tci Medicare Compliance & Reimbursement - 2019 Issue Q3
Reader Question: Know How ‘Regular Hours’ Are Defined
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Article Overview
This reader Q&A discusses how a practice’s posted office schedule affects reporting of CPT add-on services for encounters that occur on holidays or outside normal business hours. It is aimed at coding professionals, billers, and practice staff who need a general understanding of when office-hours-related CPT guidance may apply and how it relates to E/M office visit coding.
Why This Topic Matters
Accurate interpretation of scheduled office hours can affect whether a special service code is considered for a visit, which is important for compliant coding and claim submission.
Article Sections
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Question
The reader asks about reporting an office-hours-related CPT code for holiday encounters when the practice is open beyond its usual schedule.
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Answer
The response discusses the general distinction between regularly scheduled office hours and time outside the posted schedule, along with related E/M visit coding context.
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Example
A sample office schedule and same-day visit scenario is used to illustrate how the article frames office-hours-related coding considerations.
What You Will Learn
- How posted office hours can affect CPT office-based service reporting
- The general difference between regular schedule-based hours and time outside those hours
- How office-hours guidance relates to E/M office visit coding
- How an illustrative schedule example is used to frame the issue
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Physician office staff
Codes Discussed
Code Ranges Discussed
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