Practice Enhancement Through Clinically Correct Coding in Family Medicine Sessions – Ambulatory Track Included modules (16)
16 CME Credits
MODULE #1
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
MODULE #2:
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
MODULE #3:
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
MODULE #4:
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
MODULE #5:
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
MODULE #6:
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
MODULE #7:
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
MODULE #8: (COMING SOON)
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
MODULE #13: (COMING SOON)
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
MODULE #14:
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
MODULE #15: (COMING SOON)
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
MODULE #16:
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.
MODULE #17:
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
MODULE #18:
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
MODULE #19: (COMING SOON)
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
MODULE #20:
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
