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As expected, the AMA has revised the definitions and guidelines for hospital and other E/M services, including ED visits, nursing facility services, home services, and domiciliary care codes. They extended the documentation framework in place for office visits to these codes. They also deleted twenty-five codes. Coding for prolonged care services gets another overhaul, with four deleted codes, one new code, and revised guidelines. Join us for this webinar to hear about these changes which are effective January 1, 2023.

After the presentation participants will be able to:

• Describe the AMA guidelines for initial and subsequent hospital care services and apply them to their practice
• Identify the two factors in selecting a level of service for hospital visits
• Name one difference between CPT an AMA policy on prolonged care codes

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Some parts of Medicare’s 2023 proposed rule are entirely predictable. The conversion factor is less than last year’s conversion factor. But there are a few things that are unexpected. They propose to continue to allow flexibility in determining the substantive portion for selecting a shared/split service for another year. There is a long section on rules for hospital, observation, and home services and additional changes to prolonged care codes. These E/M changes are in response to the 2023 CPT^® changes. This webinar will describe the policy proposals in the 2023 Proposed Physician Rule.

At the end of the session, participants will be able to:

• Describe the timeline for comments and the final rule
• List policy changes that will affect their practices in the next year

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Administrators managing both fee-for-service and value based payment contracts must maximize revenue and minimize risk in coding for services performed in their practices. Administrators—who aren’t coders—can accomplish this through by knowing where to find definitive answers and how to assess citations and conflicting information that is presented. Source citations from CPT, CMS and ICD-10-CM have the highest priority, while secondary sources can include specialty societies and professional organizations. This webinar will provide a framework for administrators when they are called about to mediate coding disagreements within their practices.

After the session, participants will be able to:

• Identify and access definitive citations
• Minimize risk and maximize revenue in their coding policies
• Develop a process to resolve coding disagreements that arise in their practice