Abstract
•Identify the importance and rules for capturing reimbursement from three sites of community-based palliative care eligible for reimbursement.•Delineate Evaluation and Management and Time-Based service codes, including the benefits and consequences of each, including the appropriate use of Advance Care Planning codes.•State billing and coding resources. Payment for services with precise billing and coding systems is essential for revenue for palliative care programs in the community. An organization’s billing and coding system sets the foundation for reimbursement from Medicare, Medicaid, and private insurance—and ultimately the budget. Accuracy and quality of billing documentation and submission is essential, as well as monitoring code changes. Through an interactive and engaging process, this session will provide a review of the potential patient encounters eligible for billing as well as accurately capturing the delivery of services. An interdisciplinary palliative care panel—a coding expert, a palliative physician, and a palliative nurse practitioner—will provide discuss billing and coding essentials from across the spectrum. Using a game format, the session will move through a face paced look at common quandaries, pitfalls, and myths about billing and coding. Participants will learn the importance of documentation supporting codes, the benefits and consequences of Evaluation and Management and Time-Based codes, and the appropriate use of Advance Care Planning codes. Resources from the Center for Medicare and Medicaid Services (CMS), Medicare Learning Network (MLN), Center to Advance Palliative Care (CAPC), Hospice and Palliative Nurses Association (HPNA), American Academy of Hospice and Palliative Medicine (AAHPM) and National Hospice and Palliative Care Organization (NHPCO) will be highlighted. The hour will conclude with an interactive Q & A session, and useful "take home" materials.
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