Advanced Search

Podiatry Coding & Billing Alert

Reader Question:

Base E/M on Time for Counseling/Coordination Only

Published on Fri Nov 11, 2011

Question: If the physician documents: "Time spent in the evaluation of the patient with mostly medical decision making time (two thirds) is 75 min" can I choose the E/M code based on time alone?Nevada SubscriberAnswer: No, you cannot code based on time with just the documentation you have mentioned. Here's why: You should only code an E/M service based on time alone if at least 50 percent of the visit was spent on counseling or coordination of care. How it works: According to this year's CPT manual, you can use the code closest to the documented time. "If coding by time, pick the closest typical time," said Peter Hollmann, MD, during the "E/M, Vaccines, and Time-Based Codes" session at the CPT and RBRVS 2011 Annual Symposium in Chicago this past fall. That advice echoes previous AMA information. For instance, the August 2004 CPT Assistant stated, "In selecting time, the physician must [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Podiatry Coding & Billing Alert

View All