Profee and Evaluation & Management

Instructors

Faye Grile, CCS-P, CDIP, CPC, COC, CPCO, CPMA, CEMC
Beth Martilik, MA, RHIA, CDIP, CCS

Professional fee coding, commonly known as Profee, is crucial in healthcare for coding and billing the physician's services during a patient encounter. It focuses on documenting the work performed by healthcare providers and ensuring accurate reimbursement. A key component of Profee coding is the use of Evaluation and Management (E&M) codes, which range from 99202 to 99499 in the Current Procedural Terminology (CPT) system. These codes are essential for representing various patient interactions, including office visits and consultations. Advanced training in Profee and E&M coding delves into the complexities of these codes, covering the accurate determination of service levels, application of current guidelines, and strategies to avoid common errors. This specialized Training Plan is a vital tool for coding professionals to ensure compliance with healthcare regulations and to secure proper reimbursement for medical services.

The Profee and Evaluation & Management Training Plan offers extensive courses aimed at boosting expertise in professional fee coding and evaluation management. It spans a variety of medical procedures and service frameworks, including advanced practices like telehealth and critical care, as well as coding for outpatient and inpatient services. This plan ensures coders are well-equipped to handle current healthcare billing requirements effectively.

This coding training plan offers comprehensive insights into Profee (Professional Fee) coding. Key takeaways  include:

• Understanding Specialized Coding Areas: Courses like Anesthesia, Arthrocentesis, and Laceration Repair provide detailed knowledge about coding specific medical procedures, emphasizing the nuances and specificity required in coding diverse medical services.
• Updates in Coding Practices: With courses focusing on recent changes, such as "Evaluation and Management Office or Other Outpatient 99202-99215 as of 2021," coders will be updated on the latest coding standards and practices.
• Coding for Different Healthcare Settings: Courses like Emergency Dept E&M, Inpatient & OBS Discharge Management, and Telehealth and Telemedicine address the unique coding requirements for various healthcare environments, including hospitals, outpatient facilities, and virtual healthcare services.
• Complex Coding Concepts: Training in areas like Critical Care, Global Surgical Package, and Inpatient Neonatal and Pediatric Critical Care will deepen understanding of complex coding situations, particularly for high-acuity care and long-term treatments.
• Documentation and Compliance: Courses like Documenting MDM (Medical Decision Making) and Incident-To Services will emphasize the importance of accurate documentation for billing and compliance, ensuring that services are appropriately captured and billed.
• Role of Non-Physician Providers: Training on Advanced Practice Providers, Pharm-D Incident-To, and Occupational Therapy highlight the coding guidelines for services provided by non-physician healthcare providers.
• Billing for Extended or Unique Services: Courses on Prolonged Services, Psychotherapy, and Medical Nutrition Therapy offer insights into coding for services that extend beyond standard patient encounters.
• Utilizing Modifiers and Special Billing Codes: With courses like Surgical Modifiers and Place of Service Codes, coders will learn how to accurately apply modifiers to reflect specific circumstances in patient care, which directly impacts reimbursement.
• Telemedicine and COVID-19: The inclusion of Telehealth and Telemedicine for COVID-19  focuses on the evolving landscape of healthcare delivery, particularly in response to the pandemic.
• Managing Patient Transitions: Transitional Care Management and Inpatient & OBS Discharge Management courses provide skills in coding for services that manage patient transitions between care settings, which is crucial for continuity of care.
• Integrating Non-Medical Services: Courses like Scribes and Shared Visit Services teach how to code for auxiliary services that support patient care but are not direct medical interventions.

This training is invaluable for coders seeking to excel in Profee coding, offering a broad and deep understanding of the intricacies involved in coding across various medical specialties and settings. It prepares coders to handle diverse and complex coding scenarios with precision and compliance.

Benefits of Taking this Training Plan

• Enhances coding accuracy
• Updates on latest practices
• Broadens procedural knowledge
• Improves documentation skills
• Ensures regulatory compliance
• Expands telehealth coding expertise
• Facilitates multi-setting adaptability
• Deepens specialty coding insight
• Strengthens billing efficiency

FAQs

About our Medical Coding Courses