Oncology & Hematology Coding Alert

Question: The oncologist documented 60 minutes for an established patient office visit. She documented spending more than half the time on counseling because they were discussing treatment regimen options and the patient had many questions. Should I code this as 99214 for the first 25 minutes and +99354 for the remaining time? Minnesota Subscriber Answer: No. When counseling and/or coordination of care represents more than 50 percent of the total time with the patient, CPT guidelines instruct that you may choose the E/M level based on time. You should  assign 99215 (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity ... Physicians typically spend 40 minutes face-to-face with the patient and/or family) for this office visit. How it works: When the physician spends [...]