Teaching Physicians Guidelines for E&M Services
Description
Dive deep into the essential regulatory frameworks established by CMS in our comprehensive course, "Teaching Physician Guidelines for Evaluation and Management Services." Tailored to explain the intricate processes of coding, billing, and reimbursement in educational medical settings, this course examines the precise rules and protocols that govern the engagement of teaching physicians with residents and medical students during patient care. The coder will gain crucial insights into the robust documentation practices required for Evaluation and Management (E/M) services, fostering enhanced compliance with Medicare policies.
Included Lessons:
- What are Teaching Physician Guidelines
- CMS Definitions
- Reimbursement Guidelines
- Documentation Guidelines
- Examples of Minimally Acceptable Tp Documentation
- Examples of Unacceptable Tp Documentation
- Time-Based Services
- Psychiatry Services
- Critical Care
- Medical Student Documentation
- Organizational Impact
CEUs available for the following credentials:
AAPC
COC, CPC, CPC-P, Approved-Instructor, CANPC, CCC, CCPC, CCVTC, CDEI, CDEO, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIMC, COBGC, COPC, COSC, CPB, CPCD, CPCO, CPEDC, CPMA, CPMS, CPPM, CPRC, CRC, CRHC, CSFAC, CUC
AHIMA
CCA, CCS, CCS-P, RHIT, RHIA, CDIP, CHDA, CHPS
Key Takeaways
Explore the pivotal roles of teaching physicians, understanding their quintessential presence and participation criteria, and unravel the nuanced guidelines surrounding time-based services and the valuable contributions of medical students. Key takeaways for this course include:
- Understanding CMS-issued Guidelines: Participants will immerse themselves in comprehending the pivotal guidelines issued by CMS, gaining critical insights into the nuanced regulations that govern coding, billing, and reimbursement processes involving teaching physicians, residents, and medical students during patient care in educational settings.
- Effective Documentation Practices: This course emphasizes mastering robust and compliant documentation practices, enabling participants to discern between acceptable and unacceptable forms of documentation, thereby facilitating accurate and efficient Medicare reimbursement processes.
- Exploring Time-based Services Guidelines: Participants will explore the intricate guidelines specific to time-based services, acquiring detailed knowledge on the nuanced involvement, presence, and documentation necessities of teaching physicians in various medical service scenarios, enhancing overall service delivery precision.
- Medical Student Contributions and Participation: Gain valuable insights into the regulatory frameworks governing the involvement and contributions of medical students in billable services, ensuring clarity, compliance, and accuracy in the application and documentation of their participatory roles in patient care services.
Benefits of Taking this Course
- Enhanced Coding Knowledge and Expertise
- Continued Professional Development
- Continued Education Units
FAQs
What is required for a Teaching Physician to properly bill for services in a teaching setting involving residents and medical students?
A Teaching Physician (TP) can bill for services in a teaching setting where residents and medical students are involved if the TP is personally present during the critical or key portions of the service that a resident performed. The TP must document personally that they either performed the service or were physically present during these key portions when performed by the resident, and participated in the management of the patient. The combined documentation from both the TP and resident must support the medical necessity of the service, and the TP's documentation should reference the resident's notes, confirming their presence and participation.
Can medical students document services in the medical record for billing purposes, and what must a Teaching Physician do to verify a student’s documentation?
Yes, medical students may document services in the medical record, but their documentation must be verified by a Teaching Physician (TP). The TP must confirm in the medical record all student documentation or findings, including history, physical exam, and/or medical decision-making. While the TP must personally perform (or re-perform) the physical exam and medical decision-making activities of the E/M service being billed, they may verify any student documentation of these elements in the medical record, rather than re-documenting this work. This ensures that the billed services meet the necessary Teaching Physician Guidelines for Medicare reimbursement.
About our Medical Coding Courses
HIAlearn, powered by Health Information Associates (HIA)—a leader in medical coding and auditing for more than three decades—offers a comprehensive online education platform for medical coders. With a catalog of over 200 medical coding courses accepted by the American Health Information Management Association (AHIMA) for Continuing Education Units (CEUs) and a selection approved by the American Academy of Professional Coders (AAPC), HIAlearn caters to both beginners and experienced medical coders seeking to enhance their skills. The platform provides an array of training plans tailored to meet individual learning needs, from mastering challenging coding procedures to understanding broad conceptual frameworks within the coding world. Courses are available across various coding types including CPT, E/M, ICD-10-CM, ICD-10-PCS, and are designed to cater to different coder levels and coding specialties such as inpatient, outpatient, profee, and CDI. Additionally, HIAlearn offers a Coding Updates bundle to ensure coders are up-to-date with the annual changes in ICD-10-CM, ICD-10-PCS, CPT, and IPPS. Beyond individual learning, HIAlearn supports organizations with group discounts, promoting enhanced coding accuracy, efficiency, and compliance across teams.
Overview
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