Coverage and Reimbursement Policy 101 for Transfusion Medicine and Cellular Therapies

Saturday, October 19, 2024

9:45 AM - 10:45 AM

Location: 372

CE: 1 CME (AMA Physician Credit) / 1 CE (Non-Physician Credit)

Program Chair(s)

Susan Leppke, MPH (she/her/hers)

Senior Director, Public Policy & Strategic Partnerships
AABB
Bethesda, Maryland, United States

Disclosure(s): No financial relationships to disclose

Speaker(s)

Justin Halls, MD, MPH (he/him/his)

Transfusion Faculty
Phoenix Children's Hospital, Arizona, United States

Disclosure(s): No financial relationships to disclose
RG

Richard Gammon, MD

Chief Medical Officer
Carter BloodCare
Bedford, Texas, United States

Disclosure(s): CSL Behring: Consultant/Advisory Board (Ongoing)

PDF

Disclosure(s):

Susan N. Leppke, MPH: No financial relationships to disclose

Justin Halls, MD, MPH: No financial relationships to disclose

Richard R. Gammon, MD: CSL Behring: Consultant/Advisory Board (Ongoing)

Session Desription: Transfusion physicians, technologists, managers, and support staff need to have at least a basic understanding of billing and coding procedures. Those who are responsible for maintaining appropriate billing and coding need to keep up with the constantly changing expectations for coding and billing. This session is designed to provide a comprehensive overview of current coding and reimbursement information in both the inpatient and outpatient hospital prospective payment systems, including critical updates, as well as share best practices and case studies from hospitals. Coding and reimbursement for CAR-T and newer therapies will also be covered. Medicare advocacy and resources will also be discussed to help hospitals ensure they receive appropriate payment.

Learning Objectives:

Describe Medicare coverage and reimbursement for transfusion medicine and cellular therapy.
Work through case studies that identify appropriate codes to use to ensure appropriate billing and reimbursement.
Describe resources that assist with transfusion medicine and cellular therapy billing and coding needs.
Discuss AABB’s approach for expanded coverage and enhanced reimbursement.