2024 Practice Enhancement Through Clinically Correct Coding Sessions – Physician Advisor Core (8 Sessions)

2024 Practice Enhancement Through Clinically Correct Coding Sessions – Physician Advisor Core (8 Sessions)

Total CME: Physician Advisor Core Track 4.0 Prescribed AAFP/AMA PRA Cat I CME credits

8 SESSIONS (each 0.5h)

Session #26:
The Role of the Physician Advisor (PA): Expanding Beyond Status Determination

• 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

Session #31
The Hospital Quality Journey: Where is our Focus?

• 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

Session #33:
Hospital Clinical Documentation Improvement (CDI): Stating the Correct Clinical Picture

• 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

Session #34:
The Two Midnight Rule and Medical Necessity in the Hospital Setting

• Define the “Two Midnight Rule” and the inpatient vs observation determination
• 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

Session #35:
The Medical Necessity Series, Part I

• • 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

Session #36:
The Medical Necessity Series, Part II

• State documentation pearls associated with documentation of medical necessity of key respiratory conditions in the hospital setting to include:
  • COPD
  • Pneumonia

Session #37:
The Medical Necessity Series, Part III

• State documentation pearls associated with documentation of medical necessity of key neurological conditions in the hospital setting to include:
  • Encephalopathy
  • TIA
  • Stroke

Session #38:
The Medical Necessity Series, Part IV

• State documentation pearls associated with documentation of medical necessity of key infectious conditions in the hospital setting to include:
  • Sepsis
  • Cellulitis
  • Urinary Tract Infections

Total Prescribed AAFP/AMA PRA Cat I CME:                       4.0