CMS Proposed Changes to E&M for 2019 – What You Need to Know

Event Information
Product Format
Prerecorded Event
Lynn M. Anderanin, CPC, CPMA, CPPM, CPC-I, COSC
60 minutes
Product Description

Prepare for Significant Changes to Documentation and Reimbursement for Office Visits

The CMS is proposing significant changes both to the documentation for patient visits, as well as reimbursement for office visits. If approved, the proposed changes published on July 12, 2018 could negatively impact reimbursement for providers in the office. Many of the proposed changes may become reality from January 1, 2019. You need to understand what these changes are, and how they will impact your office, so that you have a head start to prepare for compliance before the winter holidays.

Get expert guidance from Lynn M. Anderanin on the proposed changes to E&M services performed in the office, how they will likely impact your practice, and what will need to be changed in the workflow, policies, and procedures. Learn about the proposed changes to reimbursement of E&M services in the office when procedures and/or services with a 0 or 10 day global period will be significantly reduced, and how they will affect you.

This session help you understand the potential changes, as well as know why CMS is proposing these changes in the first place. Anderanin will walk you through the possible payment options proposed, and the documentation changes relative to history, exam, and medical decision making. Find out what will happen if reimbursement becomes time based, a method of reimbursement for office visits used in the early 90s. And if you’re a specialty practice that relies primarily on office visits, you’ll look forward to knowing more about the proposal to make available and report G-codes in certain scenarios where visits are more complex due to the patient’s condition.

After attending this information-packed session, you’ll be well-prepared for the changes when they most likely kick in on January 1, 2019.

Session Highlights

You will learn the following:

  • Proposed payment methodologies for office visits for new and established patients in 2019
  • Significant changes to documentation guidelines that could become reality
  • How to focus the level of service on medical decision making with less focus on history and examination
  • How to assign one fee for several different levels of service
  • Potential fee reductions for office visits and procedures and/or services on the same day
  • Additional reimbursement for some specialty providers on office visits
  • How to prepare for the potential changes

Session Agenda

  • 2019 CMS physicians fee schedule (proposed rule July 12, 2018)
  • Proposed documentation requirements
  • Visits based on time
  • Teaching physician documentation
  • E/M basics
  • 1995 & 1997 examinations
  • Medical decision making
  • New patient/consultation
  • Established patient visits
  • Other documentation modifications
  • Podiatric visits
  • Specialty G codes
  • Complex visits
  • Patient relationship modifiers
  • Content of counseling summary
  • Communication technology
  • Interprofessional services
  • 99024 reporting
  • Home visit
  • Multiple visits on the same day
  • Prolonged services


Who Should Attend

  • Physicians
  • Nurse practitioners
  • Physician assistants
  • Coders
  • Billers
  • Medical office management
  • Collectors

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About Our Speaker

Lynn Anderanin - Orthopedic Guidelines Expert for ICD 10

Lynn Anderanin, CPC, CPMA, CPPM, CPC-I, COSC, is the  Sr. Director of Coding Education for Healthcare Information Services, a physicians revenue cycle management company. She has over 35 years experience in all areas of the physician practice, and specializes in Orthopaedics.  Lynn is currently a  workshop and audio presenter. She is a  former member of the American Academy of Professional Coders (AAPC) National Advisory Board, and has served...   More Info
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