Spotlight On Office Procedure and E/M Coding


*agenda subject to change

7:00AM — 8:00AM

Check-in and Breakfast (provided)

8:00AM — 10:00AM

Payment for Surgical Services 

  • Global surgical package for major and minor procedures
  • Pre-op and post-op services that are—and aren’t—part of the global payment
  • Don’t lose revenue and don’t risk an audit using E/M modifiers 24, 25, & 57
  • Know the key difference between CPT and CMS definition of the global package
  • Coding scenarios

Medicare Physician Fee Schedule

  • Update to CMS coding policies for 2019
  • Relative Value Units (RVUs)
  • Status indicators
  • Update on telecommunication coding NEW!
  • Keep informed about changed teaching physician rules UPDATE!

Category of E/M Services

  • Avoid denials by selecting the correct category of code
  • Consultation codes — Many payers still accept CPT consult codes
  • Inter-professional consultation codes NEW!
  • Coding scenarios
  • Use these reference sheets to select the correct type of service to report

10:00AM — 10:15AM


10:15AM — 12:00PM

Level of E/M Services

  • Code the level of service that is documented and supported by medical necessity
  • Selecting your code based on documentation
  • How to differentiate straightforward, low, moderate and high medical decision making
  • Using time to select a code
  • Update to CMS’s documentation rules for office services NEW!
  • Documenting inpatient, observation and emergency department services

Critical Care

  • Critical care and trauma teams
  • Determine when critical care is part of the global payment and when it isn’t
  • Understand the difference between CPT and CMS rules for critical care

Screening Colonoscopy

  • HCPCS and CPT codes for screening colonoscopy
  • Change in plans: Coding when a screening results in a procedure
  • Use of modifiers 33 and PT
  • Diagnosis coding for screening colonoscopy NEW!

12:00PM — 1:00PM


1:00PM — 2:15PM

Surgical Procedures Commonly Done in the Office

  • Excision of benign and malignant lesions
  • New CPT codes for fine needle aspiration and incisional biopsies NEW!
  • Laceration repair
  • Wound care and debridement
  • Wound care cases
  • Hyperbaric oxygen therapy NEW!

2:15PM — 2:30PM


2:30PM — 3:15PM

Diagnosis Coding NEW!

  • Establishing medical necessity for a service
  • Anatomy of a payment policy
  • Risk-adjusted diagnosis coding and HCCs
  • Signs, symptoms, screening and surveillance

3:15PM — 4:00PM

Practice Management

  • Coding related denials
  • Fee schedule analysis
  • Surgical deposits
  • Customer service in the billing and coding departments

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Coding Coaches