Learn the new documentation requirements, the subset of codes impacted, and the compliance outlook for E/M services in 2021 and beyond. This package includes 17 sessions presented by 18 experts at the Healthcare Administration Alliance Conference in September 2020.
After almost 30 years of the same E/M codes and coding guidelines, the most-commonly reported subset of E/M codes has undergone significant changes to bring E/M coding into the 21st century. This training bundle includes 17 educational sessions designed to guide healthcare providers, coding, reimbursement, management, and compliance professionals through the new changes.
NOTE: The information recorded during these presentations was current as of September 21, 2020.
Various Speakers (see "More" tab for complete listing of presenters)
Medical office coders, billers, compliance officers, administrators and clinicians will benefit from this training package focused on the new guidelines associated with Evaluation and Management coding, billing, and compliance in 2021 and beyond.
1. Evaluation and Management Coding Changes: A Payer's Perspective
Get a payer’s perspective of the E/M coding changes and guidelines. Review the private payer response to CMS and AMA decisions to implement changes to codes and their reimbursement for 2021. Learn what works - and what doesn’t according to a medical director for a major health insurance carrier.
2. A Deep Dive into Coding Medical Decision Making
Dive in to the 2021 rules for Medical Decision Making (MDM), comparing them to previous guidelines, and reviewing the impact of chart note documentation and auditing. Learn how the various pieces of the patient encounter need to come together collectively to accurately reflect the complexity of the visit.
3. Making Sense of Five Sets of Guidelines, Payer Adoption, and Provider Acceptance
Documentation requirements for healthcare providers will be positively impacted by the new guidelines for codes 99202-99215. Review the major changes including important information published by the AMA and CMS that will help you prepare for successful documentation and claims submissions in 2021.
4. Telehealth Structure and Standards: What Every Telehealth Provider Should Know
Gain a better understanding of Telehealth regulatory and compliance issues from a healthcare attorney’s perspective. The explosion of telemedicine visits and corresponding claims this year has also increased government scrutiny. Investigations have already been announced. Learn the do’s and don’ts to protect your practice.
5. Auditing According to the 2021 Guidelines - A Hands-On Experience
Roll up your sleeves for a hands-on experience auditing a real-world E/M encounter based on the 2021 guidelines. Get tips on how to train your team over the coming months. Learn how to use reference tools offered by the AMA to support your success in auditing according to the 2021 E/M guidelines.
6. Panel Discussion: Practical Application of E/M Principles for a Successful Practice
This panel discussion will help you overcome potential barriers to a successful transition. The presenters respond to participant questions and anchor key points to support your success in applying E/M principles beyond the conference.
7. Avoiding Unnecessary Paybacks
Improve your knowledge of overpayment regulations. This session will identify many situations that, while mistakes, do NOT require a refund. Examples: why billing under the name and number of the wrong professional, having a Medicare encounter with insufficient documentation, or an unsigned note will typically NOT require a refund.
8. Time-Based and Prolonged Service(s) Coding
Learn when to use office and outpatient visit codes without an add-on prolonged care code based on time. Get the facts on when and how to use the new CPT prolonged services code(s), and what will happen now that CMS has proposed different time thresholds than those published by CPT.
9. Making the Case for Moderate to High Risk E/M Services
Gain a better understanding of provider documentation and the “Medical Necessity” of the encounter. Get clear on when you can bill legitimately and confidently for higher-level services based on Moderate and High- Medical Decision Making. Learn insights and identify steps and techniques used to successfully defend clients during a payor audit.
10. Advanced Telehealth Coding
Learn the legal and technical sides of advanced telehealth services – reporting, auditing, and legislation. Review laws including temporary legislation resulting from the COVID-19 crisis and what will happen after things return to normal. This session includes a review of the diagnosis coding changes and help prepare you for accurate telehealth reporting in 2021.
11. Is Your Compliance Plan Working for or Against You?
Hear top health law experts in discuss the integration of compliance in the daily culture of your organization. From enforcing policies and procedures to streamlining practice operations, this session can help you reduce risks of statutory violations, avoid ethical breaches, and serve as evidence that your organization is complying with rules and regulations.
12. Panel Discussion: MDM - Complexity of Care, Severity, and Medical Necessity
Four healthcare experts tackle questions and share unique perspectives on important concepts related to Medical Decision Making (MDM). They will address: How do payers, providers, and attorneys evaluate a note for medically necessary services and complexity of care differently? Is it the same? How can non-clinician coders and auditors do the same?
13. Compliance Analytics: Post Pandemic Preparations
Learn how to embrace risk-based auditing and discover/address your risks before you get audited. This includes modeling for inpatient (DRG, PCS, HAC, POA, etc.), outpatient (APC, OPPS) and physician services (CPT codes and modifiers). Gain insights on audit analytics and requirements for Telehealth services, many of which are already under review by the OIG.
