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 Export to Your Calendar 6/24/2020 to 6/25/2020
When: Wednesday, June 24, 2020
8:30 AM
Contact: Kay Brewer
608-277-7477


Online registration is available until: 6/17/2020
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ArchProTraining

E&M Documentation and Coding & Reporting for Quality

Virtual  Online Training

June 24-25, 2020

 

E&M Documentation, Coding & Auditing Boot Camp -  June 24, 2020 - 9:30am - 3:30 pm

Reporting Quality in Care Management Services - June 25, 2020 9:00am - 1:00pm

 

REGISTRATION FEES

One Day:

Member   $100/attendee

Non-member   $175/attendee

 

Two Days:

Member  $150/attendee

Non-member  $300/attendee

 

Day 1: E&M Documentation & Coding Boot Camp

E/M 2021 Updates & Changes

This interactive 1day 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 

Attendee Responsibilities:  Each attendee is expected to present to class with the following:

 

2020 CPT (AMA Professional Edition strongly encouraged) - if available to you

A printed copy of the CMS Evaluation & Management Services Guidelines

A copy of any internal audit tools, templates, or score sheets currently being utilized by your facility

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.

 


Agenda Day 1 9:30 a.m. – 3:30 p.m. with a 15 minute break/Q&A in the morning and afternoon as well as a 30 minute lunch

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

Review of all remaining CPT E&M categories

Reinforcement of “key” components, modifiers, and global surgical package considerations

Overview the ArchProCoding Audit Tool

Accurate completion of the E&M Audit tool

Instructor-led cases for audit

Individual and group audit exercises

 

Day 2: Reporting Quality in Community Health: A focus on clinical documentation

New for 2020 - CME (Continuing Medical Education) Credits for MD, DO, NP, PA, RN: 4 CME Credits

*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 5.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

 

General description

This live course is designed for Rural Health Clinics (RHC) providers, quality managers, ACO leadership, and revenue cycle staff at rural health facilities who need a high-level basic explanation of how to report accurate quality metrics and who deal with HEDIS, HCC, QIP, Risk Adjustment, and Share Savings.

FQHC Overview: We will begin with a FQHC documentation>coding>billing overview including:

  • How coding and billing is different in a RHC .
  • Review of the key elements of the CMS Benefits and Claims Manual sections (chapters 9 & 13)
  • Which services are included in the All-Inclusive Rate and which services get paid via fee-for-service or via a flat fee when billing Medicare?
  • Preventive Medicine for the IPPE, AWV, and almost a dozen other “sometimes covered” G-codes performed by a RHC.

Reporting Quality:  After a brief overview of HEDIS/HCC and other Quality Improvement programs, we will dive into relevant sections of the ICD-10-CM's "Official Guidelines for Coding & Reimbursement" and will review the instructional notes associated with key diagnoses in order to most accurately report the true complexity of care for your ACO patients and to:

  • recognize the impact of medical documentation on the accuracy and completeness of quality data,
  • properly reporting Care Management services to coordinate treating chronic diseases,
  • report accurate and complete Quality Metrics via historical claims data,
  • how to fully report the true complexity of your patients via ICD-10-CM documentation rules.

Required Course Materials: CPT, ICD-10-CM. HCPCS is optional.

General Objectives

1 - Attendees will be able to unify their clinical documentation goals with the requirements of Managed Care/ACO's to adjust payments based on clinical complexity of its patient population.

2 - Attendees will learn about the specific documentation guidelines and base code instructional notes associated with the major disease categories being tracked by ACOs.

3 - Attendees will learn a structure by which they can train their providers on those additional codes and HCC categories that may become a focus in the future and how their EHRs may hinder effective training.

 

The following groups will benefit from class:

  • Providers who create clinical documentation (e.g. MD/DO/PA/NP) and have primary responsibility for capturing documentation necessary to support .
  • Nurse/Quality Managers who manage people and policies related to voluntary or contractually-required reporting of data via CPT, HCPCS-II, and ICD-10-CM codes and who serve as a link between the clinical and business staff.
  • Coders/billers who have do not have experience in measuring and reporting key quality metrics via UDS, HEDIS, HCC, and internal ACO requirements related to educating providers on proper code usage.

 

Basic Agenda (times may vary slightly)

Agenda Day 2 9:00 a.m. – 1:00 p.m with a 15 minute Q&A in the morning and after class
  • Orientation to course materials and HIPAA-approved coding manuals
  • A discussion of what the COVID-19 pandemic is and how it is impacting our health system
  • Impact of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act)
  • Applicable CPT, HCPCS II and ICD-10-CM codes will be discussed
  • Roles and responsibilities for documentation vs. coding vs. billing
  • What makes RHCs different?
  • When should we get paid the encounter rate vs. fee-for-service vs. another payment method?
  • Introduction to reporting quality and reporting chronic disease management
  • Roles and staffing responsibilities for quality reporting
  • Basics of HEDIS, HCC, ACO Shared Savings, and Risk Adjusted Coding
  • Where can diagnoses be pulled from in an encounter note?
  • Overview of CPT Category II codes and ways to increase revenue
  • Deep review of the ICD-10-CM Official Guidelines for Coding & Reporting
  • Balancing clinical care and quality reporting requirements
  • Hands-on individual and group exercises
  •  Course wrap-up and "Where do we go from here"
  • Attendees take post-test

 

CEU– 4 CEUs approved by AAPC & ArchProCoding

CME (Continuing Medical Education) Credits for MD, DO, NP, PA, RN: 4 CME Credits

*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 5.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


 

Cancellation Policy

Registered participants may substitute another participant at no charge up to the day of the conference. You will need to send an email to Lindsey Hess with the new participant name as soon as possible to coordinate meals and participant materials. Participants may cancel at no charge up to 7 days before the event begins. No refunds are available for cancellations 6 days or fewer before the event begins.