tci E/M Coding Alert - 2021 Issue Q2

Reader Questions: Be Wary of Private Payer Interpretations for This Common Pediatric Scenario

Question: The 2021 revisions to the office/outpatient evaluation and management (E/M) codes no longer contain language stating that time spent counseling the patient and/or family can be counted toward total time when billing the encounter on time. Does this mean that a pediatrician can no longer meet with a parent alone, without the patient present, and continue to bill based on total time? Alabama Subscriber Answer: When the AMA revised CPT® office/outpatient E/M codes 99202-99215 (Office or other outpatient visit for the evaluation and management of a new/established patient …) on Jan. 1, 2021, they deleted the following...

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