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

Methodology

Review

Section 3: Types of Services

Coding by Site and Type of Service

Critical Care

Review

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

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 no Relevant Financial or Non-Financial Relationship with ineligible companies to disclose.

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 no Relevant Financial or Non-Financial Relationship with ineligible companies to disclose.