Medical billing and coding is not an easy task. The system is not simple, and it is not the system I would have designed if given the opportunity, but it is the system we have. This course serves two functions. First, I’ll describe how the billing and coding system works, with the objective of completing the project so that everyone may legally and morally optimize their E&M billing. Second, we’ll go through modifiers and how to apply them to guarantee accurate invoicing.

Every year, CMS releases proposed and then final modifications to the billing and coding system, and I update the lecture to reflect these changes. Some of the recommendations are extremely radical, and if completely implemented, they would alter not only how you charge and code, but also how you practice medicine.

The training also contains a series of lectures by James Dahle, often known as The White Coat Investor, about how to record and code effectively as an emergency department physician.

Finally, I’ve included a version of a presentation I delivered on how private equity is beginning to enter the field of medicine, which, while not directly linked to billing and coding, will have an impact on how we practice medicine.

Your Professor

Mr. Henry Rosevear

Henry is a urologist in private practice with a keen interest in the business of medicine. He has written over 75 pieces for the Urology Times about how health and business combine. His objective is to ensure that all physicians grasp the fundamentals of the billing and coding system so that they may optimize their E&M billing honestly and ethically. He has taught this course at various conferences around the United States and is delighted to be able to offer it here. He is a father of four who spends his leisure time exploring Colorado’s mountains with his family.

Curriculum of the Course

Billing and Coding Fundamentals

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Table of Contents (Download PDF for reference while watching videos)

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Physical examination and system review requirements (12:39)

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Problem-based billing and the HPI (11:23)

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Time-based coding and billing for in-patients (9:25)

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Examples from the real world (7:38)

Modifiers for E&M

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The notion of bundling and unbundling modifiers (10:57)

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Part 1: The Global Period and How to Get Out of It (11:42)

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The global epoch and how to escape it (Part 2) (10:21)

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Modifiers that are less typically used (7:28)

The White Coat Investor’s Emergency Department Documentation

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Keeping Track of Your Financial Progress (6:26)

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ED Evaluation and Management Codes Documentation (25:31)

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Recording ED Procedure Codes (9:22)

CMS Proposed Changes for 2019

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Summary of CMS Proposed Changes for 2019. (8:53)

Urology and Private Equity

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One Private Equity

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Two Private Equity

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Three Private Equity

The Opioid Epidemic

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Prescription of Opioids

CMS Final Rule Changes for 2019

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Summary of 2019 Changes

CMS Proposed Changes for 2020

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Proposal Summary for 2020

Questions and Answers