tci ED Coding & Reimbursement Alert - 2003 Issue 3

Reader Question: Dont Bill for Extra Consultation Time

Question: One of our physicians spent 30 minutes speaking with a suicidal patient and wants to bill for the time using a prolonged visit code for face-to-face time. Are we allowed to report that in the ED? New York SubscriberAnswer: You shouldn't bill for the extra time. The 99281-99285 series for ED E/M services is not time-based, so billing for extra time does not apply. The time required for a level-five E/M code, which your patient's condition warrants, is open-ended. You can deny your physician's request on the grounds that time is not a criterion for reporting face-to-face encounters...

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