Codes Discussed: FS modifier (Split or shared E/M visit modifier), POS 11 (Office place of service, not allowed for Medicare split/shared services), POS 31 (Skilled nursing facility place of service), 99304-99306 (Initial federally mandated comprehensive SNF visit codes), 99223 (Initial hospital inpatient or observation care), 99418 (Prolonged service code), 99233 (Subsequent hospital inpatient or observation care), G0316 (Prolonged hospital inpatient or observation care add-on code for Medicare), 99232 (Subsequent hospital inpatient or observation care), 99291 (Critical care, first 30-74 minutes), 99292 (Critical care, each additional 30 minutes), 99204 (New patient office or other outpatient E/M visit), 99214 (Established patient office or other outpatient E/M visit), 99213 (Established patient office or other outpatient E/M visit), 99468-99469 (Initial and subsequent inpatient neonatal critical care services), modifier FS (Split/shared E/M visit), 99223-FS (Split/shared initial hospital inpatient or observation care), 99418-FS (Split/shared prolonged service), 99233-FS (Split/shared subsequent hospital inpatient or observation care), G0316-FS (Split/shared Medicare prolonged hospital inpatient or observation care), 99232-FS (Split/shared subsequent hospital inpatient or observation care), 99291-FS (Split/shared critical care), 99292-FS (Split/shared additional critical care), 99204-FS (Split/shared new patient outpatient E/M visit), 99214-FS (Split/shared established patient outpatient E/M visit)
Topics Covered: split/shared visit coding, split/share E/M coding, shared service coding, split/shared E/M service definition, AMA split/shared guidelines, CMS split/shared guidelines, CPT split/shared guidance, Medicare split/shared billing, facility setting E/M coding, physician and NPP shared services, APP shared service coding, PA shared service coding, NP shared service coding, nonphysician practitioner billing, billing provider determination, substantive portion documentation, substantive portion by time, substantive portion by MDM, medical decision making documentation, MDM split/shared visit, two of three MDM elements, problems addressed, data reviewed and analyzed, independent interpretation of tests, discussion of management plan, risk of patient management, management plan approval, physician responsibility for plan, qualifying time for E/M, distinct time documentation, overlapping provider time, face-to-face requirement, non-face-to-face E/M time, combined provider time, prolonged split/shared services, prolonged service billing, hospital inpatient E/M coding, subsequent hospital visit coding, Medicare prolonged services, critical care split/shared services, critical care time documentation, cumulative critical care time, critical care qualifying activities, critical care add-on code billing, critical care time thresholds, CPT critical care thresholds, CMS critical care thresholds, modifier FS billing, HCPCS modifier FS, split/shared claim identification, SNF split/shared visits, skilled nursing facility E/M coding, initial comprehensive SNF visit, federally mandated SNF visit, subsequent SNF split/shared visits, incident-to billing exclusion, outpatient facility shared services, POS 22 outpatient hospital coding, POS 11 office exclusion, Medicare Claims Processing Manual guidance, CMS 2024 final rule, CPT Assistant split/shared guidance, MAC guidance for split/shared services, WPS split/shared guidance, Novitas split/shared guidance, First Coast split/shared guidance, Noridian split/shared guidance, Palmetto GBA split/shared guidance, NGS split/shared guidance, provider time statements, unsupported time statements, specific minute documentation, split/shared documentation requirements, provider identification documentation, billing provider signature and date, shared visit attestation, addendum documentation, physician addendum requirements, PA note and physician addendum, NP note and physician MDM, MDM versus time documentation, local MAC guidance, hospitalist split/shared visit example, GI bleed shared service example, orthopedic shared visit example, fracture shared visit documentation, shared visit audit risk, E/M reimbursement differences, physician reimbursement, NPP reimbursement, 85 percent NPP reimbursement, 100 percent physician reimbursement, modifier FS appropriateness, NICU shared services exclusion, neonatal critical care coding, single individual critical care reporting, split/shared case studies, E/M documentation examples, coding compliance for shared services, split/shared billing compliance, E/M coding education, medical coding webinar content
Kristi Pollard, RHIT, CCS, CPC, CIRCC
Kristi serves as the Director of Coding Quality & Education and brings more than 30 years of experience in the health information and coding industry. In her role, she oversees the development of comprehensive training materials – including web-based courses, instructor-led training, and webinars – while also providing education in ICD-10-CM/PCS and CPT. Her expertise extends to conducting DRG and APC audits and leading a wide range of coding quality initiatives. With a deep background in coding education and consulting, Kristi is a nationally recognized speaker and published author on ICD-10, CPT coding, and code-based reimbursement. She has designed and implemented robust inpatient and outpatient training programs, with specialized emphasis on vascular interventional radiology, cardiology, and obstetrics.
