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Duration - 60 minutes
Speaker - Lynn M. Anderanin
Over the last couple of years, the Evaluation and Management section of CPT® has had some drastic changes, and 2024 is no exception. In an effort to reduce the time it takes to document and streamline the work involved, in 2024 revisions are being made to clarify issues with the new documentation guidelines. There also is a new CPT® code added to the E&M section that some providers will be able to take advantage of. In 2024, there also are changes being made in the CMS Physicians Fee Schedule Final rule that affect some E&M services when they are performed via telehealth now that the Public Health Emergency has ended.
Webinar Objectives
The E&M codes are an important part of nearly every physician specialty having to do with the actual visit with the patient. The E&M services require the review of the medical documentation for determination of the level of service either by time or medical decision making. The method used can be chosen by the provider from one patient to another. The difference in reimbursement between the levels can be substantial. We will look at what changes were made, as well as some common areas of concern. Insurance companies also perform audits to prove fraud and abuse which could lead to refunds and denials, along with possible penalties.
Webinar Agenda
This session will look at the changes and determine what must be changed in the documentation to meet the requirements. If the documentation is not appropriate, then it may be considered not done. Some may be responsible for educating other staff, so fully understanding what is needed is an important to know and share with others.
Webinar Highlights
Duration - 60 minutes
Speaker - Toni Elhoms
Split/shared services are one of the most misunderstood categories of billing and reporting. For evaluation and management (E/M) visits jointly furnished by a physician and NPP in the same group practice in a facility setting, CMS has historically allowed the visit to be billed under the physician's NPI. However, all of that changed in 2022 and 2023 (transitional years) with updated rules that disallowed this practice and required the visit to be billed under the NPI of the physician or NPP who either documents the history, exam, or medical-decision-making for the visit OR whoever provides more than 50% of the total service time. In 2024, the changes are even more drastic, now requiring the visit to be billed under the NPI of the individual who provides more than 50% of the total visit time. This changes everything about how these encounters are billed and dramatically impacts physician RVU allocation. The 2024 split/shared service updates will have a massive impact on providers' clinical documentation and reimbursement rates.
Join us for this information-packed webinar by Toni Elhoms, CCS, CPC, CPMA, CRC, AHIMA-Approved ICD-10-CM/PCS Trainer, and take a deeper dive into the 2024 split/shared service updates along with the discussion on the proper application of the 2024 guidelines, clinical documentation requirements, and dissect clinical documentation scenarios to map out how this will look for medical practices in 2024.
Webinar Objectives
The session aims to provide insights into the new 2024 split/shared visit rules in the facility setting, as announced by the Centers for Medicare & Medicaid Services (CMS). These groundbreaking changes are set to have a substantial impact on Medicare reimbursement, affecting both hospital-employed providers and physician practices utilizing non-physician practitioners (NPPs) in the facility setting.
Webinar Agenda
Webinar Highlights
Duration - 60 minutes
Speaker - Jill M.Young
CMS/Medicare and CPT have been in different places with their definition of "substantive portion" for a split shared visit. It was anticipated that in 2024 CMS/Medicare would again have a different way of looking at which provider can bill this type of joint service when done in a facility setting. The PFS Final rule surprised many as CMS/Medicare said they would be following the new clarified policy set forth in CPT's 2024 code book. What is this new definitions of "substantive portion" and what does it mean for your NPs and PAs working in the hospital and other facility based locations? Listen in and learn. Bring your questions with you
The rules of billing for Nurse Practitioners and Physician Assistants can be confusing and challenging. Each payer can have their own definitions for direct and indirect billing of their services. Comparing these rules reveals a diverse and oft times confusing list of what compliant billing of these provider’s indirect services entails.
CMS has been transitioning their definition of split/shared visits for the past few years in calling for a substantive portion of the work to be done by the billing provider while allowing an alternative definition. Although this has been extended until the end of 2024, CPT®’s new definition causes much discussion on where their rules would fall into place with CMS'.
