Evaluation & Management Changes for 2021 Training

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Heifer International

1 World Drive

Little Rock, AR 72202

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Event description
1-Day training for professionals involved with Evaluation and Management within AR Health Centers.

About this Event

For Questions please contact Sandi Ganus at (501) 492-8387.


This 1-day training is intended for healthcare practitioners, medical billers, coders, auditors, office managers and IT professionals involved with authoring clinical documentation, generating E&M progress notes, auditing professional physician service claims and maintaining a healthy revenue cycle. The primary course focus will emphasis documentation guidelines set forth by CMS for reporting Evaluation and Management services (E&M), as defined by CPT. The curriculum will provide attendees with a strong grasp of Evaluation and Management auditing, coding and documentation techniques.

The curriculum is designed to assist in development and mastery of the necessary skill set to successfully audit Evaluation and Management (E&M) services. This education and training has been designed to promote compliance and minimize the risk mitigation associated with post-payment review and 3rd party audit exposure.

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 to ‘link’ 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

The program primarily focuses on instruction and review of pertinent source documents (e.g., AMA’s 2019 CPT guidelines and CMS’ E&M Documentation Guidelines and some of the categories of E&M services located in CPT.

CEU– 5.5 CEUs approved by AAPC & ArchProCoding

CME – 5.5 (Continuing Medical Education) Credits for MD, DO, NP, PA, RN:

*This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint providership of the University of Nevada, Reno School of Medicine and Association for Rural & Community Health Professional Coding. The University of Nevada, Reno School of Medicine is accredited by the ACCME to provide continuing medical education to physicians. The University of Nevada, Reno School of Medicine designates this live activity for a maximum of 5.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Day 1 Agenda 8:30 a.m. – 4:30 p.m.

• Overview and CPT E&M Instructions

• Defining time in the inpatient/outpatient settings

• When to use CPT vs. CMS E&M DocumentationGuidelines

• Preventive versus Problem-Oriented E&M Services

• Documenting valid chief complaints

• History of Present Illness and Review of Systems (HPI/ROS)

• Past, Family, Social History (PFSH)

• Hands-on Exercises and QA

• 1995 vs 1997 CMS Examination Guidelines

• Geographic considerations (e.g., MAC Guidance)

• Medical Decision Making and Medical Necessity

• The role of EHRs and coding software in the auditing process

• Time based E&M coding

Proficiency Exam – You will have access to a optional 50 questions proficiency exam after the completion of the bootcamp. The exam will be online and you will receive a certificate of completion

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Heifer International

1 World Drive

Little Rock, AR 72202

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