tci Medicare Compliance & Reimbursement - 2018 Issue 9

Reader Question: Documentation Trumps Time for E/M Claims

Question: We saw a patient who hadn't been to our practice for over a decade, and she was having multiple issues. We spent about 40 minutes talking to the patient and her daughter about how to treat her condition, and we reported 99204 for the visit. The insurer denied the claim because our documentation only supported 99203, but we have enough time spent to justify 99204. How do we prove this? Supercoder.com Subscriber Answer: Before using time as the controlling factor, check off the following requirements that must be documented: 1. The total time spent with the patient...

To read the full article, sign in and subscribe to tci Medicare Compliance & Reimbursement.


Keep pace with evolving Medicare regulations — and onboard your team — with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI's Medicare Compliance & Reimbursement Alert will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, payer policies, the fee schedule, OIG target areas, and more.

  • Current newsletters added each month
  • Fully searchable archives - over 4200 articles
  • ALL years/issues back to 2003 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles
Access to this feature is available in the following products:
  • tci Medicare Compliance & Reimbursement +Archives

demo
request yours today
 subscribe
start today
 newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.