American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Office Procedure and E/M Coding

Who Should Attend This Course

General Surgeons

Getting paid is a team effort—and surgeons lead the team. If the doctors don't understand what's needed in an operative report from a coding and reimbursement point of view (something they don't teach in residency) they are short changing themselves.

Practice Administrators and Managers

You are the chief compliance officer in most private practices. In order to supervise the economic engine of the practice you must understand the business office operations.

Coders and Billers

If you're responsible for entering data, working denials, applying modifiers, posting payments, and filing appeals, your expertise in surgical and office coding must be exacting in its execution!

Hospital or MSO Executives Running General Surgery Practices

Maximize your profits! Understand what is special and unique about billing for the general surgery service line, and keep your surgeons happy and bonus-able. (Not to mention reduce compliance headaches.) Learn the rules and avoid using incorrect and expensive assumptions that result in fiscal disaster.

Register now!

Learning Objectives

As a result of this course, participants will be able to:

  • Recognize the E/M office visit coding changes for 2021
  • Demonstrate accurate coding of E/M office and hospital visits in 2020
  • Identify appropriate use of modifiers with E/M services
  • Describe the components of the global surgical package, including critical care rules
  • Demonstrate accurate coding of biopsies, FNA, excisions, and laceration repair
  • Differentiate coding for screening versus diagnostic colonoscopy
  • Apply teaching physician rules and coding for services
  • Describe accurate coding of telemedicine, eVisits, consults, and non-face-to-face services
  • Implement practice management strategies for collecting from patients with high-deductible health plans.

What's on the Agenda

E/M Office Coding Changes in 2021

  • Code definition changes for 99202-99215
  • New rules for using time for office and outpatient visits
  • New medical decision-making grid in 2021
  • Recommended changes to templates for next year

E/M Office and Hospital Coding in 2020

  • Select accurate codes for hospital and office services based on medical necessity and documentation
  • Know what shortcut phrases are supported by the Documentation Guidelines and what phrases to avoid
  • Medical decision making in its current form
  • Know when using time is the winning hand

Selecting the Correct Category of Code

  • New and established patient visits and consults
  • Select the correct category of code for initial inpatient services, regardless of payor
  • Coding for visits in the emergency department

Global Surgical Package

  • Components of the global surgical package
  • Separately reportable E/M services
  • Modifiers 24, 25, and 57
  • Differences between the CMS and CPT definitions of the global package

Critical Care

  • Critical care coding rules in and out of the global package
  • Trauma teams and critical care

Surgical Procedures Commonly Done in the Office

  • Biopsies, excisions, fine needle aspiration
  • Laceration repair

Screening Colonoscopy

  • Append the correct modifiers to screening colonoscopy services
  • Determine the primary and secondary diagnosis codes

Working in Teams with Residents, NPs, and PAs

  • Update to teaching physician rules for students and residents
  • Medicare incident to and shared services rules

Telemedicine: Separating the Hype from the Reality

  • Telemedicine as defined by Medicare
  • Place of service and modifiers for telemedicine
  • New CPT codes for online digital E/M
  • Interprofessional consults
  • Non-face-to-face prolonged services

Practice Management

  • CMS policy update
  • Key A/R metrics
  • Surgical deposits and point-of-service collections
  • Denial management