14. Gathering and Assessing Social Determinants of Health (SDOH) as Part of a Medically Appropriate History and Examination
Gain knowledge from a public health practitioner, researcher, and educator on the fundamental ways to collect, report and address SDoHs while mitigating cost through the collaboration with community-based resources. Learn how to reduce missed opportunities during patient engagement to appropriately assess the needs of patients to improve health and health outcomes.
15. Errors Will Be Made: Potential Issues with the 2021 Changes
Learn about current discrepancies between CMS and the revised CPT guidance for outpatient E/M services, coders, auditors, and physicians. Review areas of unresolved ambiguity that will no doubt frustrate coders, auditors, and physicians alike when attempting to select the appropriate level of outpatient E/M service.
16. E/M 2021 Implementation Preparation: Audits, Training, Ancillary Staff, & More
Prepare now for 2021. Find out how to check for implementation readiness in your healthcare organization by performing an audit of current Evaluation and Management encounters using the new 2021 guidelines. Discover exactly what changes will need to take place for your office to be compliant on January 1. Learn to identify which team members will require training and receive tips on techniques that will guarantee a smooth transition. Gain insight into how ancillary staff, online questionnaires, and revised EHR templates can assist in reducing provider documentation burden and improving efficiency.
17. AMA - Reimagining E/M Office Visits for 2021 and Beyond
Gain insight into the collaborative process behind the reimagined approach to office visits, an overview of the E/M office visit revisions, and the anticipated impact this first wave of revisions will have on other areas of E/M into the future.
Self-paced online content includes access to previously recorded video instruction and downloadable companion materials for 6 months.
Stephanie Allard, CPC, CEMA, RHIT is a Senior Compliance Specialist for DoctorsManagement
Allysceaeioun D Britt, PhD, MPH is a public health practitioner with 20 years’ experience and research in healthcare administration.
Frank Cohen, MPA, MBB is the Director of Analytics and Business Intelligence for DoctorsManagement, LLC.
Maxine I. Collins, MBA, CPA, CMC, CMOM, CMIS is a Consultant/Instructor with Practice Management Institute and Director of Compliance, Audits & Education, CoreMD Partners LLC.
Tracy Crane, CCS, CPC is the Assistant Curriculum Director and Medical Coding Instructor at Absolute Medical Coding Institute (AMCI).
Shannon DeConda, CPC, CPC-I, CEMC, CPMA, CEMA is the President/Founder, NAMAS and President, Coding & Billing Services, and a Partner at DoctorsManagement, LLC.
David Glaser, J.D. is a Healthcare Attorney, and the director of CPT Editorial and Regulatory Affairs in the American Medical Association’s Health Solutions unit.
Zach Hochstetler, MPP, MBA is the director of CPT Editorial and Regulatory Affairs in the American Medical Association’s Health Solutions unit.
Camille "Mrs. J" Jackson, CCS, CPC is an AAPC/AMCI Approved Instructor is one of the founders and curriculum director for Absolute Medical Coding Institute (AMCI).
Heidi Kocher, JD, MBA, CHC is a regulatory and transactional attorney and partner with Liles Parker with more than 20 years of experience in health care legal and compliance-related issues.
Robert Liles, JD, MBA, MS has an exceptional range of healthcare law. His experience, and down-to-earth character have earned high marks at past PMI conferences.
Michael Miscoe, JD, CPC, CASCC, CUC, CCPC, CPCO, CPMA, CEMA, AAPC Fellow is the President of Practice Masters, Inc., and is the founding partner of Miscoe Health Law, LLC.
Ashley Morgan, JD, CMCO, CPC, CMRS has handled claims disputes with major payors including Medicare, Medicaid, various BlueCross BlueShield entities, UnitedHealthcare, and Delta Dental.
Linda Parsi, MD, MBA, CPEDC, CMC, CMOM, FAAP runs a private pediatric practice, and heads an education and consulting company that helps practicing pediatricians with coding and practice management.
Fredrick "Rick" Watson, DO, MBA is Medical Director, Cigna Healthcare whose main responsibilities for CIGNA in the North Texas and Oklahoma region.
Paul Weidenfeld, JD, MBA is Attorney and Partners for Exclusion Screening, LLC. His practice is focused on False Claims Act cases, fraud investigations and Qui Tam lawsuits.
Sean Weiss is a Partner at DoctorsManagement and serves as Chief Compliance Officer for numerous nationally recognized health care organizations.
Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT is a healthcare auditor, coder, educator, and author with over 30 years of experience in the healthcare industry in both clinical and administrative positions.
“The panels are always the best. I get confirmation of what was taught in the classes and come away feeling more confident.”
“Everyone did an excellent job.”
“As always, very informational and helpful. Thanks so much!”
“Thank you for taking the time to present the information. It was very informative.”
“The whole conference was well done and very informative.”
“Great job providing information in a virtual format. So glad that the sessions are available to be reviewed on the website.”
“Wonderful content and presenters.”
“It was very important to get information from CMS and AMA. Thanks!”