Rightsizing Reimbursement: How to Code for What You're Owed

Do you ever wish you had a secret decoder ring to understand medical coding and reimbursement?

Now you can be as certain choosing ICD codes as you are about diagnosing… as confidently picking CPT codes as you are performing procedures… as sure as you can be that your documentation is beyond dispute. Case closed!

Rightsizing Reimbursement: How to Code for What You're Owed is a quick-study course to take the guesswork out of medical coding for urgent care clinicians. It's the 2-hour refresher course you need to fill gaps in your academic training with practical education that matters on every shift, at the end of every patient encounter. Coding and charting may not be the favorite parts of your job, but they are aspects of performance under scrutiny and sure to garner praise for those who excel.

Coding handled by someone else at your clinic? You'll still benefit from learning these coding concepts and documentation best practices, so you can be sure you're giving your coder all the backup they need to achieve coding excellence and accuracy.

Instructor: Brad Laymon, PA-C, CPC, CEMC

Brad Laymon, an urgent care veteran, shares his coder's-eye-view and insider tips on how to boost your coding proficiency and gain confidence in practice. You’ll see how procedure and diagnosis codes, backed by proper documentation, spotlight your expert clinical decisions, just as rightsizing reimbursement reflects the true value of your clinical judgment and capabilities.

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Your Price: $199

This course covers:

Make-or-break factors for rightsizing reimbursement
Undercoding and the multiplier effect
CPT, ICD, and Modifier 25 explained and applied
Provider Coding Profile boosters
1-2-3 methodology for adding up MDM elements
Level 3 or Level 4? How to decide
Automatic triggers to higher-level service codes
14 must-know coding formulas
Charting Dos and Don'ts (+ 25 documentation tips)
Real-life Coding Challenges to lock it all in

What's included:

Engaging, easy-access video modules full of practical tips
Course workbook, including calculation worksheets
Audio-only track for easy listening
3 Key Elements of Medical Decision Making and Coding Formulas
2 AMA PRA Category 1 Credits™

Features and Benefits:

Supplements basic academic training

This course is organized as a crash-course curriculum, filling in gaps in academic programs with practical education to succeed in UC.
Video modules allow learners to pace themselves and replay as needed to retain knowledge through repetition.

Sharpens coding, charting, and documentation skills and proficiency

The content emphasizes evidence-based education with practical application.
The course is designed to be an engaging, enjoyable training experience full of “sticky” content.
Learners receive resources they can keep and use as needed and methodology/techniques they can hone with practice over time.
Case presentations expose learners to right/wrong decisions with explanation and rationale designed to enhance understanding and sharpen judgment.
A multitude of samples gives learners the opportunity to apply the code selection approach presented and to study and emulate full and formulaic documentation models.

Boosts clinical confidence

Real-world scenarios show how regulations and compliance standards have an impact on their own performance in practice, as well as the overall success of the clinic/system.
This course employs the “practice makes perfect” principle with expert-guided deconstruction of straightforward and complex patient encounters, coding challenges, and documentation options representing real-life practice.

Improves accuracy

Coding/documentation training is high-yield because it pays for itself in terms of gains associated with improved accuracy and avoidance of errors that can be disastrous/costly.

Accreditation:

Accreditation: EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit Designation: EB Medicine designates this internet enduring material for a maximum of 2 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
AOA Accreditation: This course is eligible for up to 2 American Osteopathic Association Category 2-B credit hours.

Product Details:

Publication Date: December 15, 2023

CME Expiration Date: December 15, 2026

CME Faculty Disclosure: It is the policy of EB Medicine to ensure objectivity, balance, independence, transparency, and scientific rigor in all CME activities. All individuals in a position to control content have disclosed all financial relationships with ACCME-defined ineligible companies. EB Medicine has assessed all relationships with ineligible companies disclosed, identified those financial relationships deemed relevant, and appropriately mitigated all relevant financial relationships based on each individual’s role(s). Please find disclosure information for this activity below:

Faculty

Brad Laymon, PA-C, CPC, CEMC (Author/Developer): Nothing to Disclose
Tracey Davidoff, MD (Peer Reviewer): Nothing to Disclose
Suzanne Verity (Content Editor): Nothing to Disclose

Modules

Introduction & Course Overview

Meet your instructor, Brad Laymon, PA-C, CPC, CECM (Length: 03:06)

In this session, we lay the foundation for the full scope of the course and give context on how the clinical decisions you make – and how accurately you code and document patient encounters – tie directly to practice success. We’ll show you the simple math and impact of rightsizing reimbursement. (Length: 13:34)

In this session, we cover the terminology and taxonomy of medical coding as it applies specifically to urgent care. We’ll zero in on the CPT and ICD codes you use most and demystify Modifier 25 and how and when it applies. (Length: 07:43)

This is the first of 3 sessions outlining aspects of medical decision making that influence coding and reimbursement. We’ll introduce a matrix to simplify the variables and a quick-count methodology to guide code selection. (Length: 16:46)

Labs, tests, external notes, referrals… they all can add up to higher-level service. This session explains how to tally the total and assign the right code. Find out why so many pediatric encounters, regardless of the chief complaint, warrant Level 4 vs Level 3. Hint: The same principle may apply to geriatric patients, too. (Length: 08:01)

In this session, we’ll address risk and how it escalates in correlation to certain situational factors and treatment decisions. The higher the risk, the higher the level of service. We’ll teach you the triggers. (Length: 06:48)

“If it wasn’t documented, it didn’t happen.” The old maxim applies to medical charts, and what you do or don’t put in the patient record can help or hurt your practice. This session presents hallmarks of defensible charts and gives you tips for improving your habits. (Length: 11:04)

This session will unpack real-life patient encounters, highlighting decision points that dictate code selection. In turn, we’ll examine documentation that supports those decisions and selections, thus rightsizing reimbursement and mitigating risk. You’ll apply your knowledge in these case studies and lock in lessons from the previous modules. (Length: 14:18)

Your presenter, a certified professional coder who’s spent his career in urgent care, shares tricks of the trade: 14 formulas to expedite decision making and take the guesswork out of coding. Armed with these handy formulas, you’ll gain confidence on the job and add rightsizing reimbursement to your skills set. (Length: 04:43)

More Details About the Instructor

Brad Laymon, PA-C, CPC, CEMC
EB Medicine and Brad Laymon, PA-C, CPC, CEMC, developed Rightsizing Reimbursement: How to Code for What You’re Owed to further elevate the level of education available to clinicians working within the urgent care community. Laymon has practiced in an urgent care setting for the past 24 years. Early on, he took an interest in coding, reimbursement, and the economics of operating an urgent care clinic. He became a certified professional coder in 2014. Currently, Laymon works for Novant Health/GoHealth in the Winston-Salem, NC area, with dual responsibility for clinical practice and reimbursement optimization. He launched Coding Excellence, LLC, in 2023 to help other clinicians and practice leaders get better at coding and documentation. Laymon writes a regular “Coding & Charting” column and “Coding Challenges” for EB Medicine’s Evidence-Based Urgent Care. He serves on the board of the Southeast Regional Urgent Care Association (SERUCA). He also writes and speaks on related topics for the Urgent Care Association.