Advanced Care Planning - Timing

Aperene

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RE: 99497
"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or surrogate"

The code states "first 30 minutes". My question is, if the Physician spends 24 minutes with the patient, can we use the 99497 code for Advance Care Planning, as the code is not specific to if it has to be 30 minutes or UP to the first 30 minutes?

April Evans CPC
 

mhstrauss

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Best answers
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RE: 99497
"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or surrogate"

The code states "first 30 minutes". My question is, if the Physician spends 24 minutes with the patient, can we use the 99497 code for Advance Care Planning, as the code is not specific to if it has to be 30 minutes or UP to the first 30 minutes?

April Evans CPC


Per CPT Time Guidelines, once you hit the halfway point for the time required by a code (unless that code/section/chapter has a specific notation), you are able to bill for that service. Since 24 mins is more than half of 30, you can use 99497 for this service.

HTH!
 
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