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Coding, Reimbursement and Documentation for Physicians

GES 107 -- 12 hours

Course Outline

• Coding
  1. Medical Necessity
  2. Bundling
  3. Modifiers
  
  
• Compliance
  1. Office of Inspector General (OIG) Compliance Plan for Physician's Offices
  2. Fraud and Abuse
  3. Services Frequently Targeted by Audits
  4. OIG Work Plan for 2003
  
  
• Documentation
  1. Why documentation is so important
  2. Documentation of Procedure Notes
  3. 1995/1997 Evaluation and Management (E&M) Documentation Guidelines (DG)
     1. Key Components
        1. History
        2. Physical Exam
           1. General Multi-System
           2. Cardiovascular
           3. Otolaryngology
           4. Ophthalmology
           5. Genitourinary
           6. Hematologic/Lymphatic/Immunologic
           7. Musculoskeletal
           8. Neurological
           9. Psychiatric
           10. Respiratory
           11. Integumentary
        3. Medical Decision Making
     2. Other Components
        1. Counseling
        2. Coordination of Care
        3. Nature of Presenting Problem
        4. Time
  
  
• "Incident To" Services
  
  
• Teaching Physician Guidelines
  
  
• Reimbursement
  1. Physician Fee Schedule
     1. Surgical Package
     2. Fee for Service