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mbarber

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Does Progress notes need to have a time in and time out on the form to support the total time spent?

For example if a physician started talking with the Nurse at 9:45am and did not see the patient til 12pm and did not chart til 6pm how much time did he spend total with that pt
 
E/M 99201-99205, 99211 - 99215, are face-to-face time with the patient by the provider. Documenting time and using time to support a code for an office visit only works when greater than 50% of the visit is spent counseling the patient. Then the total time needs to be stated i.e.; "60 min. visit of which more than 50% has been spent counseling the patient on ............" or 60 min visit of which 45 min. was spent counseling patient on ........". The documentation needs to state which subjects the counseling was completed on.
 
E/M Time

My physicians see pt in SNF, ALF, Hospitals, Homes we conduct Hospice and Palliative Care so my question is: does there need to be a line that say..Time In and Time Out and then Total time spent doing documentation, speaking with the RN or Whoever on the forms?
 
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