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 Services
CMS broadened access to Medicare telehealth services so that beneficiaries can receive a wider range of services from their doctors without having to travel to a healthcare facility. The 1135 waiver expanded Medicare coverage for office, hospital, and other visits furnished via telecommunications and information technology across the country and including in the patient's place of residence.
Highlights:
- Learn new codes and modifier usage to bill properly and receive maximum reimbursement for telehealth services.
- Review coverage types
- Explore telecommunications methods
- HIPAA Privacy and Security guidance
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.