Webinar Objectives
Compliant billing of Non-physician Practitioners (NPPs) is no easy task. Dealing with differing sets of payer rules can give coders and billers fits. This session is intended not only to present a simplified view of NPP billing, but also to show how the updated guidelines CPT® has defined will integrate into this landscape.
Webinar Agenda
2024 CPT® updates to split shared billing. what we know today about this new definition from the AMA and how they see the day-to-day documentation changes needed to meet it.
Split shared billing’s definition from CMS’ perspective. What challenges are presented in the differing words of each
Webinar Highlights
Duration - 60 minutes
Speaker - Jill M.Young
Each year the AMA releases revisions, deletions and additions to its CPT ® coding book. There are 153 new codes for 2024. Included in the new codes are several in the Surgery subsections such as the Musculoskeletal, Respiratory, Cardiovascular, Urinary, Female Genital and Nervous Systems. There are also new codes in the Radiology section as well as the Pathology and Laboratory sections. Several of the new codes are Category III codes that are being “upgraded” to Category I codes or regular CPT ® codes.
The 2024 edition of CPT ® also has 349 editorial changes scattered throughout the book along with 49 deleted and 70 revised codes. Some of the revisions are in unlisted codes, those ending in 99 that are found in sections throughout The CPT ® book.
Most noteworthy is the CPT ®’s definition of split shared visits. The AMA has opened up a bit of a can of worms in this by offering entirely new scenarios for split shared visits that digress significantly from the ones that CMS has. Joined this webinar to know more about the code changes.
Webinar Objectives
Each year practices need to be aware and understand the implications of the coding changes that are released. A code in 2023 that was appropriate for use, may not be in 2024 because of a new code, revised guidelines or a revision in the text of the code itself. Lost revenue can easily occur in these situations because of mis-coding and the need to appeal. This session will walk the listener through the changes released for 2024 and give them a better understanding of the codes. This will give them better options in making sure their code assignment is compliant.
Webinar Agenda
Starting with the new definition CPT ® has for split shared visits, a brief discussion of how it varies from CMS’ will ensue. Then the presenter will go through the various sections of the CPT ® book, making note of not only new codes but changes in language and changes in guidelines.
Webinar Highlights
Duration - 60 minutes
Speaker - Toni Elhoms
The process of enrolling with Medicare as a provider/organization can be incredibly tedious and time-consuming. Even though Medicare is the largest insurer in the country, the number of new Medicare enrollment applications continues to decline due to the enormous complexities surrounding enrollment application requirements. The cost of getting these enrollment application submissions wrong can have systemic consequences on an organization, including cash flow delays, credentialing issues, coding issues, denial management issues, patient satisfaction, and even impact quality scores. In this webinar, we discuss the submission options, which providers are eligible for Medicare enrollment, each form type applicable in 2024, how to navigate the 2024 complicated form sections, key terminology, what ancillary documentation is needed with enrollment submission, applicable fees, most common errors, and best practice tips for successfully completing the 2024 CMS 855 forms.
Webinar Objectives
Webinar Agenda
Webinar Highlights
Duration - 60 minutes
Speaker - Jill M.Young
The Final Rule for the Medicare Physician Fee Schedule for 2024 has been released giving us information needed for the upcoming year for services. This final rule details what Medicare/CMS will be making in the way of changes to any HCPCS (and CPT) codes for the upcoming year. This includes both policies and procedures as well as codes. Understanding which are the appropriate codes for 2024 is an important piece of an office’s preparation for the new year. Not only can new codes be added to the PFS, but code descriptors can change along with the policies and procedures CMS/Medicare defines for us to use. For example, that are continuing Public Health (PHE) flexibilities under the Medicare Diabetes Prevention Program (MDPP) Expanded Model. This means that although the PHE ended earlier in 2023, there will be “exceptions” or “allowances” to the MDPP program in 2024 that CMS/Medicare is defining.
