Briefing: Developing and Maintaining Your MTF Coding Compliance Plan Date: 21 March 2007

1. Briefing: Developing and Maintaining Your MTF Coding Compliance Plan Date: 21 March 2007 Time: 1400 - 1450

2. Objectives • Know the main elements of a coding compliance plan • Understand the tools to ensure compliance with your plan

3. Elements of a Coding Compliance Plan • A general statement of your organization’s commitment to compliant coding • The source(s) of your facility’s official coding guidelines • Appropriate resources • UBU Professional Services Guidelines • ICD-9-CM Coding Clinic • CPT Assistant

4. Elements of a Coding Compliance Plan • Ultimately responsible for the code assignment in your facility • Procedures for obtaining clarification on documentation issues • Different coding rules for different places within the facility • Facility specific coding rules

5. Elements of a Coding Compliance Plan • Process for correcting coding errors • Internal • External • Process for coding of new procedures • Method to resolve coding and documentation issues • Process for dealing with claim rejections • Statement in your plan that you will not modify or assign codes strictly based on maximizing reimbursement (RVU)

6. Understand the Tools • Develop coding policies and procedures • High risk • High volume • OIG Workplan • Conduct audits per your compliance plan • Trust but verify • Keep a documentation trail

7. Understand the Tools • Take action based on audit results • Provide education to coders and providers • Revise policies • Review OIG Workplan • Modifier issues • DRG issues

8. Understand the Tools • Track the Case-Mix Index • Reviewed denied claims

9. Summary • Know the main elements of a coding compliance plan • Understand the tools to ensure compliance with your plan