UPMC Health Plan: Provider Documentation for E&M Changes from a Diagnosis Perspective

 

SPECIAL NOTE:
There is no educational content to this course. This course is designed to supplement training that has already occurred. This course is designed to only administer the post-test and collect CME evaluations.


Suggested Additional Reading:

  1. Patients Over Paperwork, Centers for Medicare and Medicaid Services (CMS): https://www.cms.gov/About-CMS/Story-Page/patients-over-paperwork
  2. CPT® Evaluation and Management, American Medical Association (AMA): https://www.ama-assn.org/practice-management/cpt/cpt-evaluation-and-management
  3. Medical Decision Making Table, AMA:https://www.ama-assn.org/system/files/2019-06/cpt-revised-mdm-grid.pdf
  4. CPT® Evaluation and Management (E/M), Office or Other Outpatient (99202-99215) and Prolonged Services (99354, 99355, 99356, 99XXX) Code and Guideline Changes, AMA: https://www.ama-assn.org/system/files/2019-06/cpt-office-prolonged-svs-code-changes.pdf
  5. ICD-10-CM Official Guidelines for Coding and Reporting, CMS: https://www.cms.gov/files/document/2021-coding-guidelines-updated-12162020.pdf
 
 
 
 
 

Target Audience

This course was designed for primary care physicians, physician assistants, and nurses.

Learning Objectives

Upon successful completion of this program, the participant should be able to:

  • Acquire knowledge of the changes to E&M documentation guidelines for 2021 set forth by the AMA-CPT and CMS.
  • Recognize the importance of the AMA-CPT definition of "problem addressed" as it relates to documenting the complexity of provider Medical Decision Making.
  • Improve provider documentation to support the Medical Decision Making component of reported office/outpatient E&M services (codes)
  • Improve provider documentation to support reported ICD-10-CM diagnosis codes.
  • Implement a clear assessment and plan of care in the medical record for all diagnoses addressed during the encounter to support the reported E&M code all while capturing HCCs and closing gaps in care.
 
 
 
 
 
Course summary
Available credit: 
  • 0.75 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.
  • 0.75 ANCC
    UPMC Provider Unit is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation
  • 0.75 Attendance
Course opens: 
01/20/2021
Course expires: 
01/20/2024
UPMC Health Plan
United States

Presenter:

Marlana Tice, BA, CCS-P, CCS, CPC AHIMA Approved ICD-10-CM/PCS Trainer - Program Director, Risk Adjustment/HCC Coding Education, UPMC Health Plan.
No relationships with industry relevant to the content of this educational activity have been disclosed.

Planning Committee Members:
Kalpana Char, MD - Senior Medical Director,
 UPMC Health Plan
No relationships with industry relevant to the content of this educational activity have been disclosed.

Patricia Green, RN, BSN, MNEd, CPC, AAPC, ICD-10-CM Instructor - Director, Risk Adjustment/HCC, UPMC Health Plan
No relationships with industry relevant to the content of this educational activity have been disclosed.

Brenda Steveson, CPC, LPN, RT(R) - Physician Educator, UPMC Health Plan
No relationships with industry relevant to the content of this educational activity have been disclosed.

 

 

All presenters disclosure of relevant financial relationships with any entity producing, marketing, re-selling, or distributing health care goods or services, used on, or consumed by, patients is listed above.  No other planners, 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 to disclose.

 
 
 
 
 

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 0.75 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 0.75 contact hours.

Other Healthcare 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

  • 0.75 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.
  • 0.75 ANCC
    UPMC Provider Unit is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation
  • 0.75 Attendance
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