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Primary Care Coding Alert

READER QUESTIONS:

Count Minutes on 'Counseling Exception' Claims

Published on Tue May 26, 2009

Question: A new patient with juvenile diabetes meets with the FP for management of her condition. One of our nonphysician practitioners (NPPs) provides the E/M for the patient, which lasts 37 minutes. Notes indicate that the NPP performed an expanded problem-focused history and exam and straightforward medical decision making, and that she spent 22 minutes advising the patient on proper diet, how to check her own blood sugar, and medication management. Is this an instance where I can code based on total encounter time? Montana Subscriber Answer: You may be able to code this encounter based on counseling/coordination of care time; be sure to double-check the total session time and the amount the NPP spent counseling before coding. If the NPP did spend at least half of the total session time counseling the patient, then report 99203 (Office or other outpatient visit for the evaluation and management of a new [...]
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