ENROLL NOW

Curriculum specifics will include:

• The “Key Components” associated with E&M code selection
• The differences between the CPT and CMS E&M documentation guidelines
• Discuss the use of utilization benchmarks to target potential risk areas
• Explain the differences between the 1995 and 1997 examination guidelines
• Determining the complexity of medical decision making (MDM)
• The importance of ‘linking’ ICD-10-CM codes to E&M services
• Risks associated with certain EHRs solutions (e.g., “wizards”)
• Distinguishing “problem-oriented” from “preventive” E&M services
• What to look for when modifiers are reported with E&M services (e.g., -25)
• How to use a well-constructed audit template to conduct reviews
• Key steps to present audit findings to providers successfully and non-confrontationally 

Who should attend:
All staff involved in medical billing for your organization, including new providers and providers that need a refresher

Times and Agenda:
9:00 AM-12:30 PM
Instructor: John Burns

Overview of key terminology for Value-Based Care and how CPT/HCPCS-II/ICD-10-CM relate to reporting key quality measures, 

• Comparing Care Management & Quality Reporting
• How ICD-10-CM codes can impact Per Member Per Month payments to clinics or payers,
• How to research the full definitions of CPT Category II codes for Performance Measurement via the AMA Clinical Topics Listing,

1:30 - 4:30 PM
Instructor: Gary Lucas

• Overview of HEDIS measures
• Review of how to achieve Shared Savings via Hierarchical Condition Categories and Risk-Adjusted Coding
• Review of the key "2022 ICD-10-CM Official Guidelines for Coding and Reporting"
• Gathering and Reporting Social Determinants of Health codes
• Outline Care Management revenue options, including Principal/Chronic Care Management, Transitional Care Management, Behavioral Health Integration, and the Psychiatric Collaborative Care Model.

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