Outpatient Coding and Coverage Issues: Evaluation and Management (E/M) Services

Outline:
Section 1: Introduction

About This Course

Learning Objectives

Background

Section 2: Guidelines

Internal Guidelines

Distribution of Visits

Review

Basics of Facility E/M Coding Guidelines

Additional Guidelines

Review

Methodology

Section 3: Types of Services

Coding by Site and Type of Service

Review

Critical Care

Section 4: Separate Services

Modifiers

Separately Billable Procedures

Example of Reporting Separately Identifiable Services

Telehealth Services

Review

Section 5: Conclusion

Course Summary

Course Contributors

References

Deborah is responsible for Elsevier's online solution of education and tools to improve employee performance for Revenue Cycle, Coding, CDI, and Compliance professionals. Deborah has earned BS degrees in Management/Human Resources and Social Psychology. She is a Registered Health Information Management Administrator (RHIA) and is a Certified Coding Specialist, Physician-Based (CCS-P). Prior to joining Elsevier, Deborah held positions such as Revenue Cycle Analyst for Mayo Clinic; Compliance Officer; educator; coding manager; and senior consultant. Deborah actively participates on projects important to the healthcare industry. As an active member of AHIMA, she has participated in the Quality Initiatives & Secondary Data Practice Council, was Chair of the Coding Policy and Strategy Committee and Board member for the Society of Clinical Coding. She has authored journal articles, been a presenter of audio-conferences and a speaker at national and state conventions. Deb was a member of the AHA Editorial Advisory Board for ICD-9-CM Coding Clinic and AHA Editorial Advisory Board for HCPCS.

Disclosure: Deborah Neville, RHIA, CCS-P has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.

Jean Russell has over thirty years of healthcare and information system experience. Her areas of expertise include the Medicare outpatient prospective payment systems (APCs, and APGs), as well as ICD-10-CM/PCS training, Charge Description Master (CDM), admission status reviews, and outpatient coding and compliance. She is a frequent speaker at the national, state and local levels for HFMA and AHIMA professional groups. Jean has her Masters from the University of Houston in Biomedical Engineering; her Bachelors from Colgate University in Biology; and her RHIT from the independent study program through the American Health Information Management Association.

Disclosure: Jean C. Russell, MS, RHIT has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.

Veronica Ziac, MBA has over twenty years of healthcare administration experience. Her areas of expertise include revenue cycle, information systems, population health and physician practice management. Most recently, she was the Director of Revenue Cycle Integrity at Cobleskill Regional Hospital. Prior to that, Veronica was the Chief Operating Officer for a large multispecialty hospital-based physician practice based in New York. Veronica has an MBA in Healthcare Administration from Union College and a bachelor’s degree from the University at Albany. She is a member of HFMA and MGMA and has been Certified in Healthcare Compliance (CHC) by the Healthcare Compliance Association.

Disclosure: Veronica Ziac, MBA has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.