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Q&A Billing Based on Time

Debi

Well-Known Member
Hello, I work in a medium sized practice, I do Physician billing for clinic billing. I have noticed over the past several months that the doctors have been billing based on time. In there documentation stating "more than 50% of the visit was spent on counseling and/or coordination of care for a total visit of 35 minutes." I guess my question is, can we bill just based on time, or does the documentation also have to reflect the Level of Service also. Meaning billing on time would be a 99214 for an established patient but documentation there is only a 99213. I have not been able to find any real clarification on this, I just want to make sure that I am coding these cases correctly. I could give an example if is needed. Thank you.
 

Laureen

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In the EM guidelines in the CPT manual on page 10 it states when counseling and/or coordination of care dominate" you can bill based on time. If your physicians are documenting that way then they can bill based on time. They should state what the counseling or coordination of care was for to be complete and fully protected in case of an auudt.

http://www.screencast.com/t/Kt45uPtFd

 
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