Documentation, Compliance, and ICD-10 Coding (Fucinari, Mar. 30-31, 2019)
You have taken all the classes, but the rules have changed again! Late last year, CMS changed the chiropractic documentation rules and regulations for Medicare. See how these changes are being implemented in all carriers of insurance reimbursement. These significant changes will impact the chiropractic office and the way you practice! The latest requirements covering Ethics and Law, History Taking, Documentation and Proper and Ethical Billing and Coding expectations will be covered. Dr. Mario Fucinari, is uniquely qualified as one of the few instructors still in full-time practice! Dr. Fucinari is a member of the Carrier Advisory Committee for Medicare, a Certified Professional Compliance Officer (CPCO), Certified Medical Compliance Specialist (MCS-P), and a Certified Chiropractic Sports Physician (CCSP®). He is a Diplomate of the Academy of Integrative Pain Management (APMP).
Dr. Mario Fucinari has been presenting Continuing Education Classes for over twenty-five years and is a nationwide speaker on Medicare, Clinical Documentation, ICD-10 Coding, Compliance and HIPAA. In his back-to-the-basics approach, Mario whittles a difficult subject to an understandable and interesting comprehension of the requirements. This class is designed for everybody; doctors, staff and billers will gain useful information!
Relicensure areas covered include:
- Ethics and Law (2 hours)
- History Taking (4 hours)
- Proper and Ethical Billing and Coding expectations (6 hours)
Saturday, 8:00am - 6:00pm
Sunday, 8:00am - 12:00pm
Improve compliance and satisfy CE requirements
Dr. Mario Fucinari is uniquely qualified as one of the few instructors still in full-time practice! Dr. Fucinari is a member of the Carrier Advisory Committee for Medicare, a Certified Professional Compliance Officer (CPCO), Certified Medical Compliance Specialist (MCS-P), and a Certified Chiropractic Sports Physician (CCSP®). He will show you step-by-step procedures to implement the new policies and coding changes into your office
Dr. Mario Fucinari has been presenting Continuing Education Classes for over twenty years and is a nationwide speaker on Medicare, Clinical Documentation, ICD-10 Coding, Compliance and HIPAA. In his back-to-the-basics approach, Mario whittles a difficult subject to an understandable and interesting comprehension of the requirements.
Documentation, compliance and ICD-10
These are just a few of the changes that have recently occurred:
- ABN form utilization changes
- Payment system overhaul in Medicare began January 1, 2017
- Claim form diagnosis pointer has changed for 2017
- PQRS is dead, but has risen as another form
- Audits are always present, but Strategic Health Solutions and Altegra audits for Medicare are resulting in HUGE recoupments. One recent case resulted in a recoupment of Chiropractic funds of $685,000. Find out why.
- BCBS X-Subset audits are ongoing
- Medicare Treatment Plan requirements have changed
Will you know how to respond if you are called to do an audit?
Attendees of the full 12 hour seminar will qualify for a 5% discount in NCMIC policy rates upon renewal.
Course Outline (12 Hours)
Ethics and Law – 2 Hours
• Scope of Practice of Chiropractic in California §302
• Scope of Practice of Chiropractic in Medicare
• Board’s Investigative Authority §306.3
• Medicare Methods of Investigation
• Doctor of Chiropractic Title §310.2
• Advertisements §311
• The Anti-Kickback Statute: NEW Deductibles and Co-Payments Regulations
• Medicare Regulations for Gifts and Inducements
• Free or Discounted Services §319
• Responsibility for Conduct on Premises §316
• Professional Boundaries §317
• Requirements for Compliance in the Patient Protection and Affordable Care Act
• HIPAA Regulations for Protected Health Information Updated Regulations and Forms
• Required Risk Analysis for HIPAA
History Taking and Physical Examination Procedures – 4 Hours
• Cert Reviews and the OIG Report
• OIG Work Plan for FY 2019
• OIG Report on Tactics to Curb Chiropractic Utilization
• Medicare Signature Guidelines
• Informed Consent Guidelines
• Consultation Documentation
• Complicating Factors and the Relation to Care
• Subjective Note
• Objective Note and Evaluation and Management (E/M)
• Medicare P.A.R.T. Assessment of the Subluxation
• Importance of Outcome Assessment Tests (OATs)
• OATs and the Treatment Plan
• The Re-evaluation – When, Why, and What?
