This course covers the new, revised, and deleted CPT® code changes, effective January 1, 2021. Learn how these changes impact your specialty to reduce denials and keep provider reimbursement on track all year long.
The AMA's Current Procedural Terminology (CPT®) code set for 2021 includes 329 changes with 206 additions, 54 deletions, and 69 revisions. Reduce denials when you understand what changes impact your specialty. This course will help you keep the practice reimbursement on track in the New Year.
CMC, CMIS, CMOM, CMCO
Jan Hailey has more than 20 years of experience in healthcare with proficiency in administration, coding, and billing roles. She joined Saint Joseph Physician Network located in Mishawaka, IN as the Director of Quality in November 2015. In 2019, her role transitioned into Director of Care Management with Select Health Network, an entity of Saint Joseph Health System. This transition allowed for her expertise to expand beyond the physician network to lead a comprehensive interdisciplinary team across the health system and work closely with providers, management, staff, community and payers to develop strategies on process improvement, gap closures and patient experience.
Jan also developed a documentation improvement program and is currently implementing an education program for Hierarchical Condition Category (HCC) coding in order to improve risk scores. She holds four professional certifications in office management, coding, and compliance. She is a member of WPS Medicare’s Provider Outreach and Advisory Group, Indiana Association for Healthcare Quality.
Jan has a passion for teaching and facilitates educational programs nationwide. Prior to joining Saint Joseph, Jan was the Director of Quality, Coding and Compliance for one of the largest health systems in Northern Indiana.
This is an intermediate-level course designed for medical office coders, billers, auditors, clinicians, and practice managers. Course materials will be provided for use beyond the classroom.
A CPT code set manual is not required to attend this course, but will be helpful to understand the context of the recent code changes.
The most impactful changes in over 25 years are to the E/M section; specifically for the office/outpatient visits (current code range 99201-99215). The new guidelines require that a medically appropriate history and physical examination be performed and documented for this code range only. However, these two components will no longer be used in determining code level selection. The AMA, CMS, and other organizational workgroups involved developed the new guidelines to reduce burdens on physicians and other providers, and to capture information in a way that better represents the clinical environment.
Other E/M codes that are currently based on the 3 key components, the guidelines will remain intact and utilized for arriving at the level of the visit under the 1995 or 1997 Documentation Guidelines. Therefore, individuals working within the industry must understand more than one set of guidelines for the E/M section on January 1, 2021.
Self-paced online program includes unlimited review of previously recorded instruction and the downloadable PowerPoint handout for 6 months.