Format :LIVE WEBINAR Presenter :Duane C. Abbey, PhD Event Date : 11/29/2018 Time: 1 pm ET | 12 pm CT | 11 am MT | 10 am PT Duration :90 Minutes $249–$449 E/M coding for physicians was introduced along with the MPFS starting back in 1992. E/M coding for hospital outpatient services started with the implementation of APCs in 2000. The use of the E/M codes are quite different between physicians and hospitals. Physicians code for what they do using mainly the history, examination and medical decision making as guides. Session Objectives: To review the E/M codes as they appear in the CPT Manual. To explore different guidelines that are used by physicians and hospitals. To understand the use of G0463 and BBA 2015 Section 603 clinics. To discuss establishing an E/M coding audit and audit program. To appreciate the difference between ‘new’ versus ‘established’ patients for physicians and hospitals. To appreciate physician coding for incident-to billing. To understand the differences in E/M coding for ER physicians and provider-based clinic physicians both primary care and specialty. To appreciate the physician E/M documentation guidelines. To explore the 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. To explore how electronic health record systems create challenges for developing proper documentation to support E/M coding. To review changes that are being made for office visit E/M codes for Medicare starting in 2019. 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 Update to Office Visit Codes for Medicare CMS Proposal for Special G-Codes Changes in Documentation Guidelines 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 Expectaion 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. Suggested Attendees: 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 Other Interested Personnel About the Presenter: Duane C. Abbey, PhD, CFP, is a management consultant and president of Abbey & Abbey Consultants, Inc., a consulting firm specializing in healthcare 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. Dr. Abbey works extensively in all areas relating to compliance reviews, coding, billing and reimbursement with particular emphasis on the chargemaster and outpatient payment. His consulting activities include hospitals and physicians based clinics.