• NEW Radiology Guidelines
• Medical Necessity – How to Show It
• Documenting the Subluxation
• Medical Necessity and Maintenance Definitions in Medicare
• Medicare Advanced Payment Updates
• Physiotherapy Guidelines
• Rehabilitation Documentation
• Orthotic Use and the Low Back
• Writing the Treatment Goals and Objectives
• The NEW Medicare Treatment Plan Guidelines
Proper and Ethical Billing and Coding – 6 Hours
• Increased Specificity in ICD-10 Coding
• ICD-10 Coding Rules for 2019
• Manipulation Coding Guidelines
• Medicare Diagnosis Coding
• Medicare Deductible and Fee Schedule for 2019
• The CMS - 1500 Claim Form Analyzed
• ICD-10 Chapter Coding Guidelines
• Characteristics of ICD-10-CM
• ICD-10 Code Structure
• The Hierarchy and Sequencing of Diagnosis Codes
• Combination Codes
• How to Properly Use A, D or S Codes
• The Diagnosis (primary, secondary and complicating factors)
• Clinical Examples of ICD-10 Coding in the Office
• Chapter 13: Rules for Diseases of the Musculoskeletal System and Connective Tissue Specific Coding Guidelines
• Specificity in Coding
• Chapter 15: Pregnancy, Childbirth, and the Puerperium Specific Coding Guidelines
• Chapter 19: Rules for Injury, Poisoning, and Certain Other Consequences of External Causes Specific Coding Guidelines
• NEW Requirements for Injury Coding
• Extremity Coding
• Coding of Spinal Conditions for 2019
• Chapter 20: External Causes of Morbidity Specific Coding Guidelines
• Examples of Coding Clinical Cases
• Questions and Answers
Park by Student Entrance on Clawiter Road side of building, then look for signage directing you to the check-in area.
See Campus Map for details.
MARIO FUCINARI, DC
Dr. Mario Fucinari has helped train doctors and staff over the last 20 years. He received his bachelor's degree from Wayne State University in Detroit and his Doctor of Chiropractic degree from Palmer College of Chiropractic in 1986. Dr. Fucinari was the recipient of the 1998 and the 2003 President's Award from the Illinois Chiropractic Society (ICS) for his work with education and training and most recently received the 2012 Chiropractor of the Year award from the ICS. Dr. Fucinari has produced classes and publications on HIPAA, Clinical Documentation, Medicare, and Stroke and Cervical Manipulation. He is a worldwide speaker for NCMIC and several state associations and a Certified Chiropractic Sports Physician [CCSP].
Biography of Dr. Mario Fucinari
Mario was born on September 7, 1956 in Hamtramck, Michigan. He often says that their family was very poor, but they just didn't know any better. In 1966, the family moved on up to the East side - Warren, Michigan. Even in Elementary school, Mario began assuming some leadership roles. He was captain of the safety boys in 5th grade.
Mario's mother died at the age of 35. Later, the family found out she died from peritonitis, due to an eight-inch hemostat left in her abdomen after surgery. At age 13, Mario, the oldest of 6 children, had to learn to do laundry, cook and mend clothes. He was active in sports at school including shotput and wrestling. He had to help his siblings with homework, since his father, an immigrant from Italy, never finished school. In high school, Mario had all his pre-requisites done to graduate five months ahead of schedule. He began working as a co-op student in the x-ray department as a senior in high school. Right out of high school, Mario entered in the South Macomb school of x-ray technology. In his second year of school, they asked him if he would like to work on the midnight shift taking x-rays at South Macomb Hospital by himself; an unheard of proposal at the time. Of course he did so. Little did he know that this is where he would meet an ER nurse, who would become his future wife and "best friend", Ginny. They were wed June 12, 1982.
