ENT

FRIDAY AM

E/M Coding & Office Procedure Coding

Agenda

*agenda subject to change

7:15AM - 8:00AM

Check-in and Breakfast (provided)

8:00AM - 10:00AM

Evaluation and Management Coding and Documentation 

  • Overview of E/M Codes
  • Categories of E/M Codes
    • When to report an outpatient/office consultation code (9924x)
    • New patient (9920x)
    • Established patient (9921x)
    • Emergency department (9928x)
    • Inpatient consultation (9925x)
    • Initial hospital care (9922x)
    • Subsequent hospital care (9923x)
    • Discharge (99238, 99239)
    • Observation services (99217, 99218-99220, 99224-99226, 99234-99236)
  • Levels of E/M Codes
    • Recently revised 9920x, 9921x code guidelines:
      • Medical decision making – problems addressed, data, risk or
      • Time
    • Other codes: history/examination/medical decision making or time

10:00AM - 10:15AM

Break

10:15AM - 10:30AM

Evaluation and Management Coding and Documentation (continued)

10:30AM - 11:30AM

E/M Modifiers and Commonly Performed Office Procedures

  • Modifiers 24, 25, 57
    • E/M and procedure on the same day – risks and rewards
    • Cancer surveillance visits – both E/M and scope?
    • Removal of impacted cerumen (Note: cerumen removal will NOT be discussed during the Saturday course)
    • Diagnostic endoscopies: nasal endoscopy, flexible laryngoscopy, nasopharyngoscopy; endoscopic sinus debridement

11:30AM - 12:00PM

Medicare: NP and PA Billing Guidelines

• Define “incident to”, split/shared, and direct reporting – who can bill under which provider in a compliant manner
• New 2022 CMS changes to split/shared billing and modifier

12:00PM

Adjourn

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Coding Coaches