2022 Practice Enhancement Through Clinically Correct Coding Sessions – All
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Total CME: 20.0
Session #1: 1.0
The Basic Evaluation and Management Guidelines for the Office Setting
- Know the definitions of the types of conditions that we use in our evaluation and management services as well as how to determine whether a patient is new or established in a practice
- Be able to correctly apply time-based coding in the ambulatory office practice setting
- Describe the Medical Decision-Making components as redefined in 2021 and be able to clinically apply them in 2022
Session #2: 0.5
Practical Applications of the Office Evaluation and Management Guidelines
- Know the two ways that office-based encounters can be billed in 2022
- Be able to define the 2021 prolonged service code and correct applications of such
- State ways to clinically apply appropriate levels of service from various clinical scenarios
Session #3: 1.0
Performing the Medicare Wellness Visits in Primary Care: 2022 Insights
- Understand the reasons behind the Comparative Billing Report of 2021 and its implications in 2022 for the Medicare Wellness Visit
- Define the three types of Medicare Wellness Visits and how to correctly perform, document, and bill for each of these services
- Understand how to correctly apply chronic disease care delivery in the context of the Medicare Wellness Visit with the addition of the -25 modifier
Session #4: 1.0
Understanding the Preventive Services in Medicare
- Define how to find the central source of updated information on Medicare Preventive Services, codes, co-insurance, and coverage intervals
- Describe the covered services offered through Medicare in cancer prevention
- Discuss the preventive services offered through Medicare related to intensive behavioral therapy, diabetes, and diabetes prevention
Session #5: 1.0
Care Management in Primary Care: CCM, PCM, Home Health, and Care Plan Oversight Services
- Know how to perform, document, and bill for Chronic Care Management (CCM) services
- Know how to perform, document, and bill for Principle Care Management (PCM) services
- Know how to document and bill correctly for home health certification, recertification, and care plan oversight
Session #6: 1.0
Documentation and Coding of Dermatology Procedures in Primary Care
- Outline documentation strategies to support dermatology procedures
- Know how to document and bill for biopsy procedures based on latest guidelines
- Describe how to document and bill for multiple procedures as well as procedures done in the context of a problem-based encounter using the -25 modifier
Session #7: 0.50
Behavioral Health Integration (BHI) and The Psychiatric Collaborative Care Model
- Define how to effectively integrate behavioral health into primary care
- Be able to outline the psychiatric collaborative care delivery model and how to correctly document, code, and bill for these services
Session #8: 1.0
Transition Care Management (TCM): The Keystone of Care Transitions
- State the importance of care coordination and understand how to transition patients from hospital to home, from home to office, and then office to home
- Differentiate between the two Transition Care Management codes (99495 and 99496) for 2022 and how and when to bill each
- Know processes needed to successfully implement TCM in your practice
Session #9: 0.5
Advance Care Planning: Helping Our Patients Transition
- State why family physicians should engage their patients in discussions relating to end-of-life care.
- Know the specific documents used for end-of-life decision making in health care
- Be able to perform, document, and correctly bill for Advance Care Planning services
Session #10: 1.0
Compliant Use of the Nurse Practitioners (NPs) and Physician Assistants (PAs) in 2022
- Define the various Advanced Practice Professionals (APPs) commonly seen in primary care
- Differentiate between “split/shared” and “incident to” services and how APPs can be an integral part this type of care delivery given the 2022 CMS updates
- Know the appropriate billing and understand the correct documentation needed to be compliant in overseeing APP care delivery
Session #11: 0.50
Social Determinants of Health (SDoH): Uncovering a Key Player in Healthcare Outcomes
- State several health impacts associated with SDoH.
