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ForwardGW Medical Faculty: Navigate Orthopaedic Evaluation and Management Coding to Improve Documentation and Payer Downcoding Strategies
Evaluation and Management coding remains one of the most scrutinized — and most misunderstood — areas in orthopaedic billing, and errors in this space can silently erode practice revenue visit after visit. This focused, practical program provides orthopedic surgeons and their teams with a working review of the current E/M coding guidelines, including medical decision-making. Addressing the most common documentation pitfalls seen with office-based procedures such as injections and aspirations. Participants will learn when it is appropriate to append an E/M modifier — such as Modifier 25 — to report a separately identifiable service on the same day as a procedure, and will explore how selecting the most specific ICD-10 diagnosis code supports medical decision-making complexity, reduces medical necessity denials, and translates directly into more accurate and defensible reimbursement. Lastly, we will wrap up the course with surgical trauma coding and a question-and-answer session.
Target Audience
Physicians, Non-Physician Providers, Billing Managers, Coding/Billing Staff, Administrators, and Revenue Cycle Directors.
Learning Objectives
- Execute the E/M guidelines for accurate levels of service
- Chart inpatient E/M visits for reimbursement
- Recognize documentation pitfalls and improvement tips for office procedures
- Recognize when it is appropriate to report an E/M modifier and office procedure
- Integrate appropriate diagnosis coding specificity to improve visit complexity
- Differentiate between global fracture care and itemized E/M billing
Commercial Support
There is no commercial support for this activity.
AKH Inc. and KarenZupko & Associates, Inc staff and reviewers have no financial relationships with ineligible companies to disclose. Identified conflicts of interest are mitigated by AKH prior to accreditation of the activity.
Disclaimer
This course is designed solely to provide the healthcare professional with information to assist in his/her practice and professional development and is not to be considered a diagnostic tool to replace professional advice or treatment. The course serves as a general guide to the healthcare professional, and therefore, cannot be considered as giving legal, nursing, medical, or other professional advice in specific cases. AKH Inc. specifically disclaim responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through participants misunderstanding of the content. If you would like to opt out from future communications from AKH please send an email to [email protected] with your information with "Opt Out" in the subject line.
Disclosure of Unlabeled Use and Investigational Product
This educational activity may include discussion of uses of agents that are investigational and/or unapproved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
In support of improving patient care, this activity has been planned and implemented by AKH Inc., Advancing Knowledge in Healthcare and KarenZupko & Associates, Inc. AKH Inc., Advancing Knowledge in Healthcare 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.
This activity was planned by and for the healthcare team, and learners will receive 5.0 Interprofessional Continuing Education (IPCE) credit for learning and change.
Available Credit
- 5.00 AAPA Category 1 CME
AKH Inc., Advancing Knowledge in Healthcare has been authorized by the American Academy of Physician Associates (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 5.00 AAPA Category 1 CME credits. PAs should only claim credit commensurate with the extent of their participation. - 5.00 AMA PRA Category 1 Credit™
Physicians
AKH Inc., Advancing Knowledge in Healthcare designates this Live Activity for a maximum of 5.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. - 5.00 Attendance
Credits: 5.00
- 5.00 AMA PRA Category 1 Credit™ Non-MD
Non-Physicians Seeking AMA Credit
AKH Inc., Advancing Knowledge in Healthcare designates this Live Activity for a maximum of 5.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.