Coding and Documenting Evaluation and Management Services: A Physician's Perspective

Instructor: CJ Wolf
Product ID: 705802
Training Level: Intermediate to Advanced
  • Duration: 60 Min
This webinar will give the physician’s perspective on how documentation and medical necessity play into appropriate coding and compliance for these E/M services. How coders and auditors need to understand what certain words, phrases, orders, and clinical plans mean when a physician uses and documents them.

recorded version

$199.00
1x Person - Unlimited viewing for 6 Months
(For multiple locations contact Customer Care)
Recorded Link and Ref. material will be available in My CO Section
Last Recorded Date: Sep-2018

Training CD / USB Drive

$249.00
One CD/USB is for usage in one location only.
(For multiple locations contact Customer Care)
CD/USB and Ref. material will be shipped within 15 business days

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Read Frequently Asked Questions

Why Should You Attend:

Coders and auditors are valuable players in a healthcare organization’s compliance and revenue cycle operations. Additionally, the OIG has recommended that a physician or other clinically trained person also be involved in audits: “The individuals from the physician practice involved in these self-audits would ideally include the person in charge of billing (if the practice has such a person) and a medically trained person (e.g., registered nurse or preferably a physician (physicians can rotate in this position).”

Understanding a physician’s perspective on Evaluation and Management (E/M) services is essential to proper coding, billing and compliance operations.

Attend the webinar to learn the physician’s perspective on how documentation and medical necessity play into appropriate coding and compliance for these E/M services. Learn how a physician thinks about the words, phrases and concepts in the 1995 and 1997 E/M documentation guidelines.

For example, the 1995 table of risk uses the phrase “Parenteral controlled substances” for high risk. What does this mean? Could as coder auditor identify which prescribed medications or physician orders signify a “parenteral controlled substance” is in play when they are determining risk? Or, when might a presenting chief compliant of “headache” actually turn out to be high risk?

It is true that physicians need to document, but it is also true that coders and auditors need to understand what certain words, phrases, orders, and clinical plans mean when a physician uses and documents them.

Areas Covered in the Webinar:

The elements of the 1995 and 1997 E/M documentation guidelines with a focus on the physician’s perspective of the:

  • History components
    • Chief complaint
    • History of present illness
    • Review of systems
    • Past/family/social history
  • Physical exam
    • How would a physician view “Problem Focused,” “Expanded Problem Focused” “Detailed” and “Comprehensive” along with the nuances and ambiguities that often arise in documentation of the exam
  • Medical decision making
    • Number of diagnoses or management options
    • Amount and/or complexity of data to be reviewed
    • Risk of complications and/or morbidity or mortality

Who Will Benefit:

  • Coders
  • Auditors
  • Compliance Personnel
  • Physicians
  • Nurse Practitioners
  • Physicians Assistants
  • Coding and Reimbursement Consultants
Instructor Profile:
CJ Wolf

CJ Wolf
Compliance Executive, Healthicity

C.J. Wolf, MD, M.Ed. has been involved in healthcare for over 20 years beginning with his years in medical school. Shortly after graduating Dr. Wolf made a career change to healthcare administration, reimbursement and compliance. He has worked in various coding, reimbursement or Chief Compliance Officer roles for Intermountain Healthcare, the University of Texas MD Anderson Cancer Center, the University of Texas System and Merit Medical Systems. He currently is Sr. Compliance Executive at Healthicity.

Dr. Wolf has a passion for teaching and education. He has developed and taught curricula for adult employees seeking national coding certifications, trade workshops and seminars, and has served as adjunct faculty for Salt Lake Community College and currently is Faculty at Brigham Young University-Idaho and adjunct faculty at the University of Illinois at Chicago College of Medicine.

In addition to his medical degree from the University of Illinois at Chicago College of Medicine, Dr. Wolf holds a master of education (M.Ed.) from the University of Texas at Brownsville. He completed his B.S., magna cum laude, from Brigham Young University, Provo, UT.

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Refund Policy

Registrants may cancel up to two working days prior to the course start date and will receive a letter of credit to be used towards a future course up to one year from date of issuance. ComplianceOnline would process/provide refund if the Live Webinar has been cancelled. The attendee could choose between the recorded version of the webinar or refund for any cancelled webinar. Refunds will not be given to participants who do not show up for the webinar. On-Demand Recordings can be requested in exchange.

Webinar may be cancelled due to lack of enrolment or unavoidable factors. Registrants will be notified 24hours in advance if a cancellation occurs. Substitutions can happen any time.

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