FACILITY APC CODING Medical Reimbursement Systems, Inc. specializes in coding, billing and auditing services in Emergency Medicine and has been providing these services for over 20 years. MRSI currently provides APC-compliant facility coding for a variety of practice types, including large academic teaching hospitals; these total in excess of 1,000,000 annual emergency visits. MRSI also currently provides compliance auditing for many of the nation’s largest Universities, national ED staffing companies, and other billing companies. MRSI’s leadership is involved in national emergency medicine coding and reimbursement initiatives and issues. Jon L. Jenkins M.D., MRSI’s President has been an emergency physician for over 20 years, and is the author of a widely published textbook in Emergency Medicine. Dr. Jenkins is an expert in ED operations, risk management, contract negotiations and department design, and is available to clients that are re-engineering their departmental operational processes. Dr. Jenkins also assists emergency physicians that would like to start their own group or convert from a hospital employed status to a fee for service model. MRSI’S CEO, Elijah Berg, M.D., F.A.C.E.P, is the Chairman of the American College of Emergency Physicians National Reimbursement Committee and is a member of ACEP’S ED Facility Level Work Group. Dr. Berg is a Past President of the Massachusetts College of Emergency Physicians, chairs MACEP's Reimbursement Committee and is an Emergency Medicine Medicare Carrier Advisory Committee Representative. Michael Granovsky, M.D., F.A.C.E.P., C.P.C., MRSI’s President of Coding, is a board certified Emergency Physician who is also a certified coder. Dr. Granovsky is a nationally recognized expert in Emergency Medicine coding and reimbursement and is a regularly featured speaker including: Scientific Assembly, Massachusetts ACEP Coding and Reimbursement Conference, Virginia ACEP Coding and Reimbursement Conference, and the ED Director’s Course. He is the course Director for national ACEP’s Coding and Reimbursement course. He serves as the editor of ED Coding Alert as well as leading the education efforts of ACEP’s National Coding and Nomenclature Advisory Committee. He is also the editor of the AAPC ED Specialty Coding Certification Exam. Dr. Granovsky directly oversees and trains MRSI’s coders while employing an AAPC approved rigorous in-service program that has been formally granted CEUs by the AAPC. Dr. Granovsky provides ongoing didactic instruction for MRSI physician clients. Using a regimented system of chart specific feedback, E-mails, and newsletters, he helps physicians compliantly optimize their documentation and reimbursement. Dr. Granovsky continually monitors the changing ED coding environment, directly interfacing with both governmental and private payers, to optimize MRSI coding for our clients while achieving maximal compliance. In our facility coding audits, we have uniformly found that facility-coders undervalue facility services and often fail to report procedures; there are currently more than 400 distinct procedures provided in the emergency department which are reflected on the facility UB-92. For 2006 and 2007, CMS introduced significant changes to the code sets for injections and infusions, and have extended the number of E/M APC codes; in our audit experience this year, these have been difficult for facility coders to effectively implement. The infusion and injection changes have effectively altered the way all medications are billed and represent a critical part of the facility revenue. For our coding clients, we review and maintain and up to date the facility chargemaster, determination of facility level, associated CPT codes, ICD-9 procedure and diagnosis codes, facility supply/pharmacy charges, remote data entry or automated upload of hospital charges, and encounter finalization prior to bill drop. We also provide electronic exception reporting of missing or incomplete records by electronically comparing received records against the ED registration log; this data is cumulatively tracked and reported until missing or incomplete records have been received. Transmittal of records to MRSI can be accomplished in a variety of ways; our preference is to receive a daily download of the ED registration log along with electronic transmittal of the prior day’s records (by direct file transfer of EMR data, dictations, or receipt of scanned images). MRSI is a national leader in implementing scanning in the ED setting; MRSI provides a turnkey scanning solution for departments using paper records. This allows secure transmittal of records, permanent availability of records for clinicians and the facility business office, and elimination of costs related to both copying and the physical transport of records. If electronic transmission is unavailable, coding can be provided via review of paper records. MRSI’s expertise is unsurpassed in the ED coding community; our reputation and internal coder education programs have allowed MRSI to be at the forefront of attracting the most talented, well-trained, and experienced coders. MRSI is the only coding company authorized by the American Academy of Professional Coders to grant continuing education credits for its in house educational programs. Based on these attributes, we are in the unique position of having the ability to choose from a large pool of highly experienced coders. For a recent review of APCs by Dr. Elijah Berg, MRSI's CEO, please visit the Massachusetts College of Emergency Physician's Website via the following link: |