how to get ceus from optum360...•online exams to test your icd-10-cm coding skills •appendix a:...

Julie Orton Van, CPC, CPC-P, CEMC

How to get CEUs from

Optum360:

It’s easy and budget-

sensitive!

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 2

Presentation disclaimer

All of the information provided is believed to be accurate and reliable; however, Optum360® assumes no responsibility for any errors. Optum360 is providing this information for educational purposes only and not as a replacement for professional judgment and experience; therefore any use of this information is at your sole risk and Optum360 neither assumes nor is responsible for its use.


Come and explore coding, billing and reimbursement resources that best suit your needs

• Specialty coding workbooks that allow you to earn 10 CEUs

• Customer-favorite educational conference earns you up to 16 CEUs

• Comprehensive learning online resources that help you stay ahead of

coding challenges and earn 1 or more CEUs per course

• CEUs Prior Approved by the AAPC and AHIMA


How to get CEUs from Optum360: It’s easy and budget-sensitive

• Optum360 is the leader in coding, billing and

compliance tools.

• We know your points of pain and focus on

the areas where you need help most.

• We put the very same quality processes and

innovation into our training and educational

materials, as we do our first-class electronic

solutions and publications.

• Come and learn from the industry leader.

Specialty coding workbooks


Targeted, specialty specific guidance is needed now

• Practices are seeking tools that assess and sharpen coding skills.

• Most needed are case studies that are appropriate for their clinical specialty and

reinforce coding conventions and guidelines.

• Most importantly, physician practices want to focus on coding issues within ICD-10-CM

specific to the specialty that are likely to affect day-to-day coding proficiency and

accuracy that significantly impact revenue.

• Physician practices are ready to work, to try their hand at routine and more challenging

cases.

• Current specialties include:

– Cardiology

– General surgery

– Ob/Gyn

– Orthopedics


Features and benefits

• NEW — Includes free access to two online ICD-10 coding exams for each specialty. Each exam includes 30 multiple choice questions taken from the book.

– Immediately get your final grade.

• Covers both basic and advanced topics. Get specialty-specific coding guidelines.

• Provides an educational format for ICD-10-CM. Case studies, tests, term definitions, fill-in-the-blanks and more.

– Repetition builds skills in ICD-10.

• Includes case-study problems. Reinforce basic coding conventions and guidelines as encountered in the specialty documentation with these real-world examples.

• Specialty coding instruction. Gives detailed, specialty-specific coding instructions that explain the correct solution to coding problems.

• Detailed answer rationale. Provides case study answers that include anatomy and physiology and documentation tips, along with coding instruction.

• Get ICD-9-CM to ICD-10-CM Code Mapping. Connects this specialty's most important diagnostic codes to ICD-10-CM.


Sample pages


• Depending on specialty:

– 40–54 case studies with detailed answer rationale

• Online exams to test your ICD-10-CM coding skills

• Appendix A: Quick Coding Reference:

– How to use

– Conventions used in ICD-10-CM Mappings

– Specialty-specific areas of most commonly coded and complex/confusing diagnoses

• Appendix B. ICD-10-CM Draft Official Guidelines for Coding and Reporting 2016:

– Section I. Conventions, general coding guidelines and chapter-specific coding guidelines

– Section II. Selection of Principal Diagnosis

– Section III. Reporting Additional Diagnoses

– Section IV. Diagnostic Coding and Reporting Guidelines for Outpatient Services

Contents

Essentials Coding, Billing and Compliance Conference


16th Annual Coding, Billing and Compliance Conference


• Industry recognized SMEs

• Timely topics and in-depth training:

• I-10-CM challenges

• PCS-CDI

• Time and motion study

• RAC audits - The insiders’ story

• 2 Midnight Rule & observation

• Transitioning outpatient coders to inpatient coding

• Risk adjustment - HCC

• CAC: The changing role of the coder

• CAC: What do you need to do if CAC is bought (as an HIM manager)

• Brain teaser: Behind the logic of the coding system

• Modifiers

• HIPA /compliance

• CDI Summit

• DRG "ask an expert" panel (bring Medicare reimbursement questions)

• Coding roundtable

• E/M roundtable

• Medicare decision-making

• HCPCS - Charge capture and how to audit for it

• All the code and regulatory updates in one setting:

• CPT

• HCPCS

• ICD-10-CM and PCS

• Final Rule

• OIG Work Plan

• Medicare Inpatient

• OPPS

• Chargemaster

• Less expensive than any other similar coding, billing and compliance conference

• Valuable networking

• User group sessions to increase your proficiency and efficiency of Optum digital solutions

• Receive all of the session slide decks, to take back and train your staff

Optum360 Essentials

Online coding courses


Online coding courses

• You've worked hard for your coding credentials, and now you

need an easy way to maintain your certification. Introducing new

online coding courses from Optum360®.

