Arizona Rural Health Center - Evaluation & Management Auditing Bootcamp
This interactive 2-day training is intended for healthcare practitioners, medical billers, coders, auditors, office managers and IT professionals involved with authoring clinical documentation, generating E&M progress notes, auditing professional physician service claims and maintaining a healthy revenue cycle. The primary course focus will emphasis documentation guidelines set forth by CMS for reporting Evaluation and Management services (E&M), as defined by CPT. The curriculum will provide attendees with a strong grasp of Evaluation and Management auditing, coding and documentation techniques.
The curriculum is designed to assist in development and mastery of the necessary skill set to successfully audit Evaluation and Management (E&M) services. This education and training has been designed to promote compliance and minimize the risk mitigation associated with post-payment review and 3rd party audit exposure.
Curriculum specifics will include:
• The “Key Components” associated with E&M code selection
• The differences between the CPT and CMS E&M documentation guidelines
• Discuss the use of utilization benchmarks to target potential risk areas
• Explain the differences between the 1995 and 1997 examination guidelines
• Determining the complexity of medical decision making (MDM)
• The importance to ‘link’ ICD-10-CM codes to E&M services
• Risks associated with certain EHRs solutions (e.g, “wizards”)
• Distinguishing “problem-oriented” from “preventive” E&M services
• What to look for when modifiers are reported with E&M services (e.g., -25)
• How to use a well-constructed audit template to conduct reviews
• Key steps to present audit findings to providers successfully and non-confrontationally