Tuesday, April 16

7:00 am - 9:00 am


202 Neurocritical Care Documentation, Coding, Billing, & Practice: Pearls and Pitfalls to Maximize Revenues and Outcomes

AANS Member Fee: $150
Non-member Fee: $150
Member Fee: $65

Moderator(s): Gregory Kapinos, MD, MS, FASN

Panelist(s): Randall M. Chesnut, MD; Navaz Karanjia, MD; Joseph Christopher Zacko, MD, FAANS

Proper documentation, coding and billing is parsimoniously covered during neurosurgical training. This seminar gives empirical pearls on how to use a thorough note for documentation optimization, better communication between clinicians, and reconciliation of the needs of coders, billers and legal analysts. We cover 99291-2 elements, 99321-3 elements, all appropriate code modifiers for neurosurgeons, discharge codes, procedural codes in the NSICU, interpretation of paraclinical data in the NSICU and how to unbundle it from critical care billing. This seminar will cover how to use appropriate unbundling of critical care codes from neurosurgical operative codes and teach pearls on documentation and judicious use of modifiers. We also give examples of inappropriate notes and corrective actions. We will show the impact of thorough notes in reducing clinical documentation queries, enhancing DRG and revenues. We give institutional concrete examples of maximized revenues and allocating manpower to different roles during the 24h of the day to help provide neurocritical care services with a business model that remains profitable, making full use of neurosurgeons as neurointensivists.

Talks include:
1) Enhancing communication, coding and billing in your progress notes in a closed neurosurgical ICU.
2) Appropriate modifiers and unbundling for neurosurgeons.
3 ) Progress notes enhancements and model of practices for neurocritical care: judicious use of a separate proceduralist , consultant, and nocturnist in your neurosurgical critical care team.
4 ) Maximizing revenues through optimal shift-work allocation, telemedicine, consultation and comprehensively coding progress notes for higher DRG.

Learning Objectives: After completing this educational activity, participants should be able to:
  • Enhance documentation in neurocritical care progress and consultation notes for clarity in inter-disciplinary communication, compliance for coding and billing purposes, reconciled with legal and patients-relationship perspectives.
  • Discuss clinical pearls for documentation and coding amelioration: the typical comprehensive neurocritical care progress notes for daily rounds by neurosurgeons.
  • Explain the financial impact of accurate thorough coding and accurate listing of neurosurgeons as neurointensivists in their scope of practice for state regulated CMS data.
  • Explain the principles and structure for a business model and approach to staffing the NSICU with neurosurgeons as neurointensivists.