Medical Auditing Boot Camp and Evaluation and Management Boot Camp—Professional Version

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Medical Auditing Boot Camp and Evaluation and Management Boot Camp—Professional Version

Product Code: MABC


1st Attendee $1,399.00*
Additional Attendee(s)
Save -$100.00$1,499.00 each

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$1,399.00
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Medical Auditing Boot Camp and Evaluation and Management Boot Camp—Professional Version

Evaluation and Management Boot Camp—Professional Version

The Evaluation and Management Boot Camp—Professional Version™ provides detailed information on the intricacies of E/M coding and teaches you how to perform effective audits.

This intensive two-day course goes beyond the basics and dives right into the many gray areas of E/M to make sense of conflicting information between CMS and local carriers. Armed with this information, you’ll be able to:

  • Tackle the subjectivity associated with the most commonly reported (and audited!) CPT® codes—E/M services
  • Accurately interpret the rules
  • Maximize E/M audits

The Evaluation and Management Boot Camp—Professional Version teaches coders, billers, auditors, and practice managers how to interpret documentation relative to national carrier guidelines, apply rules accurately, and ensure appropriate E/M category and level assignment.

You will learn how to:

  • Select the correct E/M codes based on the documentation provided
  • Explain the documentation requirements for all E/M levels
  • Append appropriate modifiers to E/M codes
  • Apply "teaching physician" rules correctly
  • Identify key areas to conduct a successful E/M audit
  • Interpret national and local carrier guidelines
  • Prepare for the Certified Evaluation and Management Coder (CEMC) exam

See the HCPro difference for yourself!

  • Custom-designed course materials: Materials are developed by our instructors specifically for this intensive learning format.
  • Hands-on learning: Attendees complete a set of exercises/case studies after appropriate modules to ensure that they understand the concepts and know how to apply them to real-world situations.
  • Small class size: Class size is limited to ensure individual attention.
  • Nationally recognized educators: HCPro is the nation's premier organization offering boot camp training courses to healthcare coding professionals.


Medical Auditing Boot Camp—Professional Services

Become a pro at assigning, verifying, and auditing E/M codes.

The Medical Auditing Boot Camp—Professional Services™ provides detailed information on the intricacies of E/M coding and teaches you how to perform effective audits.

This intensive two-day course goes beyond the basics and dives right into the many gray areas of E/M to make sense of conflicting information between CMS and local carriers. Armed with this information, you’ll be able to:

  • Tackle the subjectivity associated with the most commonly reported (and audited!) CPT® codes—E/M services
  • Accurately interpret the rules
  • Maximize E/M audits

The Medical Auditing Boot Camp—Professional Services teaches coders, billers, auditors, and practice managers how to interpret documentation relative to national carrier guidelines, apply rules accurately, and ensure appropriate E/M category and level assignment.

You will learn how to:

  • Select the correct E/M codes based on the documentation provided
  • Explain the documentation requirements for all E/M levels
  • Append appropriate modifiers to E/M codes
  • Apply "teaching physician" rules correctly
  • Identify key areas to conduct a successful E/M audit
  • Interpret national and local carrier guidelines
  • Prepare for the Certified Evaluation and Management Coder (CEMC) exam


For more detailed information about HCPro's Boot Camps, contact customer service at 800-650-6787 or email customer@simplifycompliance.com.

Medical Auditing Boot Camp and Evaluation and Management Boot Camp—Professional Version

Course Locations & Dates

Below is the current course schedule for Evaluation and Management Boot Camp. We update this schedule on a regular basis.

Registrations are processed in the order received. Class size is limited and classes often sell out. We recommend against making travel arrangements until after we have confirmed your course registration.

To register for a class, click the "Register" button.
If you would like to register multiple attendees (large groups), call 800-650-6787 for assistance.

Locations marked as "Tentative" are subject to change.

To view our cancellation policy, click here.

