By Serena Agusto-Cox | News & Views
AACVPR’s Cardiac Rehabilitation (CR) Billing & Coding Workshop enables members to connect with experts, ask questions and stay up to date on Medicare payment changes while earning 4.0 AACVPR continuing education credits. Past workshop participant Jackie Evans, LRT, BBA, coordinator for outpatient pulmonary services and cardiopulmonary rehabilitation at Michigan-based Covenant HealthCare, shares how she has incorporated resources and information from the 2023 course into her day-to-day work.
News & Views (NV): What motivated you to take AACVPR’s CR Billing & Coding Workshop? What were you hoping to learn?
Jackie Evans (JE): Our Covenant Cardiopulmonary Rehab (CR/PR) team members were immediately interested in attending AACVPR's CR Billing & Coding Workshop to keep abreast of the current regulations.
It was a great review for our team lead and I, who are veterans in the CR environment. Our newer staff found the workshop to be a great introduction to the Center for Medicare & Medicaid Services (CMS) regulations, billing and coding world.
NV: Following the CR workshop, how have you employed the strengths, weaknesses, opportunities, and threats (SWOT) analysis in your practice’s procedures and programs to ensure proper billing, reimbursement and care?
JE: Our CR team employs a SWOT analysis annually as we prioritize and set new goals for CR/PR performance improvement. The "Plan-Do-Check-Act cycle” (PDCA) and the SWOT analysis are part of our program strategy to grow and continually improve processes to meet the needs of our patients.
NV: How did the workshop motivate you to improve the fiscal health of your program? What are some of the changes your program employed and what have been the initial results of those changes?
JE: The 2023 workshop provided the most accurate information on CR coding and billing. This information has allowed each staff member to understand how patient attendance relates to revenue capture and program sustainability. The shared knowledge keeps staff members engaged in the success of CR at our health system.
It allowed us to improve our patient intake process and to get support from our CR medical director to get individualized treatment plans (ITP) signed the same day as the patient assessment/evaluation. In turn, we were able to implement group patient intakes and increase our billable charges for each intake date.
Building on the 2023 webinar, we are beginning to take a deep dive into our insurance denials. We are billing both current procedural terminology (CPT) codes 93797 and 93798 on the same date. Hence, we are reviewing to ensure that Modifier 59 is being attached to claims where both CPT codes are used on the same day.
NV: Were the staff, patients and management receptive to the changes initially? How did you get their buy-in?
JE: Initially, the buy-in was slow with staff and management. Our initial problem was not getting feedback from staff after new processes were implemented. This created a communication gap. Communication is key. Since then, we implemented daily huddles in the morning to discuss patient care. Since the 2023 CR Billing & Coding Workshop, we have also included weekly huddles to review what is working and what is not. Our program has grown from less than 50 phase two patients per day during our peak months to 104 phase two patients per day.
NV: For programs looking to improve their own billing and coding, what advice would you give them?
JE: Get your team involved and have them attend a Billing & Coding Workshop. Our team did this for both CR and PR.
Sharing the workshop information empowers each staff member to be fully engaged and grow within their role.
Learn more about the upcoming Cardiovascular Rehabilitation Billing & Coding Workshop, taking place from 10 a.m. to 3 p.m. CT on April 9, 2024.