Coding Updates for 2023: CPT, E/M, 99211 and more!

Jill M. Young

Jill M. Young

Jill M Young is the Principal of Young Medical Consulting, LLC. A company founded 18 years ago to meet the education and compliance needs of physicians and their staff Jill has over 40 years of medical experience working in all areas of the medical practice including clinical, billing and rounding with physicians. Her unique style of working...
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180 Mins
Jill M. Young & Lynn M. Anderanin & Toni Elhoms

Session 1: 2023 CPT® Coding Updates | 60 Mins | Pre-recorded | Presented by: Jill M. Young, CEMA, CPC, CEDC, CIMC

The CPT ® codes is part of the HCPCS coding system. Each year the AMA releases coding additions, deletions and revisions. This year, in addition to these yearly changes, a significant change has been made to the Evaluation and Management Chapter as a whole.

In 2021, CPT ® saw significant changes to Office and Other Outpatient Services Guidelines and their Codes. Some aspects of these changes have been affected for the upcoming year. For 2023 CPT ®, significant changes to the remainder of the E&M coding section have taken place. This includes codes for Prolonged Care. Understanding the new Guidelines and Code descriptors in addition to seeing which codes are deleted is important to anyone working with the E&M Coding system. Other changes can be found in the Integumentary subsection, Musculoskeletal, Cardiovascular and Auditory Systems. Finally, a significant number of new codes can be found in the Digestive Subsection with new codes in 4 different areas. Attend this session with industry expert speaker Jill M. Young, CEMA, CPC, CEDC, CIMC where she will discuss all of the changes to CPT ® for 2023 including the changes to E&M codes such as Hospital Observation, Initial Care codes in the hospital and Nursing Home codes to name a few. Other changes and revisions to coding guidelines and codes will be discussed. Jill will not only review each of the chapters of CPT® for both code additions / deletions and modifications but will also discuss the changes to guidelines.

Session Objective:

Modifications to the E/M codes are among 393 editorial changes in the 2023 CPT® code set, including 225 new codes, 75 deletions and 93 revisions. With 10,969 codes that describe the medical procedures and services available to patients, the CPT® code set continues to grow and evolve with the rapid pace of innovation in medical science and health technology. Areas of code change include:

  • Somatic Nerve Injection
  • Pulmonary Angiography
  • Paravertebral Spinal Nerves and Branches
  • Cognitive Behavioral Therapy Monitoring
  • Hernia Repair

There will also be a review of the new appendix that has been added in 2023 with a taxonomy for artificial intelligence/augmented intelligence (AI) applications. This new AI taxonomy provides guidance for classifying various AI-powered medical service applications, such as expert systems, machine learning, or algorithm-based solutions, into one of three categories: assistive, augmentative, or autonomous.

Session 2: E/M Coding Updates for 2023 | 60 Mins | Pre-recorded | Presented by: Lynn Anderanin, CPC, CPPM, CPMA, CPC-I, COSC

In 2021 the documentation guidelines were changed for office and outpatient visit codes to use medical decision making or time to determine the level of service for the visit. For 2023, the AMA and Medicare are revising the documentation guidelines for all other visits to coincide with the changes made in 2021. Join this session where expert speaker Lynn M. Anderanin, CPC, CPPM, CPMA, CPC-I, COSC will review the guidelines as well as discuss additions made to the guidelines to accommodate the other codes that have been deleted. For those deleted codes Lynn will review the alternatives for coding and billing. Any differences between what Medicare will accept and what the AMA CPT® says will also be defined for coding compliance with these changes.

Lynn will be reviewing each individual change in the E/M section of CPT® whether it is a revision or addition to the codes or guidelines. The information shared will be directly from CPT® and the AMA as well as Medicare alternatives to CPT®

Session Objective:

When CPT® codes are not accurately reported the provider runs the risk of an audit by any insurance company or governmental entity that is responsible for coding accuracy and compliance. Coding error can also cause claims denials which either slows or prohibits reimbursement for services rendered. Knowledge of the coding changes allows the office staff to establish workflow and process based on the coding changes and also share documentation requirements for compliance. Lynn will discsuss:

  • Codes affected by these changes
  • Deletions for previously used codes for Observation
  • Changes made to the AMA medical decision-making table
  • What codes can be reported based on time
  • Coding consultation codes with the new guidelines
  • Medicare’s physician fee schedule final rule for E/M in 2023

Session 3: Navigating the appropriate use of CPT Code 99211 | 60 Mins | Pre-recorded | Presented by: Toni Elhoms, CCS, CRC, CPC, AHIMA-Approved ICD10-CM/PCS Trainer

CPT Code 99211 is defined (by the American Medical Association’s CPT Manual) as an evaluation and management (E/M) service for an established patient that may not require the presence of a physician or other qualified healthcare professional. CPT Code 99211 remains one of the most misunderstood and misrepresented services in all of CPT Coding. One of the key requirements is that the encounter must be directed by a physician/QHCP and include actual evaluation and management. CPT Code 99211 should not be reported for telephone calls, injection visits, blood pressure checks, lab draws, etc. Although the physician does not have to “personally” evaluate the patient, direct supervision of ancillary clinical staff is required for billing purposes.

In this session our expert speaker, Toni Elhoms will discuss about the appropriate use and application of CPT Code 99211, clinical documentation requirements, who can render 99211, redline 99211 case studies together, highlight best practices, and so much more. This Session will cover the appropriate use and application of CPT Code 99211, clinical documentation requirements for 99211, describe the types of professionals that can render 99211, discuss what services do not qualify for reporting 99211, dissect some case studies together, and so much more!

Session Objective:

  • Outline the appropriate use and application for CPT Code 99211
  • Review the clinical documentation requirements for CPT Code 99211
  • Discuss the types of healthcare professionals that can render CPT Code 99211
  • Review the supervision requirements for CPT Code 99211
  • Deconstruct the concept of ‘incident to’ billing as it pertains to CPT Code 99211
  • Review relevant case studies that showcase inappropriate use of CPT Code 99211
  • Review relevant case studies that showcase appropriate use of CPT Code 99211
  • Outline best practices for compliantly supporting CPT Code 99211

Who Should Attend

  • Medical Coding Specialists
  • Medical Billing Specialists
  • Medical Auditing Specialists
  • Private Practice Physicians
  • Managed Care Professionals
  • Operations Leadership
  • Practice Administrators
  • Office Managers
  • Compliance Officers/Committees  
  • Physicians
  • Claim Adjusters
  • Claim Processor
  • Case Workers
  • NP's & PA's
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