Live Virtual Evaluation and Management Boot Camp®—Payer Version

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Live Virtual Evaluation and Management Boot Camp®—Payer Version

Product Code: EMPV

The Live Virtual Evaluation and Management Boot Camp®—Payer Version teaches coding and auditing professionals in the payer setting how to interpret documentation relative to national guidelines, apply rules accurately, and ensure appropriate E/M category and level assignment.

Live Virtual Evaluation and Management Boot Camp®—Payer Version

Course Overview

Looking for payer-specific resources? We have them!

Payer-specific evaluation and management coding training from HCPro, the most trusted name in coder education

Best-in-class E/M education for professionals in the payer setting

For the first time in more than two decades, there are huge changes to evaluation and management (E/M) office or other outpatient visit code categories (99202–99215). CY 2021 brought a new model of coding, documentation, and payment.

This class will bring payer professionals up to speed!

The Live Virtual Evaluation and Management Boot Camp®—Payer Version teaches coding and auditing professionals in the payer setting how to interpret documentation relative to national guidelines, apply rules accurately, and ensure appropriate E/M category and level assignment.

This course is ideal for coders on the payer side who verify the accuracy of codes submitted for reimbursement, as well as assess fraud, waste, and abuse related to E/M services.

In this in-depth class taught by our nationally recognized coding instructors, you will learn how to:

  • Assess the correct category of E/M codes based on the documentation provided
  • Utilize the documentation requirements for all key component–based codes
  • Apply the CY 2021 options of selecting levels of E/M codes based on time or medical decision-making
  • Assess the placement of appropriate modifiers to E/M codes
  • Measure application of “teaching physician” rules correctly
  • Analyze how to code and reimburse appropriately for nonphysician practitioners
  • Examine application of coding guidance to payer policy
  • Prepare for the Certified Evaluation and Management Coder (CEMC) exam


Ensure your E/M coding knowledge stays up-to-date by not only learning the CY 2021 changes, but also developing the critical understanding of which codes these new guidelines apply to, and which E/M code categories will continue to be assigned based on the 1995 and 1997 CMS E/M documentation guidelines.

Beginning on January 1, 2021, the key components that are traditionally used for the office or other outpatient services (history, exam, and medical decision-making) underwent a major overhaul based on input from CMS and the AMA. Level selection is based on either time or medical decision-making. Learn what activities count as time and obtain a detailed understanding of the three factors that contribute to medical decision-making.

This intensive live virtual course goes beyond the basics and dives right into the many gray areas of E/M to expose conflicting information between the various organizations and government agencies setting the guidelines for these services. Armed with this information, you’ll be able to:

  • Tackle the subjectivity associated with the most commonly reported CPT® codes—E/M services
  • Accurately interpret the rules


Our experienced instructors lead this interactive class that includes practical scenarios and plenty of time for questions answered.

See the HCPro difference for yourself!

  • Expertly 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.


Need to train a group?
Bring our industry-leading instructors to your facility to teach one of our existing boot camps or a program customized specifically for your organization.

In addition to best-in-class regulatory and compliance education, hosting an on-site class gives your staff:

  • Access
    Our instructors are all yours, so you can ask them questions and apply concepts specific to your organization.
  • Consistency
    Bring staff together to hear the same message—everyone leaves with the same understanding of the regulations.
  • Unmatched knowledge
    Each instructor has years of both in-the-field and adult education experience. They know exactly how to simplify the complex issues facing your staff.


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


Looking to train your whole team? We can bring our expert instructors to you! Learn more here!

Live Virtual Evaluation and Management Boot Camp®—Payer Version

Outline/Agenda

Module 1: Introduction to E/M

  • SOAP vs. CHEDDAR notes
  • New vs. established patients
  • E/M in group practices
  • Telehealth services
  • E/M associated modifiers
    • -24 (unrelated evaluation and management service by the same physician during a postoperative period)
    • -25 (significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service)
    • -32 (mandated services)
    • -57 (decision for surgery)
    • -Q5 and -Q6 (reciprocal and fee for time)


Module 2: Introduction to E/M Categories

  • Office or other outpatient services
  • Consultations
    • Office or other outpatient consultations
      • Medicare guidance
    • Inpatient consultations
      • Medicare guidance
  • Hospital inpatient services
    • Initial hospital care
    • Subsequent hospital care
    • Hospital discharge day management
    • Observation or inpatient services (admission and discharge on same date)
  • Hospital observation services
    • Initial observation care
    • Observation care discharge services
  • Time-based codes
    • Critical care services
      • Bundled services
      • Time calculation
      • Separately reportable procedures
    • Prolonged services
  • Age-based codes
    • Preventive medicine services
      • Annual physicals
    • Inpatient neonatal and pediatric
      • Critical care services
      • Initial and continuing intensive care services
  • Newborn care services
  • Emergency department services
  • Nursing facility services
  • Care management services


