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Common Cardiology Claim Denials & How to Avoid Them

Presenter Susan Roskos, CPC, CPPM
Broadcast Date 6/19/2019
Time 10:00am PT / 11:00am MT / 12:00pm CT / 1:00pm ET
Presentation Length 60 minutes
Price $65 (Non-members $85)
Common Cardiology Claim Denials & How to Avoid Them Webinar

Learn more about this event

In this webinar, the attendee will be presented with examples of common cardiology-specific claim denials and how to avoid them. These denials will cover CPT®, ICD-10-CM, & modifier coding, billing guidelines for global services, clinical trial-related services, and E&M coding. There will also be a review of some cardiology-specific CPT® and ICD-10-CM guidelines that, when not followed, result in claim denials. The attendee will be provided with multiple resources to support the need for applying these changes within their coding practices.

Why is this topic important?
Cardiology claim denials are increasing as the technology to process them becomes more advanced. There will always be the need for appeals of complex or unusual services, but most denials are the result of incorrect or invalid CPT®, ICD-10-CM or modifier coding. The good news is that just making a few changes in your coding practices can result in a drastic reduction of claim denials.

Who would benefit from this topic?
Physicians, mid-level providers, coders, insurance specialists, and billing managers would all benefit from this topic.

How would this benefit you and/or your company?
Identifying common cardiology-specific denial trends and implementing changes in the coding and documentation process improves the number of clean claims that are transmitted by the provider and received by the payer. The result is decreased denials, faster reimbursement turnaround, and overall increased revenue.

What information or new skills will the attendee take away from this webinar?
The attendee will have a better understanding of the “Pareto Analysis” concept and how it applies to healthcare reimbursement. The attendee will be provided with specific examples of common CPT®, ICD-10 and HCPCS modifier errors leading to denials, and how to prevent those errors.

Why is the presenter the expert on this topic?
Susan has over 30 years of experience in healthcare on the provider side of the reimbursement process. As a former practice manager, she saw great success in identifying and correcting the 20% of denials impacting 80% of reimbursement. Over the past three years, her coding attention has been focused in the specialty of cardiology, with the last year being specifically focused on the management of denials. This has allowed her to identify common denial trends and patterns that are easily preventable once corrected.

Susan Roskos, CPC, CPPM

About The Author

Susan Roskos, CPC, CPPM

Susan entered the business side of healthcare in 1985.  Her work experience includes auditing, billing, coding, E.H.R. implementation, practice operations, practice start-ups and revenue cycle management.  She has held several private practice employment positions and has also been a self-employed practice management consultant.  She formerly taught basic ICD-9-CM and CPT-4 coding courses through Kilgore College in Kilgore, Texas, and Cross Country Education (VYNE) based out of Brentwood, Tennessee.

Her coding experience includes Cardiology, Gastroenterology, General Surgery, Obstetrics and Gynecology, Plastic Surgery, Thoracic Surgery, Urology and Vascular Surgery.  Susan is currently a coding specialist for Navigant - a specialized, global professional services firm.

 

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