DecisionHealth, DecisionHealth - 2012 Issue 8 (August)

Follow CPT, CMS advice on time-based coding; round up when appropriate

Don’t lose money following CMS’ time-based E/M coding rules for private-pay patients. CPT policy, which most private payers follow, allows you to round to the nearest time interval and that could mean rounding up. Any denials should be easily appealable, so long as your math is correct, you maintain accurate time estimates and you’re only using time to select the code when greater than 50% of the visit was spent counseling the patient, coding experts say.

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