2022 Protime Practice Enhancement Through Clinically Correct Coding in Family Medicine – Ambulatory Track


2022 Practice Enhancement Through Clinically Correct Coding Sessions – Ambulatory Track Included modules (20)

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16.5 CME Credits

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 #14:      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

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


Total CME:                       16.5