2025 Practice Enhancement Through Clinically Correct Coding
PHYSICIAN ADVISOR CORE Track
Physician Advisor / Site-Specific Core Track:
Specific to the unique roles of the Physician Advisor, this curriculum provides base knowledge on physician advisor roles and the medical necessity determinations key to success in this space. Optimal for onboarding or yearly training updates. This is an example of a Site-Specific Core Track.
This curriculum can be used as an onboarding opportunity for new hires who are working in the hospital space, or documentation for capture, medical necessity, quality and compliance for your GME programs, for residency programs, or nurse practitioner PA education for the students who are going through those curriculums. It is also valuable information for new physicians, new nurse practitioners, new PAs coming on board, etc., so you can give them a nugget of information for what the hospital world is all about.
- Be able to define a “Physician Advisor” and what types of physicians can fit this role
- Know how PAs can support of case management with respect to resource utilization and quality
- State how PAs can support CDI, medical necessity, and denials management
- Know the quality metrics tied to value-based care
- Understand the conditions tied to the readmission reduction program
- Know the conditions linked to the hospital acquired infections measure
- Define the Diagnosis Related Group (DRG) concept
- Know how DRGs impact the Case Mix Index (CMI) and how these economically impact a hospital facility
- State top Diagnosis Related Groups (DRGs) and how to best document to capture the optimal clinical picture
- Apply the “Two Midnight Rule” based on the 2024 Medicare Advantage Final Rule
- State the importance of “D-Day” documentation with respect to patient status
- Understand what the “Inpatient Only List” is and a management option for correct use
- State documentation pearls associated with documentation of medical necessity of key cardiac conditions in the hospital setting to include:
- Chest Pain/ Myocardial Infarction
- Heart Failure
- Atrial Fibrillation
- State documentation pearls associated with documentation of medical necessity of key respiratory conditions in the hospital setting to include:
- COPD
- Pneumonia
- State documentation pearls associated with documentation of medical necessity of key neurological conditions in the hospital setting to include:
- Encephalopathy
- TIA
- Stroke
- State documentation pearls associated with documentation of medical necessity of key infectious conditions in the hospital setting to include:
- Sepsis
- Cellulitis
- Urinary Tract Infections
There are 8 Sessions in this track.
Until December 31st, 2025.
Available for download upon successful completion of each session.
The AAFP has reviewed Practice Enhancement Through Clinically Correct Coding and deemed it acceptable for Prescribed credit. Term of Approval is from 01/01/2025 to 12/31/2025. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Each Session has been assigned 0.5 CEU credits, for a total of 4 CEUs.
Note: You will receive a downloadable Certificate of Completion upon finishing each session