AHIMA – Expires July 6, 2027
This webinar has been approved for 1 continuing education unit for use in fulfilling the continued education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor.
- Domain: Data Structure, Content and Information Governance
AAPC – Expires July 30, 2027
This program has the prior approval of the American Academy for Professional Coders (AAPC) for 1 continuing education hour. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.
- Specialty CEUs: COC, CPC, CPC-P, Approved-Instructor, CANPC, CASCC, CCC, CCPC, CCVTC, CDEI, CDEO, CDEO-I, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIC-I, CIMC, COBGC, COC-I, COPC, COSC, CPB, CPB-I, CPC-9, CPCD, CPC-I, CPC-M, CPCO, CPCO-I, CPEDC, CPMA, CPMA-I, CPMS, CPPM, CPPM-I, CPRC, CRC, CRC-I, CRHC, CSFAC, CUC, CVBA, FMC, I, RCMS
Excellent Webinar
I learned that I need to append a laterality modifier to spinal procedures.
Great webinar.
Great webinar. Laterality modifiers and bilateral modifier explanation very helpful
Haugen is great! Appreciate your materials! Thank you
I appreciated the examples.
I learned a little bit more about discontinued or repeat procedure modifiers.
I liked the clarification on the MUE edits
I loved how fictional characters were used for the modifiers and there descriptions. She did a wonderful explaining all of them. I thought this lightened the webinar for me.
I loved that you gave the modifiers little names to help us remember who they are and what they do. Thank you for suggesting the MPFS lookup tool to help with determining if a bilateral modifier applies to our codes!
I understand the why of modifiers a little better then I did before
Love the personalities of the Modifiers, helps to identify them better with a personality! Great Job!
The visuals and how you implented the actors in the webinar was very constructive and helpful. Thank you.
Good explanation of the X modifiers
great information
I learned the modifiers for the different parts of the heart
I really like the names used in the examples.
I took away the concept of types of NCCI edits
Liked the “review”
Modifiers can be problematic. Thank you for the information : )
I always love the webinars that Kristi does – great information and dare I say, entertaining!
I thought this webinar was very informative and relevant to my current role. I like the named characters you use because it does help to retain the information! I would love to see you cover complex OB/GYN procedures for CPT. As a profee women’s health coder it would be helpful. I did appreciate your other complex OB webinar that covered PCS. Appreciate what you all do!
Very good refresher.
Very Informa
Topic broken down into characteristics was very effective!
Great information on modifier 52 reduced services, love all the examples provided for all scenarios.
Everything you said matches what I have told me time. I found the validation gratifying! I sent this to the rest of my Revenue Integrity team, passed onto the denials team, and the ED charging team. THANK YOU!
I really liked the explanation of how and what the X modifiers can be used for.
the in-depth explanation of each modifier and the description/example of each. I will definitely keep this information book marked.
All examples were great.
I loved this webinar and the way it was presented. I enjoyed her analogies with characters and the bright and cheerful slides along her upbeat personality. I have a clearer understanding of the 59/X modifiers.
Very informative and easy to follow.
I have often struggled with knowing when to capture anesthesia while coding ED procedures. Thank you for discussing this!
A good refresher webinar on Modifiers
great info
good content
Great course! I appreciate this topic so much!