Module 12: CPT and ICD-10 Diagnostic Coding for Dialysis Access
The key two items for physicians coding and billing for services rendered to patients of kidney dialysis are 1) coding compliance and 2) documentation reflecting the patient’s severity of illness. The clinical decision making with the appropriate treatment plan protocol documentation is reflected to the insurance payer only through the ICD-10 diagnostic codes and the CPT procedure codes. Patients with multiple co-morbid conditions, when coded appropriately, demonstrate the quality of care rendered to the patient and that information goes towards the profile of severity of illness, which equals data. Data quality will be reviewed by most insurance companies and government entities that give “guidance” of payment through the lens of meeting medical necessity. This module provides coding compliance advice along with key documentation requirements that will keep the provider ahead of the insurance denial pathway.
Upon completion of the educational activity, participants should be able to:
- Understand the coding/documentation compliance requirements.
- Review basic guidelines from AMA and CMS for Evaluation and Management Documentation regarding physician patient visits.
- Understand the update of the concept for “global packaging” with regards to CPT coding and modifiers.
- Verbalize the definition of the ICD-10 diagnostic history and how unspecified statements may result in non-payment.
- Outline the key elements in the patient’s documentation to capture the appropriate ICD-10 diagnostic assessments.
- List updates for CPT coding involving dialysis access and grafts, open and endovascular procedures, and peritoneal dialysis.
- Define complication of coding for Thoracic Central Vein Obstruction (TCVO) (in Module 7) at Dialysis Access Steal Syndrome (DASS) (in Module 8).
- Understand the Medicare Access and CHIP Reauthorization Act (MACRA) physician fee schedule signed into law in 2015.
The activity has been designed to meet the educational needs of vascular surgeons, interventional radiologists, nephrologists, general surgeons and physicians who perform open and or interventional dialysis access procedures in patients in the US and Internationally.
METHOD OF PARTICIPATION
To obtain credit, a score of 70% or better on the post-test is required. Please proceed with the activity until you have reviewed module materials, successfully answered all post-test questions, completed the evaluation, and have received a digital copy of your CME certificate. You must participate in the entire activity to receive credit. If you have questions about this CME activity, please contact Complete Conference Management at cme@CCMCME.com.
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Complete Conference Management and Online CME, Inc.
Complete Conference Management is accredited by the ACCME to provide continuing medical education for physicians.
NCCPA accepts AMA PRA Category 1 Credit™ from organizations accredited by ACCME.
Complete Conference Management designates this enduring activity for a maximum of 3.0 AMA PRA Category 1 Credit(s) ™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Ingemar Davidson, MD, PhD
Dr. Davidson has no relevant financial relationships reported.
Gerald Beathard, MD, PhD
Dr. Beathard has no relevant financial relationships reported.
Bart Dolmatch, MD, FSIR
Dr. Dolmatch is a consultant and advisor to Bard, Humacyte, Bluegrass Vascular Tech, Merit Medical and Histosonics.
Nicholas Inston, MD, PhD
Dr. Inston has no relevant financial relationships reported.
John Ross, MD
Dr. Ross has no relevant financial relationships reported.
Diana J. Adams, RHIA
Diana Adams has no relevant financial relationships reported.
Magdalena Biss-Mierzwińska, MD
Dr. Magdalena Biss-Mierzwińska has no relevant financial relationships reported.
Pierre Bourquelot, MD
Dr. Bourquelot has no relevant financial relationships reported.
Teresa Chuva, MD
Dr. Teresa Chuva has no relevant financial relationships reported.
Maurizio Gallieni, MD
Dr. Gallieni has no relevant financial relationships reported.
Jackie Pei Ho
Dr Ho has no relevant financial relationships reported.
Jose Ibeas, MD, PhD
Dr. Ibeas has no relevant financial relationships reported.
Hailei Li, MD, PhD
Dr. Li has no relevant financial relationships reported.
Linda Nuth, MD
Dr. Nuth has no relevant financial relationships reported.
Ramon Roca Tey, MD, PhD
Dr. Roca Tey has no relevant financial relationships reported.
Tobias Steinke, MD
Dr. Steinke is a consultant and advisor to Angiomed Karlsruhe GER, CR Bard Karlsruhe GER, TVA Medical Austin Texas USA.
Martina Tedesco, MS
Dr. Tedesco has no relevant financial relationships reported.
Steve Wu, MD
Dr. Wu has no relevant financial relationships reported.
STAFF / REVIEWERS
Tracey Fernandez, CMP
Ms. Fernandez has no relevant financial relationships reported.
Barbara O’Brien, MSN, BSN, RN
Ms. O’Brien has no relevant financial relationships reported.
This activity is supported by unrestricted educational grants from the following companies: Arrow International, Inc. Teleflex, Lutonix Technology Center/Bard, Boston Scientific Corporation, Le Maitre Vascular, Inc., Medtronic and W.L. Gore
CME Credit hours Earned: 3.0 Hour(s)
CME CREDIT HOURS EARNED
In accordance with the Accreditation Council for Continuing Medical Eduation (ACCME) Standards for Commercial Support, educational programs sponsored by Complete Conference Management must demonstrate balance, independence, objectivity and scientific rigor. All faculty, authors, editors and planning committee members participating in a CCM-sponsored activity are required to disclose any relevant financial interest or other relationship with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services that are discussed in an educational activity.
Disclosure of Unlabeled Use and Investigational Product
This educational activity may include discussion of uses of agents that are investigational and/or unapproved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Complete Conference Management makes every effort to develop CME activities that are scientifically based. This activity is designed for educational purposes. Participants have a responsibility to utilize this information to enhance their professional development in an effort to improve patient outcomes. Conclusions drawn by the participants should be derived from careful consideration of all available scientific information. The participant should use his/her clinical judgment, knowledge, experience and diagnostic decision-making before applying any information, whether provided here or by others, for any professional use.
REQUIRED HARDWARE / SOFTWARE
A computer with an internet connection. Internet Browser: Internet Explorer 7.x or higher, Firefox 4.x or higher, Safari 2.x or higher, or any other W3C standards compliant browser. Other additional software may be required such as PowerPoint or Adobe Acrobat Reader.
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