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Ob-Gyn Coding Alert

Reader Questions:

Language Barrier Doesn't Mean Time Barrier

Published on Sat Apr 03, 2010

Question: One of our providers wants to bill a preventive counseling code (99402) with 627.2. She also stated in her notes that she and the patient had a language barrier. Therefore, the visit took a lot longer to explain things. She noted her time to be 35 minutes extra. Can I base time on this obstacle? If so, how should I report this?Ohio SubscriberAnswer: First, if the patient is having menopausal symptoms -- which is the only time you can use 627.2 (Symptomatic menopausal or female climacteric states) -- the visit would not be preventive (99401-99404, Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual) but a problem visit (99201-99215, Office or other outpatient visit ...).If the typical time for the problem E/M is exceeded by 30 minutes, you can consider adding prolonged physician services code(s), but make sure you have read the guidelines in CPT carefully before reporting [...]
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