tci Medicare Compliance & Reimbursement - 2010 Issue 1

READER QUESTION: Counseling/Coordination Domination? Consider Time-Based Billing

Question: An established pregnant patient with a plan of care in place for her gastroesophageal reflux disease reports to the gastroenterologist complaining of severe morning sickness and throat pain. Notes indicate a level two E/M level: however, total encounter time was 31 minutes, and the gastroenterologist spent 20 of those minutes discussing medication options and diet, and helping the patient arrange a visit with her obgyn. Can I code this visit based on time?Answer: Based on your description, you should be able to report an E/M code based on total encounter time. On the claim, you'll likely report...

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