- Know the key SDoH risk factors and why regular screening for such is important in healthcare
- Understand the codes associated with SDoH risk factors and the importance of correct coding for these conditions
Session #12: 1.0
Know How Hierarchical Condition Categories (HCCs) and Diagnosis Related Groups (DRGs) Shape Clinical Documentation Improvement in 2022:
- Be able to explain optimal clinical documentation, redocumentation, “risk” scores and the economics associated with excellence in this area
- Know clinical conditions in the outpatient office practice that are a focus of opportunity with regards to Hierarchical Condition Categories (HCCs)
- State several Diagnosis Related Groups (DRGs) and how clinical documentation assists in capturing the correct picture of a patient’s disease state in the hospital setting
Session #13: 1.0
The Why and How to Develop Documentation, Coding and Billing Compliance in Primary Care
- Outline reasons why a compliance plan related to coding and billing is important in primary care
- Know the key focus areas of compliance audits in 2022
- Understand the process of assessment and performance improvement through encounter audits to aid in success of a primary care compliance plan
Session #23: 0.50
The Preoperative Assessment: Step 1 in Effective Care Transitions
- Understand the roles primary care plays in the surgical patient’s care
- Know areas of focus for preoperative assessment of the older adult
- State the importance of a coordinated transition care management (TCM) interaction post-operatively and strategies in delivery
Session #15: 1.0
The Many Hats of the Physician Advisor in 2022
- Be able to define a “Physician Advisor” and why primary care physicians with hospital experience ideally fit this role
- Explain the roles performed in support of case management with respect to resource utilization and quality
- Know how the physician advisor can support CDI, medical necessity, and denials management processes for healthcare systems
Session 16: 0.50 (to be launched after the PHE announcement in January 2022)
2022 Telehealth and Remote Patient Monitoring (RPM): Clinical Applications Across the Spectrum
- Be able to describe how Telehealth looks in 2022 and how to apply it to your primary care practice
- Be able to define what remote patient monitoring is and what clinical disease states can be most easily addressed as a first step outreach
- Understand the coding and billing associated with RPM services
Session #17: 1.0
The Business of Medicine: Foundational Information Not Taught in Residency
- Know the global history of the Medicare program and understand the parts (A, B, C, and D) that make it up
- Define and understand the 2022 changes to relative value units (RVUs) and the conversion factor
- Know the out-of-pocket costs associated with the Medicare Beneficiary in 2022 and how shared savings and cost of care play into payments
- Know the basic components of coding and the concept of documentation integrity and its application to how we get paid
Session #18: 0.5
Dousing the Flames of Burnout in 2022
- Know the prevalence and progression of burnout in the medical professional community and the effects of the COVID pandemic
- List the clinical manifestations of burnout and triggers that lead to this clinical state
- Discuss strategies to deploy to help reduce personal and occupational stress
Session #19: 1.0
Leadership Challenges for Today’s Physician
- Know reasons behind having physicians as leaders.
- Understand essential elements needed for effective physician leadership.
- Be able to outline practical applications of physician leadership skills across the scope of healthcare needs.
Session #20: 1.0
Population Health Management: Understanding Quality, Incentives, and Value
- Define “Population Health Management”
- Discuss how quality is aligned across the healthcare spectrum
- State how incentives, penalties and value are defined in healthcare
Session #21: 1.0
The 2022 Basic Evaluation and Management Guidelines for the Hospital Setting
- State differences in the 2021 Evaluation and Management Guidelines in the office and the hospital facility
- Know the concepts that make up the History, Exam, and Medical Decision-Making Key Components of the Hospital E&M Guidelines
- State ways to practically apply the three Key Components in clinical practice examples
Session #22: 1.5
The Two Midnight Rule and Medical Necessity in the Hospital Setting
- Define the “Two Midnight Rule” clinically and correct applications given the 2022 “Inpatient Only List” changes
- State pearls associated with documentation of medical necessity of key conditions in the hospital setting to include heart failure, myocardial infarction, pulmonary conditions, stroke, and sepsis
Session #23: 1.0
Compliant Time-based Coding and Documentation in the Hospital Setting
- Define the documentation needed for time-based services in the hospital setting
- Explain 2022 revised critical care services policy and how to document, code and bill for these services
- Explain 2022 revised split and shared services policy and how to document, code and bill for these services
- Know how to document discharge care in the inpatient site of service
Total CME: 20.0