Wiki Billing by time


Durham, NC
Best answers
If the provider documents 80 minutes total encounter with 45 minutes counseling.

Should I change the time on the encounter note to 90?

Or leave the note alone and bill at comphrensive + 30 prolonged.

I believe that the documentation by the provider should not be changed. Others in the office claim it has to be changed in order to billed comphrensive + 30.
Is the doctor just trying to communicate that more than half of the 80 minutes was spent counseling the patient? My advice is to code what you have. Not sure of the purpose behind medelling with the note.
You Bill the visit as to what meets the level of service per the guidelines for what is documented, subtract that visit level time from the 80 you are given as total time then Bill prolonged on the basis of the tome left after the subtraction. So it could be a 99213 with a 99354 or a 99214 with a 99354 or even a 99212 with a 99354..
I have understood from the doctor that stating 80 minutes gives how long the visit lasted.
Indicating it was not a 90 minute visit is all.
I always respected that more than having them put in 90 minutes, rounding up, to get the prolonged.

I was told that insurance would deny the prolonged if the note stated 80.
No there is no rounding up it is based on simple math, prolonged is when you have a minimum of 30 minutes after you subtract out the visit level time. The visit level time is per the CPT book. I am not sure why you feel you need top have 90 minutes but you can never change the time documented by the provider.
billing by time

thank you for your response.

i do not change their documentation.

i do not believe in rounding up either.

Thanks again