Working and studying has been a common theme with Mario. He has always worked and gone to school. Sciatica led Mario to a former high school teacher who had become a chiropractor. On his first adjustment, Mario said that he knew he wanted to become a chiropractor. Already earning his bachelor's degree in biology from Wayne State University in Detroit, Michigan, Mario graduated in March and went to Palmer in July 1983.
At Palmer College, Mario served as class historian, class Vice-President and eventually as Class President. At the same time, he was offered a job as a x-ray instructor and an x-ray tech at nights at the Palmer Clinic. Class President, Palmer Instructor, X-ray tech and full-time student, all at once. Is it any wonder he only sleeps five hours per night? His first child was born in Davenport. The joke was you either got married, divorced or pregnant while at Palmer so the Fucinaris were no different. Mario studied for part one of National boards in between Ginny's contractions while in labor with their first daughter, Nicole.
After graduating from Palmer College, Dr. Fucinari completed studies in chiropractic orthopedics and attained his certification as a chiropractic sports physician and certified Insurance Consultant and a member of the American Academy of Professional Coders.
Mario has always been successful in his practice. Sixty-four new patients in his first month of practice; he never looked back. At a Croft seminar in Florida, he told Dr. Doug Matzner he wanted to get involved with giving back to his profession. Soon he was on the board of the ICS. Mario has served every position from District Vice-President and President all the way up to the ICS President. He has been teaching Medicare, coding and documentation and low tech rehab for the ICS for years. He never served as Treasurer, but then, money was never his main focus.
Mario has also served his community as well. He has served on the Chamber of Commerce Business committee as its head, Medical Director for the Relay for Life, Easter Seals, Futures Golf Tournament Board and every year on the WSOY Food Drive. At church Mario served on the Praise Team for three years, where he got to live out his fantasy as a band member. He served on the church board and was director of the church day care board for two years.
Inspired by Dr. Dave Taylor to teach Medicare, Mario began teaching in the southern part of the state. As Dave Taylor told him, south of I-80. Is that really the southern part of the state? He soon found another love in teaching Medicare and insurance!
Mario was the first chiropractor to attain the Certified Medical Compliance degree. Two years later he earned his degree as a Certified Instructor for the Certified Medical Compliance Program. He is now the Chairman of the Chiropractic division of the national medical compliance program. Mario teaches for the ICS, NCMIC, Foot Levelers and many state associations. His teaching "gigs" as he calls it, has taken him to Amsterdam, Belgium and 42 out of the 50 states as well as in Puerto Rico. He has a map of the U.S. in his office and pins everywhere he has taught. His goal is to teach in all 50 states.
Mario answers emails every day from doctors all over the country. He has a website, AskMario.com, and has become the "Dear Abby" of the chiropractic insurance world.
Mario maintains a busy chiropractic office, seeing 60+ patients per day himself in his referral-based practice with no advertising and no gimmicks.
Together, Mario and Ginny mentor doctor's offices with over 200 clients. Most of Mario's work with the profession is for free, though. Many of his former students and doctors from all over the United States call Mario when they are in trouble with Blue Cross and Medicare. Mario calls it a game and loves to tell them how to get out of trouble and do what is right in their practice to stay out of trouble.
What does Mario do for fun? All of it is fun to him! He loves to travel, read fiction and leadership books and has recently increased his interest in photography. Meanwhile he spends time with, as he calls it, his best friend, Ginny, and their two daughters, Katie and Nicole.
Dr. Mario Fucinari currently practices full time in Decatur, Illinois.
See below for a list of credits available for this seminar.
Life Chiropractic College West is accredited by the CCE and the Western Association of Schools and Colleges (WASC).
