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Objectives: This Coding and Billing for Critical Access Hospitals series describes what revenue cycle, coding, and billing staff in CAHs need to know about their clinical documentation, professional coding, and medical billing processes. This series will provide a thorough overview of the coding and billing processes in a CAH.
We will describe the key activities and common issues that affect all members of the CAH workforce related to CPT, HCPCS-II, and ICD-10-CM coding and billing with a focus on their impact on revenue, facility mission, population and public health reporting.
- Primary Audience: CAH Inpatient Coder, Outpatient Coder, Biller
- Secondary Audience: Coding Manager, Billing Manager, Provider
Required Materials: You will need your 2022 CPT Professional Edition, ICD-10-CM and HCPCS. If you do not have a copy of these CLICK HERE to purchase them on our website.
- Course slides and supplemental materials will be available for download and/or print.
- Please be very familiar with the CMS regulations and tips in order to fully benefit from the class and to help get the right answers on the exam! You will find the answers to some test questions in these documents! Use the Search/Find feature to quickly locate information more quickly within the above CMS documents
- Coders/billers who have come from "traditional provider offices or hospitals" or are new to the unique nature of billing for the services Critical Access Hospitals will benefit by gaining a better understanding of the CAH designation and CAH-specific rules for coding/billing.
- Managers who hire staff, manage people and policies, supervise the coding/billing staff will benefit by gaining a high-level overview of CAH designation criteria and the systems/processes required to main CAH status with emphasis on coding/billing.
- Providers who create clinical documentation (e.g. MD/DO/PA/NP) will benefit by gaining a better understanding the coding/billing nuances that are specific to different hospital service areas.
Section breakdown - You will have 90 days to complete the 8 section video series, practice exam, and final certification exam. You must complete 90% of each lesson video to move on to the next section.
- Introduction & Course Navigation
- Lesson 1 - Introduction to Critical Access Hospital
- Lesson 2 - Introduction to CPT, HCPCS-II, ICD-10 and E-M Guidelines, HCC Coding
- Lesson 3 - Clinical Documentation
- Lesson 4- Swing Bed Coding
- Lesson 5- Inpatient Coding
- Lesson 6 - Outpatient Coding
- Lesson 7 - Hospital Professional Fee Coding
- Lesson 8 - Critical Access Hospital Billing
- Practice Exam - 30 question practice exam. In order to receive 11 AAPC CEUs you will need to complete the Practice Exam with a score of 70% and you get 2 attempts. You highest score will be saved. Be sure to take the practice exam, some of the questions will be on your final exam. Once you begin the practice exam you will have 3 hours to complete.
CAH Final Exam
- Exam is 100 questions and you need a 70% to pass
- Once you launch the exam – the 24 hour clock begins during which you must complete the test! If you have to log off during the 24 hour period, your answers will be saved.
- Once the exam is submitted, your score will be available immediately and certificate available for download and suitable for printing.
- Submit a response to each question and they will be saved. If you skip a question be sure to make a side note of the question number to make sure you submitted 100 questions before having your test graded. Once you fully submit the exam it will be graded based on the number of answers you have entered.
- You can go back to previous questions using the number bar on the bottom the screen at any time within the 24-hour time window.
- A free retest is offered if needed within the original 90 day deadline. A $75 fee will be assessed if you need an extension or a 3rd test attempt. To purchase a retest go to the course catalog under exam extensions.
CEUs - 11 CEUs Approved by AAPC & ArchProCoding