Medicare vs. CPT Policy for E/M, Split/Shared and Prolonged Visits: Manage Two Systems With Ease

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Medicare vs. CPT Policy for E/M, Split/Shared and Prolonged Visits: Manage Two Systems With Ease

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Medicare vs. CPT Policy for E/M, Split/Shared and Prolonged Visits: Manage Two Systems With Ease

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Presented on: Wednesday, February 22, 2023 | 1:00–2:00 p.m. Eastern

Presented by: Nancy Enos, FACMPE, CPC-I, CPMA, CEMC, CPC emeritus

How are you handling the two sets of policies for E/M, split/shared visits and prolonged services?

Medicare kept billing policies for facility visits that don’t match the new CPT® guidelines. But that’s not all. Practices must apply two split/shared definitions to visits performed by a physician and a qualified health care professional and manage different times and codes for prolonged services.

Practices that don’t have a solid plan for following both sets of policies will experience a cascade of denials and improper payments from Medicare and private payers. This 60-minute webinar will show you where CPT guidelines and CMS rules don’t match up and give you tips for managing both systems with ease.

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

  • Report inpatient, observation, emergency department and nursing facility visits with the correct policy.
  • Train staff to follow both policies for combined E/M visits by a physician and a qualified health care professional.
  • Accurately calculate time and select codes for prolonged services.


Agenda

  • Tips for implementing Medicare’s rules and the new CPT guidelines.
    • E/M in the facility. Understand where Medicare rules and CPT policy don’t match for visits in the inpatient, observation, emergency department and nursing facility settings.
    • Split/shared visits. Learn the difference between the CPT guidelines for coding and Medicare’s rules for billing services by a physician and a qualified health care professional.
    • Prolonged services. Compare Medicare’s four codes and time calculations to the CPT policy for two codes.
  • Live Q&A. Ask our speaker how to manage these two similar but different policies.

Who Should Listen?

  • Coders
  • Billers
  • Compliance staff
  • Consultants

Meet the Speaker

Nancy M. EnosNancy M. Enos, FACMPE, CPC-I, CPMA, CEMC, CPC emeritus, is an independent consultant with the MGMA Health Care Consulting Group and a principal of Enos Medical Coding. Enos has 40 years of experience in the practice management field. She was a practice manager for 18 years before she joined LighthouseMD in 1995 as the director of physician services and compliance officer. In July 2008, she established an independent consulting practice, Enos Medical Coding. As an Approved PMCC and ICD-10 Instructor by the AAPC, Enos provides coding certification courses, outsourced coding services, chart auditing, training and consultative services and seminars in CPT® and ICD-10 coding, E/M coding and documentation, and compliance planning. Enos frequently speaks on coding, compliance, and reimbursement issues to audiences including national, state, and sectional MGMA conferences, and at hospitals in the provider community specializing in primary care and surgical specialties. Enos is a Fellow of the American College of Medical Practice Executives (ACMPE) and served the ACMPE as a college forum representative.

Continuing Education

 BMSC
This program is approved by the Board of Medical Specialty Coding & Compliance (BMSC) for 1 CEU(s).

Ability to claim credits for this webinar expires on: 2/21/2024

Instructions

Webinar system requirements and program materials: 
To fully benefit from the webinar experience, please note you will need a computer equipped with the following:

Browser: Microsoft Internet Explorer or Edge, Firefox, Chrome, or Safari, with JavaScript enabled 
Internet: Internet connection (high-speed connection recommended) 
Streaming: Access audio/video streaming from any browser on a computer, mobile, or tablet device

Prior to the webinar, you will receive an email with detailed system requirements, your login information, presentation slides, and other materials that you can print and distribute to all attendees at your location. 

CAN'T LISTEN LIVE? 
No problem. The On-Demand version will be available. Use it as a training tool at your convenience—whenever your new or existing staff need a refresher or need to understand a new concept. Play it once or dozens of times. A $199 value! 

PLEASE NOTE 
Participation in the webinar is just $199 per site. All materials must be retrieved from the Internet.

Call your customer service representative toll-free 800-650-6787 or email customerservice@hcpro.com if you have questions.