October 2020


Nashville, TN

 

October 5 - 9, 2020
8:00AM – 5:00PM  (Days 1-3)
8:00AM – 3:00PM  (Day 4)

Hyatt House® Nashville at Vanderbilt
2100 Hayes Street
Nashville, TN 37203
615-320-9000
Hotel website


Room Rate: $165/night
Room Rate Cut-Off: September 4, 2020

 

November / December 2020


Scottsdale (Phoenix), AZ

 

November 30 - December 4, 2020
8:00AM – 5:00PM  (Days 1-3)
8:00AM – 3:00PM  (Day 4)

Homewood Suites by Hilton Scottsdale
9880 North Scottsdale Road
Scottsdale, AZ 85253
480-368-1200
Hotel website


Room Rate: $130/night
Room Rate Cut-Off: October 30, 2020

 

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Medical Auditing Boot Camp and Evaluation and Management Boot Camp—Professional Version

Outline/Agenda

Module 1 – Overview of Professional Services Auditing and ICD-10-CM, CPT, and HCPCS Coding Concepts

  • Demonstrate an understanding of professional service auditing, its purpose and types of audits performed
  • Be able to identify the coding systems applicable to professional medical record audits
  • Be able to locate and utilize source authorities required for professional medical record auditing
  • Demonstrate an understanding of available medical record audit certifications available
  • Be able to articulate the role of the auditor


Module 2 – Documentation Guidelines and Medical Records

  • Demonstrate an understanding of HIPAA Overview and Privacy Rule
  • Be able to understand the medical record as a legal documentation
  • Be able to identify the necessary components of medical record documentation
  • Be able to identify documents and forms of the medical record: Registration, Benefit Assignment, Privacy Notice Receipt, Release of Information, Advanced Beneficiary Notices, Notice of Non-coverage, and Consent
  • Be able to demonstrate an understanding of the documentation requirements of operative reports, diagnostic testing and laboratory reports
  • Be able to abstract, audit, and verify the medical record based on type of service
  • Be able to correctly interpret teaching physician guidelines and demonstrate an understanding of documentation requirements


Module 3 – Evaluation and Management Categories

  • Be able to identify the categories of E/M codes
  • Be able to apply the CPT E/M category guidelines
  • Be able to define the common symbols and terms used in the CPT book
  • Be able to accurately assign Evaluation and Management codes by category
  • Be able to accurately assign appropriate E/M modifiers


Module 4 – Evaluation and Management Level Assignment

  • Be able to identify history of present illness (HPI) terms and definitions
  • Be able to identify terms in documentation and assign them to the HPI
  • Be able to understand and apply the HPI documentation guidelines
  • Be able to identify the review of systems (ROS)
  • Be able to understand and apply the review of system documentation guidelines
  • Be able to identify past personal, family, social, history (PFSH)
  • Be able to identify terms in the documentation and assign them to the PFSH
  • Be able to assign the overall history using the history elements
  • Be able to identify organ system and body areas of the examination
  • Be able to understand and apply the examination guidelines appropriately
  • Be able to understand and apply the medical decision making elements
  • Be able to assign Evaluation and Management codes by level
  • Be able to apply E/M knowledge and effectively utilize E/M tools


Module 5 – Elements of Surgical and Other Professional Services

  • Be able to apply correct coding for surgical, radiology, pathology, and medicine services
  • Be able to correctly append surgical service modifiers
  • Be able to correctly assign CPT and HCPCS Level II modifiers
  • Be able to identify a “Separate Procedure” and when they are reported
  • Understand the auditor’s role in determining medical necessity
  • Identify National and Local Coverage Determinations


Module 6 – National Correct Coding Edit Initiative (NCCI)

  • Be able to present an understanding of NCCI and MUE edits
  • Be able to access NCCI files and NCCI policy manual
  • Demonstrate an understanding of PTP, MUE and Add-on Code Edits files
  • Identify NCCI associated modifiers
  • Be able to apply NCCI edits accurately to ensure correct coding


