue cycle problems and provide a documentation check sheet for working through this process at your organization.

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