• Stay ahead of your CEU certification requirements — or get

certified if you aren't already — with our self-paced courses

designed to boost your knowledge of coding, ICD-10 and

everything else involved in your day-to-day workflow.

• Delivered online, our coding courses are a cost-effective method

for continuing your education and enhancing overall productivity.

In addition to fulfilling your CEU requirements, these courses

support clinicians, administrators and coders against the financial

risks of the shifting health care market.


Role-based training

• Introduction to Medical

Coding Basics (2)

• Foundations of Medical

Terminology (2)

• Understanding

Insurance (2)

• Introduction to

Procedure Coding (2)

• Introduction to HCPCS

Level II Coding (2)

• Introduction to

Present-on-Admission

Diagnoses (2)

• Coding from the

Operative Report for

ICD-10-CM and PCS (4)

Level 1 Level 1 Level 1


Level 1 courses

• Introduction to Medical Coding Basics — The billing and reimbursement process depends on the accurate coding of medical services and procedures, as well as the correct interpretation of these codes and the coding rules and guidelines that impact the reimbursement process.

• Introduction to Procedure Coding — This course provides and overview of procedure coding for new employees in the health insurance field. This perspective is broad enough that it can be used as part of an orientation process or it can be used by individuals with specific job functions, such as, customer service, claims processing, coordination of benefits, prior authorization, utilization reviews and others.

• Foundations of Medial Terminology — This course is designed to provide an introduction to medical terminology. Its perspective is broad enough that the course can be used as part of an orientation process. A variety of job functions will find this course useful, including: customer service, claims processing, coding, and billing, coordination of benefits and patient registration, to name just a few.

• Understanding Insurance — Every industry has its own set of words and expressions, tools and systems. The health insurance industry is no different. This fundamentals course concentrates on the terms and expressions commonly used in the industry. It also introduces you to various types of private and public payers, explains many of the systems and procedures used by health care payers, and outlines how private health coverage is regulated.

• HCPCS Level II Coding — This course is an introduction to HCPCS coding. Through the use of this course, you will gain an understanding of the coding system's organization and format. This lesson will teach you how to locate the correct HCPCS code and the coding and billing rules for DMR, prosthetics, orthotics, oxygen, injectable drugs, biologicals and procedures.


Level 1 target learners

• Employees new to the health care field

• Customer service

• Claims processing

• Coordination of benefits

• Prior authorization

• Utilization review

• Clinicians

• Reception

• Patient accounting

• Patient registration

• Transcription

• Medical records

• Medical coding

• Others


Level 2 course

• Introduction to Present-on-Admission Diagnoses — The topics in this course include:

– Background

– Federal law requirements

– General POA reporting guidelines

– Specific POA reporting guidelines

– General guidelines for identifying the conditions that are present-on-admission

– Describing the twelve-conditions that Medicare will monitor to present-on-admission status that may affect reimbursement

– Reporting to Medicare using the UB-04 and 837i formats

– POA clinical examples

– Test Your Knowledge

– Present-on-Admission Reporting Final Exam



• Medical coding

• Billing

• Case managers

• Claims processing

• Medical records

• Clinical staff

• Others


Level 3 course

• Coding from the Operative Report for ICD-10-CM and ICD-10-PCS ‚— In this course, you will learn about how coding from the operative report for ICD-10-CM and PCS has been impacted by the following:

– A brief history of operative reports

– The importance of medical documentation

– How ICD-10-CM procedures and coding has evolved from ICD-9-CM

– Current reimbursement practices

– Laws to follow to stay within fraud and abuse guidelines

– Operative report coding guidelines

– Case studies from every section of ICD-10

– Answer rationale for each study



• Seasoned physician coders new to inpatient coding

• Inpatient claims processing

• Coordination of benefits

• Prior authorization

• Utilization review

• Inpatient medical records

• Inpatient medical coders

• Others


Coming soon

• Post-acute care introductory courses:

– Introduction to Home Health Care

– Billing Home Health Care

– Coding Home Health Care

– Introduction to Hospice Services

– Billing Home Hospice Services

– Coding Hospice Services

– Introduction to Skilled Nursing Facilities

– Billing for Skilled Nursing Facilities

– Coding for Skilled Nursing Facilities

• CEUs yet to be granted

Contact information

Julie Orton Van, Product Manager, CPC, CPC-P. CEMC

801-982-3430

[email protected]

how to get ceus from optum360...•online exams to test your icd-10-cm coding skills •appendix a:...

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