E/M Coding and Documentation Guidelines: Putting It All Together
Evaluation
and management (E/M) services are vulnerable to fraud and abuse, scrutiny from the OIG, government-contracted, and third-party
auditors. Providers must accurately determine the appropriate
complexity level of an E/M service, corresponding to the amount of skill,
effort, time, responsibility, and medical knowledge required for the healthcare
provider to deliver the service to the patient. AMA &
CMS guidelines for E/M code selection, and various policies,
coverage determinations and requirements must be considered for each major
payor.
Learn all the E/M coding rules and documentation
guidelines, including the major changes
for 2021. Master the process of accurately determining
the appropriate E/M code level for services provided, and improve your
understanding of the criteria utilized in making the determination. Learn the new vs. established
patient guidelines distinctions, and coding E/M services based on time vs Medical Decision
Making (MDM).
Highlights:
- Review essential coding guidelines for E/M services to ensure proper
claims submission
- Understand the role of history and exam per guideline
- Medical Necessity and Nature of the Presenting Problem
- Total time for 99202 - 99215; what is included and excluded?
- Revised reporting rules for prolonged services in 2021
- Receive coding tips and strategies for successful documentation and
claims submissions
PMI CEUs: PMI Certified Professionals will earn 3 PMI Continuing Education Units (CEUs) for attendance at this program. If you are seeking CEU credits for other certifications, contact your organization for preapproval and credit guidelines. A certificate of attendance will be provided for attendance at this program.
Billing for Telehealth and Virtual Services
Learn how to bill appropriately for telehealth and virtual services and avoid penalties associated with fraudulent billing of these services. Understand relevant HIPAA Privacy and Security guidelines and comprehend the importance of reviewing payer-specific service requirements to ensure proper claim submission.
The policy and payment landscape around telehealth continues to be complex. Medicare did not extend the flexibilities available during recent years with an exception for the prescribing of controlled medications. Understand which practitioners can no longer furnish Medicare Telehealth services, what services will continue to be covered by CMS, and the in-person visit requirement exception for FQHCs and RHCs.
Understand which non-face-to-face services are not subject to the rules that apply to Medicare telehealth services and why. Gain clarity on recent updates to supervision requirements. New rules allowing virtual direct supervision and permitting teaching physicians to be virtually present will be explained.
PMI CEUs: PMI Certified Professionals will earn 3 PMI Continuing Education Units (CEUs) for attendance at this program. If you are seeking CEU credits for other certifications, contact your organization for preapproval and credit guidelines. A certificate of attendance will be provided for attendance at this program.