Unlock Secrets of Outpatient E/M Coding and Reimbursement: MDM vs Total Time
Course Description:
The American Medical Association (AMA) has created new guidelines for Evaluation and Management codes for the new and established patient office visits 99202-99215 only. Later the guidelines were extended to outpatient consultations and certain inpatient services that base the level of service on medical decision making. Practitioners may choose the level of service using medical decision making or total time for these services. The AMA provided a coding tool to assist when choosing the level of service on medical decision making. The coding tool consists of the three elements of medical decision making. We will take a close look at the elements and learn how to use this tool when selecting the correct office visit code based on the documentation.
For the first time, the American Medical Association provided definitions of terms used in the coding tool. We will discuss the definitions to better understand the necessary information to include in the documentation to represent your practitioner’s work and how to credit their work in the coding tool. We will also review the allowed activities to consider when code selection is based on total time and information the time statement must include.
Learning Objectives:
- When to level the visit on medical decision making vs total time
- Definitions of terms used in the AMA’s coding tool
- Become familiar with the three elements of medical decision making
- How to document to support the elements of medical decision making
- Identify missed opportunities in the documentation
- How to select the level of service based on the documentation
- When to use medical decision making vs total time for leveling the service
- How to count time and document an appropriate time statement
- Level of service 5 visits with prolonged services
- Discuss how Medicare vs other payors count time for Prolonged Services
Areas Covered in the Session:
- Current Evaluation and Management Rules and Guidelines
- Leveling based on medical decision making
- AMA E/M Coding Tool
- AMA Definitions: Terms used in the coding tool
- Necessary documentation to support the level of service
- Leveling based on total time
- What counts for total time
- Information to include in the total time statement
- Prolonged Services
- Live Q&A Session
Suggested Attendees:
- Physicians and Non-Physician Practitioners
- Medical Coders
- Medical Billers
- Practice Managers
- Coding Managers
- Directors of Coding
- Denial Team
- Coding Compliance Team
- Auditors
- Revenue Cycle Team
- Outpatient Hospitals
- Outpatient Hospitals Staff
About the Presenter:
Jimmie is a Certified Professional Coder (CPC), Certified Medical Coder (CMC), Certified Medical Chart Auditor E/M (CMCA-E/M), Certified Medical Office Manager (CMOM), and Certified Medical Insurance Specialist (CMIS). Additionally, she has special expertise in the areas of human resource management and patient advocacy. Jimmie has conducted managed care contract analyses and negotiation and has extensive training and experience in diagnostic and procedural coding as well as effective reimbursement and collections techniques. She is well versed in Medicare issues, coding, and compliance.
Jimmie owns her own consulting company and has opened many physician practices in the greater Houston area. She is currently taking a break and pursuing her greatest passion which is teaching. Jimmie has traveled the country teaching physicians, medical practice administrators and staff about the latest issues in medical practice management and the business of management. Her background includes management of several multi-physician, multispecialty clinics, along with overseeing the revenue cycle operations of all Texas practices for a nationwide healthcare system.
Additional Information:
After Registration: You will receive an email with login information and handouts (presentation slides) that you can print and share with all participants at your location.
System Requirement:
- Internet Speed: Preferably above 1 MBPS
- Headset: Any decent headset and microphone which can be used to talk and hear clearly
Live Course Cancellation Policy: If for any reason Skillacquire need to cancel this program, Skillacquire will notify participants by email of the cancellation no less than 24 hours prior to the expected start time.
Can’t Listen Live?
No problem. You can get access to an On-Demand webinar. Use it as a training tool at your convenience. For more information, you can reach out to the below contact:
Toll-Free No: 1-302-444-0162
Email: care@skillacquire.com
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