NOTE to DCs licensed in: CO, CT, DE, DC, ID, IL, IN, IA, MD, MA, MI, MS, MT, NE, OH, OR, RI, SC, UT, VT, VA, WA, WY, BC, NB, ON, QC. These states generally accept programs sponsored by a college that is accredited by the Council on Chiropractic Education (CCE). These states and provincial boards do not require an application from CCE colleges. While it is higly likely that credits will be accepted, Life Chiropractic College West cannot guarantee that any session of this offering will be accepted by these licensing board(s). Life West urges licensees to familiarize themselves with the laws governing continuing education in the jurisdictions where they hold licensure.
Available Credit Hours
- 2.00 CA Chiropractic Board, Category A EthicsCalifornia Board of Chiropractic Examiners, Category A Ethics
- 10.00 CA Chiropractic Board, Category A Exam/Adjust/BillingCalifornia Board of Chiropractic Examiners, Category A Exam/Adjust/Billing
- 12.00 CO Chiropractic BoardColorado Board of Chiropractic Examiners
- 12.00 CT Chiropractic BoardConnecticut Board of Chiropractic Examiner
- 12.00 DE Chiropractic BoardDelaware Board of Chiropractic
- 12.00 DC Chiropractic BoardDistrict of Columbia Board of Chiropractic
- 12.00 ID Chiropractic BoardIdaho Board of Chiropractic Physicians
- 12.00 IL Chiropractic BoardIllinois Medical Licensing Board
- 12.00 IN Chiropractic BoardIndiana Board of Chiropractic Examiners
- 12.00 IA Chiropractic BoardIowa Board of Chiropractic
- 12.00 MD Chiropractic BoardMaryland Board of Chiropractic Examiners
- 12.00 MA Chiropractic BoardMassachusetts Board of Registration of Chiropractors
- 12.00 MI Chiropractic BoardMichigan Board of Chiropractic
- 12.00 MS Chiropractic BoardMississippi Board of Chiropractic Examiners
- 12.00 MT Chiropractic BoardMontana Board of Chiropractors
- 12.00 NE Chiropractic BoardNebraska Board of Chiropractic
- 12.00 NJ Chiropractic BoardNew Jersey Board of Chiropractic Examiners
- 12.00 OH Chiropractic BoardOhio Chiropractic Board
- 12.00 OR Chiropractic BoardOregon Board of Chiropractic Examiners
- 12.00 RI Chiropractic BoardRhode Island Board of Examiners in Chiropractic
- 12.00 SC Chiropractic BoardSouth Carolina Board of Chiropractic Examiners
- 12.00 UT Chiropractic BoardUtah Chiropractic Physicians Licensing Board
- 12.00 VT Chiropractic BoardVermont Board of Chiropractic
- 12.00 VA Board of MedicineVirginia Board of Medicine
- 12.00 WA Chiropractic CommWashington Chiropractic Quality Assurance Commission
- 12.00 WY Chiropractic BoardWyoming Board of Chiropractic Examiners
Changes and Refunds
Every attempt is made to offer Life West CE programs as announced. However, Life West reserves the right to adjust program faculty, locations, dates, times and tuition to accommodate unanticipated occurrences and to cancel programs owing to insufficient enrollment, illness, or other factors. Life West will notify advance registrants of any cancellation or significant program changes. Life West is not responsible for any expenses incurred by registrants due to adjustments or cancellations.
Refunds for program registration are granted if requested in writing no later than one business day before program begins. If registrants cancel within one week of program start date, a $50 processing fee will be deducted from refunds.
Less than one business day before the program begins, registration is nonrefundable but a credit voucher may be issued. Vouchers must be requested within sixty days of the program. The credit voucher may be applied towards another Life West Postgraduate & Continuing Education program and must be redeemed within one year of the original scheduled program date or it will be forfeited. A $25 processing fee will be deducted from vouchers.