Money Matters: Optimizing Acute Care Billing in the Clinical Setting

Sunday, April 27, 2025

2:00pm – 3:30pm HST

Location: Convention Center: 323

CE: 1.5

Leader(s)

Suzanne Ramazani, DO (she/her/hers)

Assistant Professor of Pediatrics, Division of Pediatric Hospital Medicine
University of Rochester Medical Center
Rochester, New York, United States

Co-Leader(s)

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Tina Sosa, MD, MSc (she/her/hers)

Assistant Professor of Pediatrics, Chief Quality Officer
Golisano Children's Hospital, University of Rochester Medical Center
Rochester, New York, United States
Steven Bondi, JD, MD

Associate Professor
Golisano Children's Hospital at The University of Rochester Medical Center
Rochester, New York, United States
Mirna Giordano, mg2267@cumc.columbia.edu (she/her/hers)

Associate Professor of Pediatrics
Columbia University
New York, New York, United States
Hadley Brighton, MD, MA (she/her/hers)

Assistant Professor of Clinical Pediatrics
Weill Cornell Medicine
New York, New York, United States
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Vipul parikh, MD

Senior Faculty
Baylor College of Medicine/ Texas Children's Hospital, United States
Lauren Hess, MD FAAP ABPM-CI (she/her/hers)

Associate Professor of Pediatrics/ Associate Chief Medical Information Officer
Baylor College of Medicine/Texas Childrens Hospital, United States
Andrea Hadley, MD

Assistant Professor
Helen DeVos Children's Hospital
Grand Rapids, Michigan, United States
Adam Vukovic, MD, MEd (he/him/his)

Associate Professor
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, United States

Disclosure(s):

Suzanne Ramazani, DO: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Tina Sosa, MD, MSc: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Steven Bondi, JD, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Mirna Giordano, mg2267@cumc.columbia.edu: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Hadley M. Brighton, MD, MA: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Vipul J. parikh, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Lauren M. Hess, MD FAAP ABPM-CI: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Andrea Hadley, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Adam A. Vukovic, MD, MEd: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Workshop Description: Appropriate billing and coding are essential to healthcare quality and safety, as missed opportunities can lead to substantial financial repercussions. Children’s hospitals across the country are experiencing increasing financial strain, which can impact institutional operating margins, program development, and business sustainability, leading to more hospitals being acquired, merging, or closing.

Acute care billing codes for intensive and critical care services are distinct from standard billing practices and can be applied by any clinician regardless of location, yet this work is often not accurately reflected in physician billing or relative value units. As pediatric acuity continues to rise and patients are increasingly cared for outside of the intensive care unit (ICU), clinicians must consider the application of acute care billing both within and outside of the ICU to accurately capture the services provided and corresponding reimbursement.

In this session, pediatric billing experts from a variety of disciplines and institutions will teach attendees how to optimize and support acute care billing with an emphasis on clinical vignettes. Presenters with experience in informatics, quality improvement, and utilization management will share clinical scenarios from multiple settings, including the emergency department, newborn nursery, general inpatient ward, and critical care unit. Attendees will leave the session with a clinical decision support toolkit containing specific documentation tips, templates, and implementation tools to improve acute care billing at their home institution. Presenters will actively engage the audience with interactive polling, small group breakout sessions, and audience Q&A.

Learning Objectives:

Describe the impact of improved billing practices on institutional operating margins, program development, and business sustainability.
Identify and optimize acute care billing codes to accurately reflect the services provided with supporting documentation in clinical scenarios both within and outside of the intensive care unit.
Practice incorporating acute care billing codes in a variety of clinical settings utilizing a clinical decision support toolkit with documentation templates provided to participants.