2025 Practice Enhancement Through Clinically Correct Coding
Hospital Core Track
Hospital Core Track:
Ideal for new providers embarking on hospital-based, general internal medicine medical care which covers topics of coding/billing optimization as well as tactics on “medical necessity” capture.
Sessions are updated each year, so this offering can serve as a yearly staff requirement that promotes quality, compliance, and enhances revenue – all with an applicable tie-in to the clinical workload of busy providers.
CME: 4 hours of AMA PRA Cat I/AAFP Prescribed credit allowed upon completion. Suitable for all providers (MD/DO, NP, PA)
- 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
- Explain how the E&M Services Guide released 08/2024 defines the hospital encounter
- Understand how to document/perform care related to both the time-based coding and Medical Decision-Making components in the hospital setting
- Understand how to use prolonged services in the hospital setting
- 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