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Wiki Counseling codes 99401-4 VS E/M 99212-4

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JM.Geyer

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Much needed help please.

When my NP's do our chemotherapy and radiation therapy teachings we are billing out the counseling codes 99401-4. My NP's seem to think we can bill the E/M 99212-4 based on time alone. Can someone please help me with this. I can't find any LCD guidelines for the counseling codes. Are the NP's correct that we can bill the E/M's based on time alone?
 
You can't do oncology/rad preventive counseling on a patient that already has a oncology/rad disease or DX

If the encounter is for discussion/counseling rather than eval/treatment, then document time and what was discussed and you can code the encounter based on time

The CC would be something like "pt here to discuss Rad treatment plan"

Time documentation must include total visit time and counseling time. Such as "60 minute visit with 50 minutes counseling"

Must also document "significant detail" to support counseling time claimed
 
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