Auditing Evaluation/Management Coding For Physicians

Event Information
Product Format
Prerecorded Event
90 minutes
Product Description

Learn About the Compliance Challenges Surrounding E/M Coding and How to Organize an E/M Coding Audit!

Are you wondering how physicians and hospitals use E/M codes? Want to learn the CMS technical E/M coding principles and understand the difficulties with E/M coding for the ED? Do you know how to adjust to CMS dropping the consultation codes? Are you aware of the differences between Specialty Clinic Coding and Primary Care Clinic coding for E/M services?

Expert speaker Duane Abbey, Ph.D. will discuss the above mentioned questions and more in an information-packed webinar. He will help you understand the documentation system including ‘copy and paste’ capabilities; the interplay between Facility component E/M Coding and Physician E/M Coding; and learn the difference between a ‘New’ patient versus an ‘Established’ patient.

Additionally, Duane will help you understand how to organize an E/M Coding Audit, importance of the “-25” Modifier, and look deeper into the compliance challenges surrounding E/M coding.

Session Highlights: 

  • Review the E/M codes as they appear in the CPT Manual
  • Discussion on how to establish an E/M coding audit and audit program
  • Appreciate the difference between ‘new’ versus ‘established’ patients for physicians and hospitals.
  • Review of physician coding for incident-to billing
  • Understand the differences in E/M coding for ER physicians and provider-based clinic physicians both primary care and specialty
  • Understand the physician E/M documentation guidelines
  • Perceive compliance challenges faced by both physicians and hospitals for E/M coding and the “-25” modifier
  • Recognize how to make changes to accommodate CMS’s dropping the use of the consultation codes
  • Know how electronic health record systems create challenges for developing proper documentation to support E/M coding

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
    • 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

Prerequisites for Participating:  General knowledge of coding and billing for E/M services for both physicians and hospitals.

Who should attend:

Clinic Managers; Clinic Administrators; Coding Personnel; Billing and Claims Transaction Personnel; Nursing Staff; Clinical Service Area Personnel; Chargemaster Coordinators; Financial Analysts; Compliance Personnel; Physicians; Non-Physician Practitioners; Healthcare Auditors; and Other Interested Personnel

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

We Also Recommend
Order Form

(Select the format below)

Choose Quantity:

(*) Single User Price

You can also order through:




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
More Events By The Speaker

Why ProfEdOnDemand?
  • Save money on travel.
  • Meet your specific training needs.
  • Keep learning after the event.
  • Save time training your whole staff.
Join Our Mailing List