oksanap
New
Hello,
We recently had a debate with my Doc regarding time based coding. Doctor saying that since some insurances do not cover smoking cessation consulting and counseling is actually done we need to code it as time based E&M visit. I personally think that since CPT code for tobacco counseling exist it should be separated from E&M. Also I'm not sure if we can bill insurances differently depending on benefits. Any suggestions?
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IV. Documentation of an Encounter Dominated by Counseling and/or Coordination of Care
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 Nursing Facility), 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, the total length of time of the encounter should be documented and the record should describe the counseling and/or activities to coordinate care. For example, if 25 minutes was spent face-to-face with an established patient in the office and more than half of that time was spent counseling the patient or coordinating his or her care, CPT code 99214 should be selected.
_____________________
Oksana Pokoyeva, CPC
WCH Service Bureau
Email: oksanap@wchsb.com
We recently had a debate with my Doc regarding time based coding. Doctor saying that since some insurances do not cover smoking cessation consulting and counseling is actually done we need to code it as time based E&M visit. I personally think that since CPT code for tobacco counseling exist it should be separated from E&M. Also I'm not sure if we can bill insurances differently depending on benefits. Any suggestions?
________________________________________
IV. Documentation of an Encounter Dominated by Counseling and/or Coordination of Care
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 Nursing Facility), 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, the total length of time of the encounter should be documented and the record should describe the counseling and/or activities to coordinate care. For example, if 25 minutes was spent face-to-face with an established patient in the office and more than half of that time was spent counseling the patient or coordinating his or her care, CPT code 99214 should be selected.
_____________________
Oksana Pokoyeva, CPC
WCH Service Bureau
Email: oksanap@wchsb.com
