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



Practice Enhancement Through Clinically Correct Coding in Family Medicine Sessions – Ambulatory Track Included modules (16)

16  CME Credits


The Basic Evaluation and Management Guidelines for the Office Setting: 2021 Update

  • 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
  • Define the 2021 Medical Decision-Making components and be able to correctly apply them clinically 


Practical Applications to the 2021 Office Evaluation and Management Guidelines

  • Know the two ways that office-based encounters can be billed in 2021
  • Be able to define the prolonged service (G2212) and the complexity add-on (G2211) codes for 2021
  • State ways to clinically apply appropriate levels of service from various clinical scenarios


Transition Care Management:  Hospital to Home, Home to Office, and Office to Home Primary Care

  • 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 2021 and how and when to bill each
  • Know processes needed to successfully implement this in your practice


Performing the Medicare Wellness Visits in Primary Care

  • Define the three types of Medicare Wellness Visits
  • Know 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 


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 diabetes and diabetes prevention
  • Outline the Intensive Behavioral Therapy services offered to Medicare Beneficiaries 


Care Management:  Patient Engagement and Quality Gap Closure

  • Outline reasons for care management service delivery in primary care and understand how to use add-on codes for visit complexity offered in 2021
  • Know how to document and bill correctly for home health certification, recertification, and care plan oversight
  • Know how to perform, document, and bill for Principal Care Management and Chronic Care Management services 


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 health care decision making
  • Be able to perform, document, and correctly bill the Advance Care Planning service 


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 


The Expanding Role of the Physician Advisor in the Hospital Space

  • Be able to define a “Physician Advisor” and why family 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


Understanding the Basics of the Business of Medicine

  • Know the global history of the Medicare program and understand the parts (A, B, C, and D) that make it up
  • Know the out of pocket costs associated with the Medicare Beneficiary in 2021 and the concept of co-insurance across the spectrum of healthcare
  • Be able to state the basic components of coding and the concepts of documentation integrity and its support of how we get paid
  • Define relative value units, conversion factor, shared savings, and cost of care and how these play into how providers get paid 


Burnout 101:  Addressing the Issue with Strategies for Success

  • Know the prevalence and progression of burnout in the medical professional community
  • 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 


Today’s Physician:  Stakeholder and Leader for Sustainable Change

  • 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. 


Population Health:  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 across the healthcare spectrum 


A Strategic Path to Documentation, Coding and Billing Compliance in Primary Care

  • Outline reasons why a compliance plan related to coding and billing is important in primary care
  • Define key areas of focus for primary care practices in 2021
  • Understand the process of assessment and performance improvement through encounter audits to aid in success of a primary care compliance plan 


Clinical Documentation Improvement: Capturing Risk Across the Healthcare Space

  • 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 


Compliant Use of the Advance Practice Professionals (APPs) in Primary Care

  • Define the various Advanced Practice Professionals commonly seen in primary care
  • Differentiate between “shared” and “incident to” services and how APPs can be an integral part this type of care delivery
  • Know the appropriate billing and understand the correct documentation needed to be compliant in overseeing APP care delivery
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