Hospital Outpatient Infusion Services: 2021 Reimbursement & Compliance Update

Protect high-volume payments from high-risk practices

Nearly every patient who enters your hospital receives an infusion or injection of some kind. Which leads to important questions: What’s the compliance risk if documentation isn’t fully supportive of the charges for infusions and injections? What’s the impact of missed revenue opportunities due to coding mistakes and omissions repeated over a large volume of patients? The answers might shock you.

Recent years have seen a host of compliance issues with auditors targeting infusions and injections, paying special attention to code assignments lacking sufficient documentation. The scrutiny is likely to intensify.

By attending this annual update webcast, you can start the year with a clear understanding of the threats to your compliance and payments, as well as the steps you need to take to mitigate risks from the start. In addition, you will learn about common challenges, and pitfalls your peers are facing, helping to solidify full-proof understanding. Don’t let outdated or incomplete information sabotage your compliance. 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.

Webcast Takeaways

• A review of key changes, trends and compliance risks, including:
  • The risks inherent with hydration therapy, drug administration, and other audit targets
  • Commercial payer trends, including discussion of "brown bagging" vs. "white bagging” drug supplies
  • What Medicare, MACs and private payers are saying about documentation for drug administration charges
  • Changes to APC payment methodologies under the Hospital Outpatient Prospective Payment System (HOPPS)
  • Current issues with infusion/drug administration including escalating payer reimbursement challenges such as payers no longer paying for the drugs administered prior to chemotherapy and a push towards bundled payments.
• Expansive explanation of commonly asked hydration therapy questions and topics such as avoiding hydration therapy pitfalls related to documentation, medical necessity, indications, limitations, modifiers, and more; includes clinical examples and links to additional background from Noridian, Medicare, the AMA, and other sources
• What documentation is required to support outpatient injection and infusion codes, plus help with common EHR documentation challenges
• Explanations on modifications to the infusion services supervision requirement for the COVID-19 pandemic
• A close look at the physician order and nursing documentation; includes a quick-reference procedure chart to help identify essential elements, including start and stop times
• Identifying and mitigating the potential risks associated with charges for prolonged infusions
• How to communicate with nursing staff about the importance of complete, high-quality documentation
• Guidance with properly documenting time increments for infusion services; includes answers to questions such as: “If a patient is receiving an IV infusion for hydration therapy and the stop time is not documented in the medical record, how should the service be coded?”
• How to handle the initial hour of infusion, additional hours of infusion and infusions over the midnight hour
• Conducting internal audits — tips for process improvements
• Time permitting, answers to attendee questions

Webcast Access Privileges: Only one login is allowed per webcast purchased. Discounted pricing for additional registrants is available. For more information about webcast pricing and requirements, click here.