Evaluation & Management Boot Camp - Professional Version
Learning Objectives
Module 1 - Introduction to CPT E/M Categories
- Be able to identify the categories of E/M codes.
- Be able to apply the CPT E/M category guidelines.
- Be able to define the common symbols and terms used in the CPT book.
- Be able to accurately assign Evaluation and Management codes by category.
Module 2 - Evaluation and Management Associated Modifiers
- Be able to identify when an E/M modifier is warranted.
- Be able to understand the usage of E/M associated modifiers.
- Be able to understand and apply appropriate modifier to correct E/M codes.
Module 3 - Non-Physician Practitioner (NPP) E/M Services
- Be able to identify when to apply 99211 services and who can report them.
- Be able to identify and understand professional incident-to rules.
- Be able to determine whether a particular non-physician practitioner service qualifies for "incident to" coverage.
- Be able to understand and apply split and shared visits.
Module 4 - Assigning E/M Levels Based on Key Components & Time
- Be able to understand the 1995 documentation requirements.
- Be able to understand the 1997 documentation requirements.
- Be able to identify the differences between 1995 and 1997 guidelines.
- Be able to identify history of present illness (HPI) terms and definitions.
- Be able to identify terms in documentation and assign them to the HPI.
- Be able to understand and apply the HPI documentation guidelines.
- Be able to identify the review of systems (ROS).
- Be able to understand and apply the review of system documentation guidelines.
- Be able to identify past personal, family, social, history (PFSH).
- Be able to identify terms in the documentation and assign them to the PFSH.
- Be able to assign the overall history using the history elements.
- Be able to identify organ system and body areas of the examination.
- Be able to understand and apply the examination guidelines appropriately.
- Be able to identify medical decision making.
- Be able to understand and apply the medical decision making elements.
- Be able to assign Evaluation and Management codes by level.
Module 5 - Teaching Physician of Residents & Students
- Be able to understand definitions of teaching physician rules.
- Be able to identify and apply the documentation requirements for a teaching physician when residents are involved in patient care.
- Be able to identify acceptable teaching physician attestation statements.
- Be able to identify and apply supervision documentation requirements.
- Be able to identify and apply time-based codes documentation requirements.
- Be able to identify and apply primary care exception documentation requirements.
- Be able to provide an overview of Medicare coverage of services provided by interns and residents.
- Be able to identify situations in which a teaching/attending physician's presence is required when residents are involved in patient care.
- Be able to determine the proper way to report for a resident's involvement in patient care (including the appropriate use of modifiers).
Module 6 - Audit Strategies
- Be able to understand comprehensive error rate testing (CERT) findings and how they may impact your practice.
- Be able to ask the right questions to perform data mining of E/M services.
- Be able to understand the importance of E/M bell curve profiling and how to use the information as a guide for compliance and revenue opportunities.
- Be able to understand the function and focus areas of recovery audit contractors (RAC) for physician services.
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