Urology Coding Alert

You Be the Coder:

Counseling

Published on Sun Apr 01, 2001

Question: Some of our patients require a lot of time with the physician before deciding how to treat their prostate cancer. The physician talks to the husband and wife for an hour or more. How can we be reimbursed for this time?

Connecticut Subscriber

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.

Answer: When a physician spends 50 percent or more of encounter time performing counseling, you can use time as a factor in determining what level evaluation and management (E/M) service to bill. For example, if the physician spends 10 minutes on an exam, five minutes on a history, and 45 minutes on counseling, he or she can bill a 99215 for an established patient, or 99204 or 99243 for a new patient.

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