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Wiki 15 minute 99214 visit

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LevaMarvin

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Im trying to find some information for one of my providers about the length of time a 99214 visit should be. The CPT manual says "Physicians typically spend 25 minutes face-to-face with the patient and/or family".

Can a 99214 visit be 15 minutes long if the nature of the problem, the work involved(ordering lab, referrals, ect), and the documentation supports a higher level of service?

I have always thought that the nature of the problem, the documentation and the work involved should be the determining factor, but he is questioning me which is causing me to question myself.

Any help would be greatly appreciated! Thank you!
 
You are correct, the visit does not have to take 25 mintues before you can report a service. If the documentation supports a 99214 with the components and the nature of the presenting problem, workup and treatment plan, then you would be correct to report the appropriate service.

A 99205 can be as quick as needed to treat a very ill patient, (eg. chest pain, abnormal EKG showing an MI) and may not take the full 60 minutes. But the presenting problem is Acute and life threatening. This goes without saying for any E&M level.
 
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