tci General Surgery Coding Alert - 2012 Issue 1

Reader Question: Count Time Differently for CPT® vs. CMS

Question: If the physician documents: "Time spent in the evaluation of the patient with mostly medical decision making time (two thirds) is 75 min," can I choose the E/M code based on time alone?Texas SubscriberAnswer: No, you cannot code based on time with just the documentation you have mentioned. Here's why: You should only code an E/M service based on time alone if at least 50 percent of the visit was spent on counseling or coordination of care. How it works: According to the 2011 CPT® manual, you can select the code that represents the time "closest...

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