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"10 minutes of medical discussion"

J

JDACPC

Guru
Local Chapter Officer
Messages
171
Location
Richfield, PA
For the audio-only codes, when using MDM rather than time, have you initiated a policy that requires the providers to attest to "more than 10 minutes of medical discussion?" If you have found any authoritative guidance on the requirement, I would love to see it. I have found plenty of info on time-based codes and the requirements for minutes must be met or exceeded, code to the full description, but nothing that mentions this scenario specifically. Thank you!!

Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion.
 
Hi there, I can't find anything in the 2025 CPT Changes or a few private payer polices that spell out documentation requirements or recommendations. Personally I think having them document the exact time makes sense because it might allow for a higher code than MDM for a visit. I also think identical statements for time give auditors something to pick at, but again, I can't find any authoritative statements that say it is wrong.
 
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