FRIDAY PM

2023 Reporting Hospital E/M Codes and Split/Shared and Critical Care Services

Agenda

*agenda subject to change

1:00pM — 2:45PM

E/M Codes and Documentation: Changes for 2023 NEW!

  • Changes to Categories of E/M codes
    • Inpatient and observation codes
    • Discharge management codes
    • Consultation codes
    • Emergency department codes
    • New and revised prolonged services codes
  • Reporting by Time or Medical Decision Making
  • Element #1: Problems Addressed
    • Do more problems mean a higher level of E/M?
    • Differentiating between exacerbation and severe exacerbation
    • Documenting problem severity
  • Element #2 Data Reviewed and Analyzed
    • Order and review, can both be “counted”?
    • When can interpretation of results be counted?
    • External notes, when do they count and can more than one be counted
  • Element #3 Risk
    • Defining level of Risk: what does CPT say?
    • Documenting level of Risk. Do the original Risk table examples still apply?
    • How do test and treatment decisions impact co-morbidity and risk?

2:45pM — 3:00pM

Break

3:00pM — 3:45pM

Reporting Split/Shared Services for 2023 NEW!

  • Split/shared in the facility (ED, observation, inpatient)
  • Is split/share applicable to an office/clinic or provider-based clinic
  • When to apply modifier FS

3:45pM — 5:00PM

Reporting Critical Care Services for 2023 NEW!

  • Medicare changes to guidelines
    • Billing critical care during a global period.
    • How is modifier FT used?
    • Billing split/shared critical care; how does this work?
    • What about private payors or other MACs?
  • Audits and critical care

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