Medicare Compliance & Reimbursement

Question: An established pregnant patient with a plan of care in place for her gastroesophageal reflux disease reports to the gastroenterologist complaining of severe morning sickness and throat pain. Notes indicate a level two E/M level: however, total encounter time was 31 minutes, and the gastroenterologist spent 20 of those minutes discussing medication options and diet, and helping the patient arrange a visit with her obgyn. Can I code this visit based on time? Answer: Based on your description, you should be able to report an E/M code based on total encounter time. On the claim, you'll likely report 99214 (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: a detailed history; a detailed examination; medical decision making of moderate complexity ... Physicians typically spend 25 minutes face-to-face with the patient and/or family) for the [...]