Medicare Compliance & Reimbursement

Here's when you can code past the three E/M component levels. The physician provides an evaluation and management service for an established patient that requires an expanded problem focused history and exam. The E/M encounter, however, takes nearly 45 minutes to complete. How would you report this E/M service? Opportunity: If the visit meets the correct counseling/coordination of care parameters, you might be able to report the visit using time as the controlling factor rather than the standard three key components. Check out this FAQ on when to invoke to the counseling/coordination of care rule and when to choose the E/M level based on traditional means. When Can I Code Based on Counseling Time? Coders can choose an E/M code based on time "when counseling is more than 50 percent of the encounter," explains Kathleen Goodwin, CPC, coding coordinator with La Porte Regional Health Systems in Indiana. Remember: "This is [...]