AMDCP Credit Designation:

This session has been approved for a total of 3 Management credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).

The American Medical Directors Association designates this educational activity fora maximum of 3 AMA PRA Category 1 Credit(s)^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Presenter(s): Alva S. Baker, MD, CMD;Leonard Gelman, MD, CMD

Disclosure(s):
Allpresenters reported they had no relevant financial relationships to disclose.

Session Description:
This session provides a review of the most recent CPT changesrelevant to nursing home services and discusses lessons learned in theiruse. Procedural codes, codes withmodifiers, coding for care by nurse practitioners, and day-of-death codes arediscussed in-depth. Instruction includescase-studies and vignettes as examples and participants are led through aprocess of determining codes based on modifiers and procedures.

Learning Objectives:

• Use the Medicare Carriers Manual as a reference source for definingpayment parameters
• Explain the concept of medical necessity as it relates to reimbursement
• Delineate and apply evaluation and management codes for long termcare for physicians and other providers