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Course Detail: WELL-9284 - Understanding the Complex World of Therapy Services: Documentation, Coding and Billing
This seminar is designed for physical and occupational therapists and assistants treating pediatric, adult, and geriatric patients in outpatient settings. It covers essential documentation requirements for evaluations, progress notes, daily notes, discharges, and Medicare Part B certification/recertification to support medical necessity and compliance with insurance and state regulations.
Participants will review CPT coding for commonly used therapy procedures, including the new Caregiver Training Services (CTS) codes-especially relevant for pediatric care-and learn proper documentation and billing practices for CTS codes. The seminar also addresses the National Correct Coding Initiative (NCCI) edits, correct use of Modifier 59, and Medicare's 8-minute rule, with billing scenarios to ensure accurate claims across all payers.
Course Objectives:
- Describe and implement the necessary components of an initial evaluation to support the need for skilled therapy services
- Identify when a reevaluation is appropriate to perform on a patient and bill to an insurance carrier
- List the required and necessary components of a progress report to support the therapy already provided and the need for continued skilled therapy services
- Apply strategies to more effectively support medical necessity and skilled services in your daily notes
- Describe and implement the necessary components of a discharge report to demonstrate the nature of skilled services provided to support why you should be paid for those services
- Understand the certification and recertification process for Medicare Part B therapy services
- Distinguish between therapeutic exercise, neuromuscular reeducation & therapeutic activities
- Identify how to select the correct CPT code(s) based on interventions and techniques provided and documentation in the medical record
We are pleased to announce that a significant portion of the workshop cost is being covered by a grant from the Illinois Community College Board. Lunch is included.
Class Note: Upon successful completion, six (6) contact hours will be awarded to occupational therapists and physical therapists.
