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2021 PFS and E/M Office Visits: Making it Work in Your Practice

Total Credits: 1 including 1 AOA Category 1-A Credit(s)

Average Rating:
State Associations:
NCOMA - North Carolina
David Hitzeman, DO |  Cynthia Penkala, CMM, CMPE, CMSCS, CPOM |  Michael Warner, DO |  Elena McGannon, MPA, RHIA, CCSP, PCCP
1 Hour 11 Minutes
Never expires.


The Evaluation and Management 2021 coding changes are in effect as of January 1, 2021. Concerned on how to implement in your practice? Are you wondering how these changes impact Osteopathic Manipulative Treatment (OMT) performed on the same day? This presentation will review the E/M changes, cover documentation components, and code selection. The session will also cover when OMT is performed during the office visit.

Learning Objectives

  • Describe the 2021 Evaluation and Management (E/M) office – outpatient visit changes
    • Medical Decision-Making Grid
    • Total Time
  • Discuss E/M documentation workflow
  • Document E/M services performed on the same day as OMT
  • Discern what to submit for an E/M -25 modifier, and OMT related denial

The NC Osteopathic Medical Association (NCOMA) is accredited by the American Osteopathic Medical Association to provide continuing medical education to physicians.  NCOMA designates this program for a maximum of 1 AOA Category 1-A credit and will report CME and specialty credits commensurate with the extent of the physician's participation in this activity.  



David Hitzeman, DO's Profile

David Hitzeman, DO Related seminars and products

Dr. David Hitzeman has been actively involved in osteopathic medicine for nearly 40 years. After graduating from the Kansas City College of Osteopathic Medicine in 1974, Dr. Hitzeman completed his Internal Medicine Residency at Oklahoma Osteopathic Hospital in Tulsa.  Over the course of 20 years in private practice, Dr. Hitzeman helped to form and govern four group practices. He has influenced the next generation of osteopathic physicians as chairman of the Department of Internal Medicine at Oklahoma State University Medical Center and as a Professor of Internal Medicine at Oklahoma State University College of Osteopathic Medicine and Program Director for the Internal Medicine Residency Program at Oklahoma State University Medical Center. For two decades, he has held the position of chief delegate of the Oklahoma Osteopathic Association to the AOA’s House of Delegates.

In addition, Dr. Hitzeman has served in other AOA leadership capacities such as Chair to the Bureau of Socioeconomic Affairs and Chair to the Joint Committee on Quality and Payment. After being appointed by the governor of Oklahoma to the Physician Manpower Training Commission, Dr. Hitzeman worked to address the state’s diverse health care workforce issues, a position he held for 10 years.  He has served two terms as Board member of the Oklahoma Foundation for Medical Quality and performed peer review for the last 30 years.

Dr. Hitzeman has represented the American Osteopathic Association at the American Medical Association’s Relative Value Scale Update Committee (RUC) since 1996 and chaired or served on all the RUC standing subcommittees and multiple workgroups. In 2012, the American College of Osteopathic Internists named Dr. Hitzeman its Internist of the Year. In 2013, the American Osteopathic Association’s Board of Trustees honored David F. Hitzeman, DO with an AOA Presidential Citation as an expression of its sincerest gratitude for his expertise in delivery system design and payment reform as well as his commitment to training the next generation of DOs. 

Cynthia Penkala, CMM, CMPE, CMSCS, CPOM's Profile

Cynthia Penkala, CMM, CMPE, CMSCS, CPOM Related seminars and products

Cynthia Penkala is the Senior Director of the Physician Services Department at the American Osteopathic Association (AOA). In her role, she provides guidance for AOA affiliates, osteopathic physicians, and their practices on issues impacting the medical practice's daily operations. She raises awareness of issues that may impact osteopathic physicians and their practices. She also oversees the development of member education to assist physicians. She has over 40 years of experience working in the health care industry, including; 13+ years of medical association experience, 18+ years managing physician practices, owning her own billing and consulting service, and an additional ten years working in the medical field in other capacities. Cindy uses her versatile skill set to help physicians and their practices be successful. She does this through a continual focus on service offerings, investigation, education, process improvement, and a solid background in healthcare services, organizational management, medical billing, and personnel recruiting. Her passion fuels her drive to make sure physicians have a choice between becoming employed and remaining independent.

Cynthia Penkala discloses that she has no relevant financial relationships with any organization producing, marketing, reselling, or distributing health care goods or services consumed by, or used on, patients relative to the content of this presentation.

Michael Warner, DO's Profile

Michael Warner, DO Related seminars and products

Dr. Michael J. Warner received undergraduate degrees in Biology and Philosophy from Villanova University. He earned his Doctor of Osteopathy (D.O.) from Des Moines University where he also served a one-year undergraduate Osteopathic Manipulative Medicine teaching fellowship. Following fellowship, Dr. Warner completed his internship and family medicine residency at Atlantic City Medical Center, NJ. Dr. Warner is board certified in family medicine (ACOFP) and neuromusculoskeletal medicine (AOBNMM). Dr. Warner practiced family medicine for over 20 years in the Ebensburg/Johnstown, PA region. Most of those years, he was in private practice with his wife, Margaret Warner, D.O. Dr. Warner moved cross country and currently is an associate professor of osteopathic principles and practice at Touro University California, Vallejo, CA. He also represents the AOA as an alternate advisor on AMA RUC and serves AAPC as a National Advisory Board member. He is also president of non-profit Patient Advocacy Initiatives and faculty advisor for TUC’s Patient Advocacy Club.  

Elena McGannon, MPA, RHIA, CCSP, PCCP's Profile

Elena McGannon, MPA, RHIA, CCSP, PCCP Related seminars and products

Elena McGannon is the Manager, Physician Payer Relations in the Physician Services Department at the American Osteopathic Association. In Elena’s role she is responsible for supporting the AOA Affiliates, Osteopathic Physician Members, and their practices with payor advocacy issues, coding and billing expertise, revenue cycle processes, and documentation audits. She also provides physician and practice education informally or formally for Osteopathic Associations. Ms. McGannon has worked in the healthcare industry for over 20 years overseeing business and revenue cycle operations and electronic health record implementations. Her career includes working at large integrated healthcare delivery systems, independent physician groups, and independent consulting within the revenue cycle space. She holds a Master’s in Public Administration from the University of Illinois, Chicago and is certified through AHIMA as a Registered Health Information Administrator (RHIA) and Certified Coding Specialist Physician (CCSP). Additionally, she is certified through Procsi as a Certified Change Practitioner.

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