Get the facts on the proposed changes to E/M that could go into effect January 1, 2019. Learn about the CMS plans for a major overhaul to E/M coding and reporting and its possible impact to various specialties billing for office visits and other outpatient services.
CMS has proposed the most consequential changes to Evaluation and Management (E/M) coding since the 1995 and 1997 guidelines were established decades ago. This course will relay the E/M details from the 2019 Medicare Physician Fee Schedule proposed rule. Learn about the proposed major overhaul to E/M coding and reporting and highlight the potential impact to various specialties billing for office visits and other outpatient services in 2019 should the proposals be adopted in the final rule.
The goal is the reduction in the complexity of E/M documentation to a level appropriate for clinical purposes. CMS attempts to address E/M subjectivity by allowing providers more flexibility when choosing the most appropriate basis for distinguishing among the levels of E/M visits. They aim to simplify code processes and relax documentation requirements.
Critics claim these changes may have a disproportionately negative impact on specialties that treat patients with chronic illnesses. Standard payment rates based only on whether a patient is new or established could wind up reducing reimbursement for some physicians and specialties that see sicker patients, though the introduction of new, add-on codes could improve payments for some providers. Selecting an E/M level based on Medical Decision Making alone also conflicts with CPT® rules. Could that change create unintended consequences and increase audit risk for providers?
Get the facts on the proposed changes to E/M. Prepare now for an implementation date that might be just around the corner, on January 1, 2019.
· Single base payment rate for new vs established services
· Add-on codes for required additional resources
· MDM or Time as a basis to determine the appropriate level of visit
· Two new time thresholds for new and established patients
· Documenting expanded history is important
· Providers need to verify the data added to the record by ancillary staff
· Ancillary staff will be allowed document more than ROS
MBA, CPA, CMC, CMIS, CMOM
Maxine has more than thirty years of experience in medical practice management, adult education and general business. She has taught courses at various levels, including teaching business communications and accounting at Midwestern State University in Texas. Maxine has extensive experience teaching administrative and clinical personnel essential medical office skills such as medical terminology, coding, reimbursement, OSHA, and HIPAA compliance. She is adept at personnel management, government rules and regulations, accounting and budgeting. Additionally, her experience with practice marketing and development make her a knowledgeable and much sought-after practice management resource.
Maxine has served as an administrator of a multi-specialty clinic, where she was responsible for all clinic operations including medical records, billing and collections, OSHA, HIPAA and Medicare compliance, and all accounting operations. She also has experience in medical practice consulting, and has successfully launched multiple practices.
Maxine holds a MBA in business from Midwestern State University. She is also a Certified Public Accountant and holds three PMI credentials.
This is an intermediate-level course. Content assumes knowledge of outpatient coding and reimbursement. Participants will receive digital presentation materials plus a bonus final rule summary once the E/M proposals are finalized. No additional outside resources are needed.