time based billing

  1. C

    How to know when to go to the next 9940 code

    Hi! When billing the 99401 series codes, how do you know when to go up the next code if the time is in between 2 codes. For example, if a provider spends 20 minutes with a patient would you use 99401 which is approx 15 mins or would you bump up to 99402 which is approx 30 mins?
  2. M

    Coding Help for ABA-Autism Billing

    Can anyone help me with a billing/coding question in regards to ABA services, codes 0364T and 0365T? I need to know what the guideline/rules are for billing the secondary code 0365T, as far as the times/rounding up? What is the guideline, for billing the secondary code and rounding up? Does it...
  3. L

    Time based coding

    Is the following phrase sufficient to bill based on time? "Total time spent was 45 minutes and more than 50% was in face-to-face discussion" In the assessment and plan the doctor elaborates on what all is being discussed, however we have a question as to whether the word "discussion" is...
  4. J

    Time based coding for diagnostic testing

    Time based coding is usually face-to-face but is it the same for testing, specifically 95974? If so, where is this documented? The region is J8 but it would be good to see requirements from other regions for comparison. Thank you.
  5. K

    compliant time based coding statement 99215?

    Hello, We are having an inter-office difference of opinion on whether a time based statement for a E5 encounter fulfills the guidelines to charge by time or not, does this statement meet requirements to charge 99215 based on time? The note contains all of the counseling details and the dx to...
  6. M

    Medical Nutrition Therapy code 97804

    Hi all, I have been searching online to no avail. We have some patients who saw one of our dietitians as a group. We are billing 97804 and this code is billed in units for every 30 minutes. These group MNT patients were seen for 1 hour and 45 minutes (105 minutes total). Would this be billed as...
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