Medical Necessity Documentation for Pain Management
Date : 29 January 2019
Time : 12 : 00 PM EST
Duration : 60 Minutes

Amy Turner, RN, BSN, MMHC, CPC is the Director of Billing Compliance and Business Development for CE Medical Group. She holds a Bachelor of Science in Nursing and Master of Healthcare Management from Vanderbilt University in Nashville.  Amy’s unique combination of clinical experience and coding & billing offers insights that speak well to both the clinician and the billing & coding expert.

Amy has 18 years of pain management experience, working in both small and large private practice environments as well as in academics at Vanderbilt University Medical Center. Further, her experience includes working with hospital-based providers and ambulatory surgery centers. Amy’s expertise has resulted in invitations to present at pain management conferences and webinars across the nation.  Amy lives in Murfreesboro, TN.

Medical necessity denials can be very frustrating. In this webinar, we will discuss tools that can be used to educate the physicians and staff on what may or may not be considered medically necessary. We will begin by looking at Medicare publications that can be used for medical necessity guidance. Also, we will discuss commercial payer policies that have recently changed. Thorough documentation is a necessity to validate your medical necessity. We will discuss where to be the most specific in the documentation to accomplish this goal. Lastly, we will discuss the importance of reporting to capture medical necessity denials.

Areas Covered

  • What is the difference between National Coverage Determination and Local Coverage Determination 
  • What needs to be documented for urine drug screening
  • UDS Risk Assessment
  • Discuss the stages of Local Coverage Determination policies and how physicians can influence these policies
  • What to document to gain prior authorization for diagnostic imaging, procedure, and medication precertification
  • How to properly document moderate sedation
  • How to sufficiently document procedure results, diagnostic imaging results, lab results
  • Links to National Correct Coding Initiative edits and Meaningful Unlikely Edits

Who Should Attend

Biller, Coder, Provider, Manager, Clinical staff

Why Should Attend

Being keenly aware of medical necessity guidelines is very important in the financial health of a practice. Many practitioners are unaware of the input they can have in the creation of Local Coverage Determinations and payer policies.

  • $149.00