tci Medicare Compliance & Reimbursement - 2010 Issue 15

Part B Coding Coach: FAQs: Double Your E/M Payout on Some Counseling 'Domination' Claims

Here's when you can code past the three E/M component levels. The physician provides an evaluation and management service for an established patient that requires an expanded problem focused history and exam. The E/M encounter, however, takes nearly 45 minutes to complete. How would you report this E/M service?Opportunity: If the visit meets the correct counseling/coordination of care parameters, you might be able to report the visit using time as the controlling factor rather than the standard three key components. Check out this FAQ on when to invoke to the counseling/coordination of care rule and when to choose...

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