Hospital Outpatient Infusion Services: 2023 Reimbursement & Compliance Update

Recent years have seen a host of compliance issues with auditors targeting infusions and injections, paying special attention to code assignments that lack sufficient documentation. The scrutiny is likely to intensify – don’t let outdated or incomplete information sabotage your compliance and put you at risk of an audit!

By attending this annual update webcast, you will start the year with a clear understanding of the threats to your revenue integrity, coding compliance, and payments, as well as the steps you need to take to mitigate risks from the get-go. In addition, you will learn about common challenges, and pitfalls your peers are facing, so you can avoid these missteps.

Through in-depth explanations, case examples, and visual aids, our expert presenters will show you the way to fully compliant coding, billing, and documentation requirements in all care settings. This webcast is an excellent training opportunity for both audio and visual learners.

What’s on the agenda:

• 2023 code changes for drug administrations
• A review of industry trends and compliance risks, including:
  • The risks inherent with coding and billing of hydration therapy, drug administration, and other audit targets
  • Commercial payer trends, including discussion of payer requirements to utilize drugs obtained through specialty pharmacy rather than your hospital’s pharmacy
  • What Medicare, MACs, and private payers are saying about documentation for hydration therapy charges
  • Current issues with reimbursement of injections and infusions, including escalating payer reimbursement challenges such as a push towards bundled payments.

Webcast Takeaways

• Documentation requirements for drugs requiring prior authorization
• Coverage and reimbursement risks associated with high-cost drugs
• Approach for improved documentation practices of physicians and nursing staff; includes a quick-reference procedure chart to help identify essential elements, including start and stop times
• Identifying EMR documentation weaknesses and resolving broken workflows that threaten revenue integrity and interfere with the continuity of documentation, charge reconciliation, and compliant claims submission
• Detailed discussion of coding and billing rules for time-based infusion services; includes answers to questions such as: “If a patient is receiving an intravenous infusion and the stop time is not documented in the medical record, what alternatives are allowed for billing of timed services?”
• Avoiding hydration therapy pitfalls related to documentation, medical necessity, indications, limitations, and more
• Conducting internal audits — tips for process improvements
• Time permitting, answers to attendee questions

P.S. Our annual infusion & injection coding update webcast is also included in our Infusion & Injection All-Access Pass! With an All-Access Pass, everyone on your team, regardless of location, can receive unlimited education, anytime they need it, from any internet-connected device, for one affordable annual fee. Plus, an All-Access Pass provides a convenient way to earn essential continuing education credits to maintain credentials.

Each All-Access Pass is your gateway to a comprehensive set of resources, such as webcasts, eBooks, coding charts, newsletters, and articles — catering to a broad range of learning preferences. To learn more, click here!

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