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Medical Decision Making OR Medical Necessity

Medical Decision Making OR Medical Necessity
This workshop highlights frequent (but problematic) methods used in code selection, such as utilizing the Evaluation and Management Documentation Guideline’s Medical Decision Making component to determine Medical Necessity. This and other myths can lead to coder confusion that may artificially inflate (or deflate) coding. This workshop also provides you with alternate solutions that really work.

What You Will Learn:
  • How to confidently code the correct E/M level every time
  • Discover when documentation becomes a compliance problem
  • How to stop over-coding or under-coding claims based on Medical Necessity
  • E/M myths that cause errors

This workshop debunks these common myths (and more):
  • "I can use the level of the MDM to validate the Medical Necessity of the service"
  • "My EMR suggested the code, which validates that the level of service is correct"
  • "When an established patient has three chronic conditions, the code is always a 99214"
  • "An 'unobtainable history' is automatically equal to a comprehensive history"
  • "I document the total time and counseling at 50%, therefore the service level is always correct"

If you work with physicians or providers, this workshop will provide you with valuable insights to communicate more effectively with them and other stakeholders about E/M coding and Medical Necessity issues.

  • Gain an essential understanding of regulations that effect E/M documentation
  • Combat today’s most challenging E/M leveling errors with actionable information
  • Learn the 5 things every coder should do to code E/M correctly and confidently

About The Author

Stephanie Cecchini, CPC, CEMC, CHISP, is the Vice President of Coding Operations at Aviacode. She joined Aviacode in 2012 where she continues her commitment to best serve the revenue cycle management needs of physicians and the healthcare community. She is an executive level healthcare operations expert with significant & broad ambulatory healthcare business experience with emphasis on multi-specialty physician groups, hospitals and payers. She has extensive experience in using data to drive payer audits. Stephanie has developed E/M audit selection algorithms to identify physician coding errors and recoup overpayments for both federal and commercial payers. She brings more than eighteen years’ involvement in healthcare regulations including: coding and billing compliance, HIPAA privacy, security, and transactions, and HITECH meaningful use compliance. Previously, Stephanie served as SVP at the American Society of Health Informatics Managers, working to fill the needs of physicians adopting Health IT and at its sister organization, AAPC as VP, Product Management. In prior roles she served as Chief Audit Officer for Parses, assuring physician audit accuracy and quality control for payer driven recovery audits of professional fees and was responsible for driving sales & managing new audit programs. As a public speaker and published writer, she is a nationally respected advocate of fair and proper payment for medical services.

Register to Access this On Demand Event

  • Get access to the author-recorded webinar broadcast
  • Includes electronic workbook, downloadable mp3, ipod/iphone video, and presentation slides
  • Learn at your own pace with the ability to pause, rewind, etc.


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*On demand and virtual workshops are for single person use only and may not be rebroadcast, retransmitted, shared or disseminated. A computer with a high speed Internet connection and speakers (or headphones) is recommended to connect to the event.

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