Module 7 – The Audit Process

  • Be able to demonstrate an understanding of types of audits
  • Be able to identity audit process and associated steps
  • Demonstrate an understanding of audit sampling: random, focused, and statistically valid
  • Be able to identify audit type based on audit focus
  • Be able to demonstrate an understanding of coding vs. payer guidance
  • Be able to understand the importance of E/M bell curve profiling and how to use the information as a guide for audit and compliance
  • Be able to demonstrate and understanding of implementation of audit findings
  • Be able to identify components of a corrective action plans
  • Be able to identify self-disclose audits and demonstrate and understanding
  • Demonstrate and understanding of Corporate Integrity Agreements and the role of Independent Review Organizations


Module 8 – Regulations, Statutes, and Compliance

  • Demonstrate an understanding of the following Federal regulations: False Claims Act (FCA), Anti-Kickback Statute (AKS), Physician Self-Referral Law (Stark Law), Civil Monetary Penalties Law, Exclusion Statute
  • Be able to identify the Civil Monetary Penalties associated with specific violations and entities
  • Be able to understand the role and function of the Office of the Inspector General
  • Demonstrate and understanding of the Office of Inspector General’s Compliance Plans
  • Demonstrate an understanding of the Centers for Medicare and Medicaid Services program oversight
  • Be able to understand the role and function of the CMS Recovery Audit Program


Course outline/Agenda subject to change.

Medical Auditing Boot Camp and Evaluation and Management Boot Camp—Professional Version

Learning Objectives

At the conclusion of this educational activity, participants will be able to:

  • Demonstrate an understanding of professional service auditing, its purpose and types of audits performed.
  • Locate and utilize source authorities required for professional medical record auditing.
  • Demonstrate an understanding of available medical record audit certifications available.
  • Articulate the role of the auditor.

Medical Auditing Boot Camp and Evaluation and Management Boot Camp—Professional Version

Instructor

Adrienne Commeree, CPC, CPMA, CCS, CEMC, CPIP, serves as the lead instructor for the Evaluation and Management Boot Camp—Professional Version. She is a regulatory specialist teaching the Certified Coder Boot Camp® programs. As a seasoned instructor, she has extensive knowledge of not only professional services coding guidelines including E/M but she also possesses many years of experience in the healthcare industry, including coding, auditing, training, and compliance expertise for hospital inpatient and outpatient services. Prior to joining HCPro, Commeree was a coding auditor/medical assistance program specialist with the Washington State Health Care Authority (HCA)’s Clinical Review Unit, working within the state’s Medicaid program.

She also served as a coding consultant to other HCA departments by assisting providers, policymakers, and data analysts to identify aberrant coding patterns and potential fraud, waste, and abuse. Before working for Washington, she served as a coding specialist and trauma registrar with Trauma Trust, an organization that serves two major healthcare systems in the Tacoma area by providing Level II trauma and acute care surgical services.


Yvette M DeVay, MHA, CPC, CPMA, CIC, CPC-I, is the lead instructor for HCPro’s Medicare Boot Camp®—Physician Services Version. As a regulatory specialist, she also instructs the Certified Coder Boot Camp® (live and online) and the Evaluation and Management Boot Camp®. DeVay has extensive experience as a professional/outpatient coding consultant. She has assisted physician practices with coding integrity, internal audits, charge capture, and litigation defense. She served as the ICD-10 project manager for a state Medicaid agency, where she established the implementation schedule, steering committees, and workgroups; participated in gap analysis, policy review, and ICD-10 revisions; and oversaw departmentwide ICD-10 awareness and education.

An AHIMA-approved ICD-10-CM/PCS trainer, DeVay is accredited as a Certified Professional Coder, a Certified Inpatient Coder, and a Professional Medical Coding Curriculum (PMCC) instructor by the AAPC. She holds a Master of Health Administration from Seton Hall University and a Bachelor of Science in Applied Behavioral Sciences from Pennsylvania State University.