Module 3: Assigning E/M levels Based on Key Components & Time

  • History
    • Chief complaint
    • History of present illness
      • 1995 vs. 1997 (difference)
    • Review of systems
    • Past personal/family/social history
  • Examination
    • 1995 (organ system & body areas)
    • 1997 (exam types by “counting bullets”)
  • Medical decision-making
    • Number of presenting problems
    • Data ordered/reviewed
    • Table of risk
  • Counseling and coordination of care
  • CY 2021 E/M office visit level selection based on time or medical decision-making
  • Incident-to
  • Split/shared visits
  • 99211 reporting
  • Physician at teaching hospital (PATH) rules
    • Time-based codes for teaching physicians


Module 4: Case Studies


Course Agenda/Outline subject to change.

Live Virtual Evaluation and Management Boot Camp®—Payer Version

Learning Objectives

At the conclusion of this educational activity, participants will be able 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
  • Interpret national and local carrier guidelines

Live Virtual Evaluation and Management Boot Camp®—Payer Version

Questions/Answers

What is the focus of the Live Virtual Evaluation and Management Boot Camp®—Payer Version?
The Live Virtual Evaluation and Management Boot Camp®—Payer Version will teach you the fundamentals and intricacies of E/M coding. The course goes beyond the basics and dives right into the many gray areas of E/M to expose conflicting information between the various organizations and government agencies setting the guidelines for these services. This intensive training course is geared to both coding and auditing professionals. The class will show how to evaluate documentation relative to national guidelines with a strong emphasis on interpreting rules accurately.

What is the live virtual class format?
The live virtual boot camp is instructor-led education that can be accessed from the comfort of your own home. Classes are led by our expert instructors, typically take place over the course of a week or two, and allow instructor/student interaction and engagement.

How long does the course last?
The live virtual course runs from 12:00 p.m. ET/9:00 a.m. PT until 4:30 p.m. ET/1:30 p.m. PT Monday–Friday for one week. Each day involves four hours of education plus one 30-minute break.

What computer setup do I need to attend the course?
This course will be hosted on the GoToMeeting® platform. You should have access to a computer that has a microphone and speakers to participate. There is also an option to dial in over a phone line if you need to connect on your phone. You can read the full system requirements for GoToMeeting by visiting https://support.goto.com/meeting/help/system-requirements-for-attendees-g2m010003. You can also test your system by visiting https://support.logmeininc.com/gotomeeting/get-ready.

Does HCPro offer the Live Virtual Evaluation and Management Boot Camp®—Payer Version as an on-site course?
In addition to our open registration courses, we also offer this boot camp as an on-site program (with a substantial discount) for organizations that have a number of employees who need training. For more information on hosting an on-site boot camp, click on Host an On-Site Course.

What if I need to cancel or transfer my registration?
Please click here to view our cancellation policy.

Who typically attends the Live Virtual Evaluation and Management Boot Camp®—Payer Version?

  • Auditors and claim review personnel
  • Coders and billers
  • Benefit integrity staff
  • Fraud, waste, and abuse staff
  • Case managers/care managers
  • Physicians, NPs, PAs, and other clinicians
  • Compliance officers and auditors
  • Finance and reimbursement managers/staff
  • Healthcare consultants, CPAs, and lawyers
  • Health plan and insurance company personnel
  • Medicare carrier and intermediary personnel


What material does the course cover?
To view the course outline, click on the Course Outline tab above.

Does the course require any previous coding experience?
No. The course starts with coding fundamentals and does not assume that participants have any particular background or experience. However, because of the fast-paced nature of the course, it is recommended (but not required) that Live Virtual Evaluation and Management Boot Camp®—Payer Version participants have at least one year of experience working in the healthcare industry in a billing/review/audit-related, administrative, or clinical position.

How is the course taught?
The course is taught using a combination of lecture, class discussion, and case studies.

You will need a current CPT manual for the class. You may order this book through HCPro by clicking here.

Does this course cover both professional and technical E/M coding?
No. This course focuses on the professional services portion of E/M coding only.

Does HCPro ever share contact information (e.g., name, address, phone number, email address, etc.) with other companies?
Historically, we have not shared contact information with anyone outside of our company. However, it is possible that at some point we might share contact information with other companies that offer products and services that we think would be of interest to our customers. If you would like us to keep your contact information confidential, please let us know so that we can flag your information in our customer database as "Do Not Share."

How do I get more information?
Contact our sales team at 615-724-7200 or email PD-IS@SimplifyCompliance.com.