Medical Coding Basics (Enduring)

The purpose of this presentation is to furnish a high-level review of the official code sets used by physicians (CPT, ICD-10-CM, and HCPCS).  Reporting services rendered, severity of illness, and quality measures, along with the different reimbursement methods based on these code sets will be discussed.  Medical coding is critical to all aspects of healthcare data making compliant physician documentation and accurate code reporting important.

Target Audience

This course is designed for physicians, nurses, and clinical staff

Learning Objectives

1. Obtain a general understanding of the different code sets utilized by providers that becomes data in a standardized format for the different reimbursement models.   

2. Recognize the importance of the provider's role in compliant documentation and coding data that is analyzed to identify the healthcare needs of different populations.

3. Recognize the importance of the provider's role in compliant documentation and coding data where statistics are analyzed for infections or diseases to assist in clinical control and treatment strategies.

 4. Recognize the importance of the provider's role in compliant documentation and coding data for complex actuarial models’ predictions of future health care expenditures.

Course summary
Available credit: 
  • 0.00 AMA PRA Category 1 Credit™
    The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
  • 0.00 ANCC
    UPMC Provider Unit is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation
Course opens: 
08/01/2024
Course expires: 
08/01/2027
UPMC Health Plan Brainshark
United States

Marlana R. Tice, BA, CCS-P, CPC, CCS, AHIMA-Approved ICD-10-CM/PCS Trainer

Program Director, Risk Adjustment-HCC Coding Education

UPMC Health Plan

 

Kalpana Char, MD

AVP, Special Needs Plan Medical Services

UPMC Health Plan

 

Molly Dell, MBA, BSN, RN, CPC

Senior Director, Risk Adjustment Government Rev

UPMC Health Plan

All individuals in a position to control the content of this education activity have disclosed all financial relationships with any companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. All of the relevant financial relationships for the individuals listed below have been mitigated.

CONFLICT OF INTEREST DISCLOSURE

No members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships with any companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

 

DISCLAIMER STATEMENT

The information presented at this CME program represents the views and opinions of the individual presenters, and does not constitute the opinion or endorsement of, or promotion by, the UPMC Center for Continuing Education in the Health Sciences, UPMC / University of Pittsburgh Medical Center or Affiliates and University of Pittsburgh School of Medicine.  Reasonable efforts have been taken intending for educational subject matter to be presented in a balanced, unbiased fashion and in compliance with regulatory requirements. However, each program attendee must always use his/her own personal and professional judgment when considering further application of this information, particularly as it may relate to patient diagnostic or treatment decisions including, without limitation, FDA-approved uses and any off-label uses.

Accreditation Statement:

In support of improving patient care, the University of Pittsburgh is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician (CME)

The University of Pittsburgh designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nursing (CNE)
The maximum number of hours awarded for this Continuing Nursing Education activity is 1.0 contact hour.

Other health care professionals will receive a certificate of attendance confirming the number of contact hours commensurate with the extent of participation in this activity.

Other Health Care Professionals

Other health care professionals will receive a certificate of attendance confirming the number of contact hours commensurate with the extent of participation in this activity.

Available Credit

  • 0.00 AMA PRA Category 1 Credit™
    The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
  • 0.00 ANCC
    UPMC Provider Unit is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation
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