Billing and Coding: Something Old, Something New (11/20/2019)

1.5 CMD Management / 1.5 CME / 1.5 MOC

This session will provide details about billing for services that have recently been approved by the Centers for Medicare & Medicaid Services (CMS). Participants will learn the peculiarities of the billing changes for these codes. Speakers will discuss the new direction CMS may be heading for evaluation and management (E&M) documentation and billing as delineated in the proposed Physician Fee Schedule (PFS) for 2018. The session also will review and explore the finer points of some classical billing and coding enigmas that continue to challenge many PALTC practitioners.

Learning Objectives:

  • Discuss details of billing complexities for recently approved billing codes used in the geriatric care continuum
  • Discuss CMS’ potential new direction for E&M documentation and billing
  • Review details of some recurrently perplexing PALTC coding and billing issues


Charles Crecelius, MD, PhD, FACP, CMD is a practicing geriatrician, Director, Post-Acute Care Services for the BJC Medical Group ACO, multi-facility medical director for Delmar Gardens Enterprises, and Associate Clinical Professor of Internal Medicine and Geriatrics at Washington University School of Medicine. He is also the Project Medical Director for the CMMI-funded Missouri Quality Initiative for Nursing Homes (MOQI) which is studying ways to decrease unnecessary hospitalizations. He is a Past President of AMDA – The Society for PALTC Medicine, represents the Society in the American College of Physician’s Subspecialty Advisory Group on Socioeconomic Affairs and the AMA Relative Value Update Committee, and is on the Steering Committee of their Practice Management Section.

Robert A. Zorowitz, MD, MBA, CMD is Medical Director at Optum Care Plus (formerly EverCare) in New York, NY. He is a graduate of Albany Medical College, completed his residency in Internal Medicine at Long Island Jewish Medical Center and his fellowship in Geriatric Medicine at Mount Sinai Medical Center. He received his Master of Business Administration from Goizueta Business School at Emory University.

 Speaker Disclosures:

 Charles A. Crecelius, MD, PhD, CMD:  Has no relevant financial relationship to disclose.

Robert A. Zorowitz, MD, MBA, CMD: Has no relevant financial relationship to disclose.

Speakers are required to provide verbal disclosure prior to each talk. If the learner perceives any bias toward a commercial product or service, please report this to the Society’s staff. According to the Society and ACCME policy, all those in a position to control content are required to disclose any relevant financial relationships.


The following AMDA Education Committee members have financial relationships to report: John Loome – Genesis HealthCare: Full-Time Employee; Diane Sanders-Cepeda, DO, CMD – UHG-Optum: Full-Time Employee; all others have no financial relationships to disclose.


Online Education Subcommittees have no financial relationships to disclose.


The speakers have no financial relationships to disclose.


AMDA staff have no financial relationships to disclose.