tci ED Coding & Reimbursement Alert - 2014 Issue 5

Reader Question: Heed This Counsel: Time is Not a Component of ED E/M Codes

Question:  A patient with a chronic gastric ulcer reports to the ED complaining of nausea, vomiting, and headache. One of our nurse practitioners spends 34 minutes with the patient, and performs an expanded problem focused history and exam and moderate-complexity medical decision making during the encounter.  During the history portion of the E/M, the patient reveals that she has not been to a physician in several years for treatment of her ulcer. The note indicates that the NP spent 21 minutes advising the patient on proper diet and medication management, and encouraging the patient to resume regular...

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