Wiki Integrative Medicine and Time-based coding

[mmcneil03@yahoo.com]

Hi All,

I have a client who is an integrated medicine facility. My supervisor has indicated that because they allow for more time to see their patients that they should steer clear of coding based on counseling/coordinating care, which is understandable.

My question is in regards to the prolonged services codes 99354-99357. One of the providers at the Integrative medicine practice is asking me if it is ok to use these codes. My supervisor says "yes" if they go above and beyond a required 99215 - however, if they are not supposed to code based on time, how can it be possible for them to use the prolonged services codes? Especially because these are time-based codes????

I appreciate any and all feedback!!!!! Thanks! Megan

 

[Pam Warren]

Maybe I'm not understanding this clearly, but I don't believe it matters how much time you 'allow' for patient care: if the documentation of the visit supports the level of service for key components, and the nature of the presenting problem meets medical necessity, then the documentation for counseling and coordination of care (if complete and appropriate) can be used in any specialty or circumstance. The nature of integrative medicine, particularly if used to counsel the patient on the holistic nature of the treatment as relative to the complaint, is conducive to using time to capture the provider's work. I would caution using time for every encounter, but I don't know that you have to categorically exclude it. And there is no other way to document prolonged service without documentation of time that I am aware of.

 

[mmcneil03@yahoo.com]

That's what I thought.....Thanks for the response!