Program Objectives

To address complex coding issues that often challenge a coders understanding

To offer participants an understanding of the what and why of complex procedures

Participants will gain a solid foundation of the coding guidelines within each area and will learn how to completely and accurately code cases

Participants will gain an understanding of how code assignment impacts the MS-DRG, as well as how to avoid system edits and denials

Program Objectives:

• To afford participants an overview of the most current issue of Coding Clinic


• To offer a platform to ensure that coders are aware of the most up to date advice


• an opportunity for discussion and questions related to the quarterly update

“Critical care is an all-encompassing specialty with almost limitless boundaries. Critical care involves the use of life-sustaining, high-technology medicine catering to a patient population that extends to both extremes of age. In adult ICUs, the average age is increasing and is now commonly well over 60 years. Although ICUs admitting patients for preplanned brief stays after planned major surgery have very low mortality rates, the rates in adults ICUs among patients admitted “for cause” are generally around 15 percent in developed countries. In recent study of Medicare beneficiaries in the United States, 29.2 percent of patients had been treated in an ICU during the last month of their lives. Currently, most deaths in ICUs are expected, and ICU clinicians regularly face the decision of when to change the focus of treatment from attempting to cure to providing palliative care.” (New England Journal of Medicine, 2013)

This full-day conference will provide education on “hot button” critical care issues and creative strategies to tackle new and emerging critical care challenges.

This program will build upon the June webinar which the Department of Health and the Division of Consumer Affairs discussed the regulations governing the Health Care Professional Responsibility and Reporting Enhancement Act (HCPRREA). The HCPRREA requires all licensed New Jersey health care entities to report licensed or certified health care professionals whose conduct is impaired and/or who exhibit incompetence or professional misconduct to notify the New Jersey Division of Consumer Affairs, Health Care Professional Information Clearing House Coordinator.

The Department of Health regulations under HCPRREA address information that is required to be provided by health care entities to other health care entities in New Jersey as part of the employment process.

Participants will learn about provider and DOH and DCA experiences and lessons learned, as well as the practical, everyday implications of achieving compliance.

Obstetric hemorrhage is a leading cause of maternal morbidity and mortality. In the United States the overall rate of postpartum hemorrhage increased 26 percent between 1994 and 2006. The increase was driven primarily by a 50 percent increase in cased of uterine atony.

Rapid recognition and treatment are necessary to prevent progression of hemorrhage as women can lose large volumes of blood very quickly due to the physiology changes of pregnancy. However, obstetric hemorrhage is also a low-volume, high-risk event for any given birth facility; without advance planning the probability of mounting a rapid, coordinated response is low. Severe hypertension is also a leading cause of maternal morbidity and mortality in the United States a well as New Jersey. Maternal mortality reviews have consistently revealed problems with recognition, communication and effective application of interventions as contributory factors in deaths from maternal hemorrhage and severe hypertension.

Birth facilities and health systems that have implemented systematic protocols for recognizing and responding to hemorrhage and hypertension have demonstrated improved outcomes such as decreased use of both blood products and higher-level interventions such as uterine artery embolization and hysterectomy.

This program will familiarize the participants on the AIM toolkit, which was designed to assist birth facilities in demonstrating adoption of the National Partnership for Maternal Safety Hemorrhage Bundle by developing systems that promote readiness, recognition and response to obstetric hemorrhage and hypertension.

Session I: You Can Have it All! ICD-10 Coder Productivity & Quality
Discover solutions to improve coder performance. Learn how to identify issues decreasing coding productivity and quality in your department and how to increase the productivity while improving the quality of your coders using ICD-10

Session II: Modifiers Made Simple
Gain an understanding of the NCCI edits, procedure-to-procedure edits, and medically unlikely edits and learn how to append modifiers appropriately to ensure proper reimbursement. Modifiers Made Simple includes E&M modifiers, Modifier 59 and the X-Modifier subcategory, Modifier 50, 33, and more

Session III: Query Do’s & Don’ts
Gain an understanding of the importance of the query process while learning the do’s and don’ts of query writing. You will be walked through the process with real query examples for debridement, MI’s, urosepsis, CHF, BMI, and more.

Improving patient safety and quality of care requires a redesign of relationships in healthcare and a greater emphasis on patient and family engagement (PFE) – often overlooked in quality improvement efforts. Studies suggest that patients and families who feel part of the care team tend to be happier with their care and ultimately have better medical results; are more likely to comply with their treatment and prevention plans; are less likely to engage in unhealthy behaviors; and they have fewer ED visits and hospitalizations (Green and Hibbard, 2011). Additionally, when patients and families are involved, hospitals and healthcare systems have an opportunity to improve quality and reduce medical errors, healthcare-associated infections and readmissions (AHRQ, 2009)

There are countless ways that patients and families can become engaged. They can serve as advisors to enhance quality and safety, redesign systems of care and educate healthcare professionals and other staff about safety. Some are formal and ongoing, others are time-limited and informal. All are necessary to ensure that care is safe and truly responsive to patient and family needs, priorities, goals and values. (IPFCC, 2004; AHA, 2013).

This full day conference will continue to build on the work of the NJHA Patient and Family Engagement Collaborative webinars and other educational events in encouraging all hospitals in New Jersey engage in patient and family-centered care.

In-house attorneys, human resources professionals, and compliance officers are regularly called upon to investigate employee workplace complaints, allegations of corporate improprieties. When is the duty to investigate triggered? Who should conduct the investigation? What makes an investigation effective? How will the investigation and its conclusion potentially be used during litigation? Join attorneys from Saul Ewing’s Labor and Employment Practice Group for a full-day executive session addressing these and other difficult questions regarding internal investigations. Dena Calo, Ruth Rauls, and Gillian Cooper will provide in-depth strategies for conducting investigations into employee complaints, while remaining mindful of employee privacy, confidentiality, and retaliation concerns.

The New Jersey Hospital Association’s (NJHA) Institute for Quality and Patient Safety is committed to working with its members to improve hospital Antimicrobial stewardship programs (ASP) and associated patient outcomes.

The mission of the NJHA Antimicrobial Stewardship Learning Action Collaborative is to promote the use of the appropriate agent, dose, duration, and route of administration of antimicrobial agents both in the acute care setting and in the post-acute care setting in order to improve quality of patient care and patent safety while reducing excessive costs attributable to inappropriate antimicrobial use.

Now in it's 12th year, this popular program, developed by NJHA Healthcare Business Solutions, is updated and offered quarterly throughout the year.  Each unique program will provide a comprehensive overview of new and revised Medicare rules and regulations.  Our expert staff will research, analyze and decipher the coding and billing rules and present them in a straightforward and organized manner cutting to the chase and presenting in simple terms what you really need to know.

Each quarterly program will address new, timely and evolving issues with its own list of agenda topics that are hot-off-the-press.