2010 AKAPTA Spring Conference

From Policy to Documentation to Payment:
 Assuring Compliance and Minimizing the Risk of Audits

18 Contact Hours 1.8 CEU’s

Stephen M. Levine, PT, DPT, MSHA
Dr. Levine is a nationally recognized expert in the physical therapy profession, and consultant to physical therapy providers, as well as local and national third party payers, regulators, and case management agencies in the areas of CPT coding and relative values, RBRVS, cost containment, fraud and abuse, quality assurance issues, payment/reimbursement strategies for physical therapy services, electronic health records, and physical therapy documentation, utilization review, and medical necessity. He is a certified peer reviewer, and has provided education and training to both providers and payers at the local and national level for over 20 years. He has written numerous articles in his areas of expertise, and contributed to two book chapters in the areas of medical necessity, payment policy, Medicare regulations, and computerized documentation. Additionally, Dr. Levine has worked extensively with federal investigative and law enforcement agencies, including the Office of the Inspector General, Department of Justice, and Federal Bureau of Investigation in the areas of fraud, abuse, medical necessity, over-utilization and medical policy review.
Stephen M. Levine is a partner in Fearon & Levine.  Dr. Levine has been an active member of the American Physical Therapy Association for 25 years, having served many positions at the state and national level. Nationally, he was Vice-Speaker of the House and a member of the APTA Board of Directors from 1997 – 2002, following which he served as an APTA Board member and Speaker of the House of Delegates from 2003 - 2008. Additionally, Dr. Levine has served as adjunct faculty in multiple physical therapy professional and post-professional educational programs across the country, currently including the post-professional doctoral programs at Nova Southeastern University and the University of Montana, where he teaches in the areas of health care administration, practice management, coding, documentation, compliance, and payment policy.

Course Description

A comprehensive 2-day intensive seminar designed to educate health care providers and administrative personnel in issues related to documentation, coding, billing, and compliance in physical and occupational therapy, current Medicare payment policies, utilization management and review activities, fraud and abuse issues, governmental and private payer audits and investigations, and current regulations and pending legislation effecting PT and OT practice. Practical tips to maintain compliance with the rules are provided throughout the seminar, and essential information to assist health care providers to minimize their risk of audits are emphasized.

Course Objectives

Upon completion of this seminar participants will be able to:
Describe and understand the current issues in the federal legislative and regulatory arena and their impact on delivery, documentation, and coding requirements for rehabilitation in 2010 and beyond
Understand the most significant risk areas for audits, specific to outpatient rehabilitation and how to best address through documentation both clinically and administratively
Learn the definition of medical necessity used by most third party payers and how to best apply to the reporting of services in your practice environment
Learn the most updated Medicare documentation requirements as well as other Medicare compliance issues and any implications to other third party policy
Understand the Therapy Cap and Exceptions Process as clarified for 2010
Identify areas of risk in coding from a compliance perspective and learn documentation tips important in support of the use of codes to describe clinical practice in the private practice setting
Appropriately document and report ICD-9 codes for OP rehabilitation services and begin to learn some basics regarding the transition to ICD-10
Review the elements of documentation that focus on describing function, from evaluation through discharge
Understand the process to successfully transition from paper to paperless when considering your practice setting’s documentation and billing
Understand common audit flags related to coding, documentation, and billing that are likely to cause an audit, medical review, or likely denial of payment from payers
Begin to prepare and plan for the inevitable transition from hand-written documentation to an electronic system
Acquire recommendations to assist in effectively transitioning to an electronic medical record
Understand basic criteria that every physical therapist or physical therapy provider should expect when beginning the search for an electronic documentation system
Begin critically assessing your current electronic documentation system for situations that are likely to contribute to claims or documentation audit flags

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