Wiki MFM-Time based consultation coding (educational video included or not?)

[karitoon]

Hopefully someone can provide some further insight into a question I was asked by one of my MFM providers. When a patient is seen for an initial consultation along with NT screening by a MFM Physician, part of the consultation includes a "deep dive" into the prevention of preeclampsia, the educational speech is the same for each patient then a discussion and/or questions answered.

The question asked was: If the provider makes a video for the patient to watch while waiting in the exam room; could the viewing time (length of educational video) be counted towards the total time spent when selecting the correct CPT code? It would be the provider on the video not other staff providing the information.

I'm leaning more towards no it would not count because to me it's just like giving a patient a pamphlet or other educational materials, you wouldn't count that because the patient viewing and/or reading material isn't part of the work/time spent provided by the provider.

Thank you in advance for any help on answering this.

 

[csperoni]

No. If the provider is not personally spending the time, you cannot count it. You can count the time the provider is discussing and answering questions (and just about any other work done on the date of the encounter). Similarly, if a nurse is providing education, that cannot be counted as physician time.
From the AMA E&M guidelines:
For coding purposes, time for these services is the total time on the date of the encounter. It includes both the face-to-face time with the patient and/or family/caregiver and non-face-to-face time personally spent by the physician and/or other qualified health care professional(s) on the day of the encounter (includes time in activities that require the physician or other qualified health care professional and does not include time in activities normally performed by clinical staff). It includes time regardless of the location of the physician or other qualified health care professional (eg, whether on or off the inpatient unit or in or out of the outpatient office). It does not include any time spent in the performance of other separately reported service(s).