Oncology & Hematology Coding Alert

Question: When youre coding a two-hour or more outpatient visit (99215), how do you document the additional time? Some companies are requesting time-in and time-out sheets but thats kind of impractical.

Anonymous NV Subscriber

Answer: To bill for time-based codes, including E/M services that are dominated by counseling and/or coordination of care, the length of time must be well documented. A summary of the discussion with the patient, along with a statement of time spent, should suffice. However, each insurance company may have specific requirements, so check with your carriers to determine the most common method required in your area and document all of your services of this type very well. Dont forget also to bill prolonged service codes when appropriate. These codes are used in addition to the base E/M code, so a session would be coded 99215 for the first 40 minutes, 99354 for the next 30-74 minutes, and 99355 for each 30 minutes after that. No modifiers are necessary.

Editors Note: Answers to these questions were provided by Mindy Anderson, Pacific Cancer Medical Center in Anaheim, CA, an oncology biller for more than 16 years.