Perfect Your E&M Coding for Physicians & Hospitals

Event Information
Product Format
Prerecorded Event
90 minutes
Product Description

Take Your E&M Coding Skills to the Next Level


Evaluation and management (E&M) coding has had a long and sorted history, from its roots in 1992, and CMS’ implementation of Ambulatory Payment Classifications (APCs) in 2000. Then, in 2014, CMS threw you a curveball when it instituted a single Healthcare Common Procedure Coding System (HCPCS) code – G0463 – for the 10 clinic level visits. You have all this confusion to deal with and then some when you’re tackling E&M coding for physicians and hospitals.

Learn how to improve your E&M coding in this information-packed audio conference by healthcare compliance guru Duane C. Abbey, PhD. Explore E&M coding rules for both physicians and hospitals, including documentation issues and challenges associated with auditing E&M coding. Dig deep into compliance issues and concerns for E&M coding, including the common misuse of modifier 25, along with other E&M modifiers for the global surgical package.

After attending this audio conference, you will walk away with expert audit techniques to ensure proper compliance with E&M coding rules and the tools you need to establish your own E&M coding audit program. You’ll have a solid understanding of the different guidelines for physicians and hospitals, as well as the use of G0463 and Bipartisan Budget Act (BBA) Section 603 clinics. You’ll get insights into physician coding for incident-to billing, how to make changes to accommodate now non-existent consultation codes, the challenges of using electronic health record systems for developing proper documentation to support E&M coding, and so much more.

Session Objectives

This program will teach you how to:

  • Understand how physicians and hospitals use E&M codes – and the difficulties with E&M coding for emergency departments.
  • Review your E&M coding and judge the associated documentation so you don’t face needless claims denials.
  • Master CMS facility E&M coding principles and the G0463 code.
  • Adjust to CMS dropping the consultation codes and other compliance challenges surrounding E&M coding.
  • Understand the differences between specialty clinic and primary care clinic coding for E&M services, as well as the interplay between facility component and physician E&M coding.
  • Organize an E&M coding audit for either physicians or hospitals.
  • Stop making common mistakes when appending modifier 25 (CMS is cracking down on this).
  • Understand the difference between a “new” patient versus an “established” patient.

Session Agenda

  • Overview
    • E&M coding under RBRVS
    • E&M coding under APCs
    • E&M codes – general categories
    • Physician use of E&M codes
    • Electronic Health Record systems
  • E&M coding guidelines
    • Physician guidelines
    • Hospital developed guidelines
      • G0463
      • BBA 2015 Section 603 Clinics
    • Variations for ED and provider-based clinics
    • Consultation code issues and the “-AI” modifier
  • CMS Coding system principles and guidance
    • CMS guidelines
    • CMS audit criteria
    • CMS expectations
  • Planning an E&M coding audit
    • Overall objective
    • Number of cases for selection
    • Stratification of E&M levels
    • Use of OIG’s RAT-STATS program
    • Audit guidelines
    • Developing recommendations
    • Assessing impact of Electronic Health Record computer systems
    • Report writing and recommendations
  • Case studies/exercises
  • Sources for further information

Who Should Attend

  • Clinic Managers
  • Clinic Administrators
  • Coding personnel
  • Claims transaction personnel
  • Nursing staff
  • Clinical Service Area personnel
  • Chargemaster Coordinators
  • Financial Analysts
  • Compliance personnel
  • Physicians
  • Non-Physician Practitioners
  • Healthcare Auditors
  • Other interested personnel

Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.

Order Below or Call 1-844-384-4744 Today

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About Our Speaker

Duane Abbey Hospital Coding & Compliance Expert

 Duane C. Abbey, Ph.D. is a management consultant and president of Abbey & Abbey, Consultants, Inc., which specializes in healthcare consulting and related areas. Duane earned his graduate degrees at the University of Notre Dame and Iowa State University and has more than 20 years of experience as a consultant. He performs various types of financial analysis involving business structuring, organizational development, enrolment and other financially related concerns of organizations....   More Info
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