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Advanced Care Planning Codes

StacyGalloway

Networker
Messages
72
Location
Olathe, KS
Best answers
0
99497 - states that this is for the first 30 minutes. Can anyone please clarify if this means "up to" 30 min? Or does the documented time need to be 30 min in order to bill the charge? We have a Health Care worker that completes this service in conjunction with the physician when the Medicare Wellness Exam is preformed. (modifier 33) The visit time ranges from 15-25 min from what I have seen thus far. I just want to make sure we are doing this correctly.

Thank you.
 

aciardelli

Networker
Messages
25
Location
Ohio
Best answers
0
My understanding of this code is that the provider has to document more than 15 mins (16 or more) to bill the code. And the time has to be dedicated to what is required to the ACP codes.
 

mitchellde

True Blue
Messages
13,538
Location
Columbia, MO
Best answers
2
When you state the visit time is 15-25 min. Is this the entire encounter? If so then you would not be able to bill the wellness and the advance care planning together. The time spent on the advance care planning must be separately documented and separately timed and would be a minimum of 16 minutes to be billable.
 

StacyGalloway

Networker
Messages
72
Location
Olathe, KS
Best answers
0
The time mentioned in the first post was time spent on the ACP only. (in addition to the MWE)


Thank you.
 
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