Also, this webinar will give tips on how to search and access information in the final rule document, which is over 2,000 pages. Our expert speaker will also offer her personal comments on finding hidden gems of information within the rule.
Webinar Objectives
The Physician Fee Schedule (PFS) final rule is a powerful document that is often overlooked in an office educating itself for the upcoming year. Medicare has its own policies and procedures that may be defined or updated within this final rule. If an office does not identify what changes, specific to their Medicare patients are happening, problems such as improper billing and coding of services, missing modifiers and ultimate lost revenue can occur. Looking at the highlights below, one will see what will be covered in offering solutions to problems that may occur in 2024 with Medicare patients. One of the most significant of which is use of the Visit Complexity Add on code. This is not a code for all physicians to use. In fact, CMS/Medicare is very specific in instructing who should use this code and how often. A very important discussion to hear.
Webinar Highlights
The Physician Fee Schedule (PFS) Final Rule Highlights include the topics of
Who Should Attend
Coders, auditors, billers, compliance, physicians, Physicians Assistants, Advanced Nurses, Medical Assistants, Scribes, Medical Coding Specialists, Medical Billing Specialists, Medical Auditing Specialists, Private Practice Physicians, Managed Care Professionals, Operations Leadership, Practice Administrators, Office Managers, Compliance Officers/Committees, Chief Medical Officer, Credentialing Specialists, Enrollment Specialists, Contracting Specialists, Operations Leadership, Practice Administrators, Office Managers, Medical Practices, Accountable Care Organizations, Medical Societies, Medical Associations
Lynn Anderanin, CPC, CPB, CPPM, CPMA, CPC-I, COSC, has over 35 years’ experience in all areas of the physician practice, specializing in Orthopedics. Lynn is currently a Workshop and Audio Presenter. She is a former member of the American Academy of Professional Coders (AAPC) National Advisory Board, as well as several other boards for the AAPC. She is also the founder of her Local Chapter of the AAPC.
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Jill M Young is the Principal of Young Medical Consulting, LLC. A company founded 18 years ago to meet the education and compliance needs of physicians and their staff Jill has over 40 years of medical experience working in all areas of the medical practice including clinical, billing and rounding with physicians. Her unique style of working with physicians is not only effective but helps bridge the gap between coders and physicians from a practical perspective. Her comments and opinions can be seen in several publications and also heard on a variety of audio-conferences. Her background gives her a unique style of teaching using real life examples of coding and…
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Toni Elhoms, CCS, CRC, CPC, AHIMA-Approved ICD10-CM/PCS Trainer is a nationally known speaker and recognized subject matter expert on medical coding, reimbursement, and revenue cycle management. She is the Founder and CEO of Alpha Coding Experts, LLC. She holds multiple credentials with the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). With over a decade of industry experience, she has led and supported hospital systems, universities, physician practices, payers, government agencies, and other entities on coding, billing, and compliance initiatives. She is a frequent contributor to various…
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| Nov 13, 2024 | The Future of Telehealth: 2025 Changes | 60 Mins | $199.00 | |
| Nov 13, 2024 | Telehealth in 2025: Key Changes, Insurance Denials and Effective Appeal Strategies under CMS's New Physician Fee Schedule | 180 Mins | $399.00 | |
| Oct 08, 2024 | Insurance Denials - Understand How To Appeal, Track & Never Lose Money From Payers | 60 Mins | $199.00 | |
| Sep 11, 2024 | Understanding Coding for Injections and Infusions | 60 Mins | $199.00 | |
| Aug 28, 2024 | CMS 2025 Proposed Physicians Fee Schedule | 60 Mins | $199.00 | |
| Aug 07, 2024 | Demystifying Insurance: Breaking Down Complex Terms and Policies! | 60 Mins | $199.00 | |
| Jul 16, 2024 | Future-Proofing Your Practice: 2024 E&M Revisions, CMS 2025 Proposals, and Efficient Use of Modifier 22 | 180 Mins | $399.00 |