Surefire Methods for Defensible Coding: Know What Makes it Correct

Overview:
We all like to think we are 100% accurate. But if you were forced to prove it – could you? Can you find and differentiate controlling from persuasive criteria?For a coder, mistakes are transparent and create potential for big problems, such as failed audit results, improper denials and lost practice revenue - or worse, improper payments and potential post-payment liability. For 100% accuracy, coders need to have complete confidence in their ability to find controlling criteria for each payer, or to select from various persuasive authorities in the absence of controlling rules to ensure that you can defend your ultimate code selection. This workshop will teach you a hierarchy of analysis for identifying the relevant rules for compliant and defensible coding.

This Workshop Will Help You:

• Identify all rules/laws and persuasive standards that impact all coding decisions
• Successfully address and resolve suspicions of fraud in the workplace,
• Properly defend your coding decisions or audit results
• Scan statutes, provider contracts, and carrier medical policies and “zero in” on relevant language
• Differentiate between fact and opinion – and what stands up to legal scrutiny
• Predict when proper methods of coding may be open to interpretation and how to resolve ambiguity
• Build unshakable credibility and value in your professional abilities in the eyes of your peers, employer, and providers or carriers on the other side of the claim

Author:
Michael D. Miscoe JD, CPC, CASCC, CUC, CCPC, CHCC

Mr. Miscoe has a bachelors of science degree from the United States Military Academy, a juris doctorate degree from Concord Law School, is a Certified Professional Coder, Certified Ambulatory Surgical Coder, Certified Urology Coder, Certified Chiropractic Professional Coder, Certified Healthcare Compliance Consultant, the President of Practice Masters, Inc., and the founding partner of Miscoe Health Law, LLC. He is a past member of the National Advisory Board of the American Academy of Professional Coders (AAPC) and is a current member of the AAPC Legal Advisory Board. He is admitted to the Bar in the state of California as well as to the practice of law before the US District Courts in the Southern District of California and the Western District of Pennsylvania.

Mr. Miscoe has nearly twenty years of experience in healthcare coding and over thirteen years as a compliance expert testifying in civil and criminal cases. He has an extensive national speaking background and has been published in numerous national publications on a variety of coding, compliance and health law topics.