In 2023 the hospital and nursing facility evaluation and management code documentation guidelines changed to match the American Medical Association CPT guidelines for office and outpatient visits.  There are some of the Hospital Evaluation and Management sections within CPT that do not have the four levels of service in which office and outpatient Evaluation and Management and so that complicates the coding of these visits. Consultations are also part of these changes, but many insurance carriers are not recognizing the codes, but should be reported when the insurance company will reimburse for them. There have also been several updates to the guidelines for 2024 to clarify questions that have come up. These updates will assist in reporting the codes in the appropriate.

Join us for this information-packed webinar by industry expert Lynn M. Anderanin, CPC, CPPM, CPMA, CPC-I, COSC, to have a clear understanding of how to apply not only the 2023 guidelines, but the updates for 2024. This will allow the correct choosing and reporting of Evaluation and Management level of service for visits performed in the hospital and nursing home settings. Insurance carriers are frequently auditing providers to confirm that the levels of service are being reported for these visits, and a negative audit can result in refunds to an insurance company and possibly even monetary fines.

Webinar Objectives

•   Gain a clear understanding of the 2023 updates to hospital and nursing facility Evaluation and Management (E/M) code documentation guidelines, aligning them with the American Medical Association’s (AMA) CPT guidelines for office and outpatient visits.
•   Learn how to apply the 2023 guidelines and the latest updates for 2024 to correctly choose and report the E/M level of service for visits in hospital and nursing home settings.
•   Understand the complexities in coding hospital E/M visits, including sections of the Hospital E/M codes that do not align with office and outpatient E/M codes.
•   Recognize the inclusion of consultations in the updated guidelines and how to report them, even if not recognized by all insurance carriers for reimbursement.
•   Prepare for insurance carrier audits by ensuring accurate reporting of E/M codes, reducing the risk of refunds and fines.

Webinar Agenda

•   Review of the 2023 guidelines and 2024 changes
•   Discuss the available CPT codes by place of service
•   Compare codes within the different sections of CPT

Webinar Highlights

•   Choosing hospital evaluation and management codes by time or medical decision making
•   Looking at the codes base on level of service
•   Understanding the codes by specific facility
•   Review 2024 updates to the documentation guidelines for clarification
•   Shared/split visit rules for these CPT codes.
•   Incorporate the AMA Medical Decision Making table

Who Should Attend

Hospitalist Physicians, Physicians, Physicians Assistants, Advanced Nurses, Coders, Billers, Reimbursement Specialists, Collectors, Claims Adjuster, Case Manager