Wiki G0442 Alcohol screening

[01085585]

Hello- This code is a screening code and states 15 minutes. Does this mean the screening time has to be 15 min or up to 15 min? If they screen negative it would be hard to spend 15 min on it? Thoughts...

 

[CodingKing]

Uness otherwise specified. Times codes you must spend 50% of the time specified in the code so 8 min is the threshold for 15 min codes.

 

[Cynthia Hughes]

G0442 and time

The CPT midpoint rule is not applied by Medicare except when CMS has specifically stated it applies (as they did for advance care planning). However, in a CMS call on 08/15/12, Yvette Cousar of CMS stated the time for these codes was up to 15 minutes (see transcript at https://www.cms.gov/Outreach-and-Education/Outreach/NPC/Downloads/08-15-12-Transcript.pdf). That said, Medicare Administrative Contractors (MACs) may disagree and it is worthwhile to make an inquiry to your MAC regarding their acceptance of this guidance from CMS and ask for a reply in writing. Additionally or alternatively, one could write directly to CMS asking for publication of official guidance on this. For depression screening, the Medicare Preventive Services manual is clear that the time requirement is up to 15 minutes but be sure the total time spent in providing the service is documented to avoid issues with auditors.

I hope that is helpful.
Cindy

Hello- This code is a screening code and states 15 minutes. Does this mean the screening time has to be 15 min or up to 15 min? If they screen negative it would be hard to spend 15 min on it? Thoughts...

 

[01085585]

Thank you so much for the help!