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Pediatric Coding Alert

Time-based Coding:

CPT Allows You to Select Code Based on 'Closest Typical Time' When Counseling Dominates Visit

Published on Fri Mar 18, 2011

Remember to always document visit times when coding based on the clock.Picture this: A pediatrician provides an E/M 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 because the doctor spends so much time educating the patient. How would you report this E/M service?Opportunity: If the visit meets the correct counseling/coordination of care parameters, you should report the visit using time as the controlling factor rather than the standard three key components.Keep in mind: CPT notes that "this includes time spent with parties who have assumed responsibility for the care of the patient or decision-making, whether or not they are family members (eg, foster parents, person acting in loco parentis, legal guardian."But how you select the right code may boil down to the fine print in CPT 2011. According to this year's CPT manual, you can [...]
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