EM Coding Alert

Question: Now that we can code many E/M services based on time, and we can use more than face-to-face time, are there any tips about what types of services we can’t count toward time?

California Subscriber

Answer: Yes, CPT^® guidelines provide some very specific instructions about what items you should not count as time toward an appropriate evaluation and management (E/M) service level, depending on the type of encounter.

You should not include the following when you’re counting time spent in an E/M encounter:

• Clinical staff time
• Travel time
• Time spent by the provider on general teaching activities
• Resident or medical student time in a teaching setting
• Time spent performing other services reported separately from the E/M service

In a situation involving shared or split visits, such as by a provider and nurse practitioner (NP), you can’t double dip. If both individuals are with the patient for a certain period of time, you should count the time of only one individual.