Wiki 2021 Time Question

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Can a provider start billing CCM one month skip a couple of months and start billing CCM again.
Example CCM bill March didn't contact patient next two months then starts CCM in June bills for June them skips July.
I need help!

coder21

Guru
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Question- I was on a call today and the coder stated that you can use the time for the provider to write the note in the 2021 time based code. Does anyone have prove of this?
 

TPeniston61

Networker
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47
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Carlsbad, California
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2021 E/M Coding Guideline allow the provider to determine the level using either time or medical decision making/complexity. Time can include non-face-to-face time as well as face-to-face time. It can include any kind of preparation required in order to treat the patient: reviewing notes from referring physician or previous visits, interpreting x-rays and MRIs, consulting with other physicians on the case, coordinating with other caregivers for the patient's recovery.
 

wongs84

Contributor
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Hi everyone,
I have a question regards to the new Prolonged Service Codes 99417; this code is to apply in addition to E/M codes 99205 & 99215 if you code based by time. I do understand that this code can not be applied for any time unit less than 15 minutes but according to the guidelines 99205 is 60-74 minutes. If I were to use code 99417 in addition that means the provider must spent 89 minutes Correct? Since less than 15mins doesn't count but how come the 2021 CPT book shows 75-89 minutes? Any feedback would be appreciated!
Thank you so much!
Shirley
 

wongs84

Contributor
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Thank you for the feedback! What I am confused about was why they show a time range of 75-89 instead of just 89 minutes?
 

lcolborn

Networker
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I think what that meant is from 75 minutes starts the clock for the 15 minute increment w/c is 89 minutes. 99205 is 74 minutes..., once you hit that 75 minutes and or 15 minutes past 74 minutes to equal 89 minutes.
 

shanamarie

Networker
Messages
79
Location
Eagan
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Hi everyone,
I have a question regards to the new Prolonged Service Codes 99417; this code is to apply in addition to E/M codes 99205 & 99215 if you code based by time. I do understand that this code can not be applied for any time unit less than 15 minutes but according to the guidelines 99205 is 60-74 minutes. If I were to use code 99417 in addition that means the provider must spent 89 minutes Correct? Since less than 15mins doesn't count but how come the 2021 CPT book shows 75-89 minutes? Any feedback would be appreciated!
Thank you so much!
Shirley
I don’t have the grid in front of me but once you reach 75 minutes then you could bill 99417 per CPT. CMS on the other hand is stating you need to meet the max amount of 89 minutes in order to bill 99417.
 
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