KaylaRieken
True Blue
If Face to Face time of 25 minutes, majority counseling was spent with a new patient, would you consider this a 99202 or a 99203?
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Wiki 25 minutes
- Thread starter KaylaRieken
- Start date
Pathos
True Blue
From CMS '97-'95 guidelines:
"When counseling and/or coordination of care dominates (more than 50 percent of) the
physician/patient and/or family encounter (face-to-face time in the office or other outpatient
setting, floor/unit time in the hospital, or NF), time is considered the key or controlling
factor to qualify for a particular level of E/M services. If the level of service is reported
based on counseling and/or coordination of care, you should document the total length
of time of the encounter and the record should describe the counseling and/or activities
to coordinate care."
To me that suggests that documentation also should include a description of what was being counseled and/or coordinated.
The time threshold for New Patients are (from EM University):
99201 - 10
99202 - 20
99203 - 30
99204 - 45
99205 - 60
Based on your example, and if you used time solely as the overriding factor, I would recommend 99202. E/M components (History, Exam, Medical Decision Making) could possibly increase the level, if documentation and medical necessity are properly present.
I do understand your question however, since 25 minutes is between 99202 and 99203; however based on the guidelines, 25 minutes is not enough to reach 99203.
Hope this is helpful!
"When counseling and/or coordination of care dominates (more than 50 percent of) the
physician/patient and/or family encounter (face-to-face time in the office or other outpatient
setting, floor/unit time in the hospital, or NF), time is considered the key or controlling
factor to qualify for a particular level of E/M services. If the level of service is reported
based on counseling and/or coordination of care, you should document the total length
of time of the encounter and the record should describe the counseling and/or activities
to coordinate care."
To me that suggests that documentation also should include a description of what was being counseled and/or coordinated.
The time threshold for New Patients are (from EM University):
99201 - 10
99202 - 20
99203 - 30
99204 - 45
99205 - 60
Based on your example, and if you used time solely as the overriding factor, I would recommend 99202. E/M components (History, Exam, Medical Decision Making) could possibly increase the level, if documentation and medical necessity are properly present.
I do understand your question however, since 25 minutes is between 99202 and 99203; however based on the guidelines, 25 minutes is not enough to reach 99203.
Hope this is helpful!