Psychiatric E/M for deaf client

jcochran

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So, when a client who is congenitally deaf who comes in for her quarterly med check we have a little confusion as far as coding. After reviewing all of the documentation from my psychiatrist, this definitely meets the 1997 documentation guidelines for 99214, but at the end the MD noted that face to face time with client is 60 minutes and also noted this due to the client's deafness, ASL was needed, therefore prolonging the visit to 99215.

So my question is, given that the face to face time is noted as 60 minutes, would it be appropriate to code 99215 even though the rest of the documentation for E/M only supports 99214 other than face to face time with client?

Also, I know that because it was only 60 minutes face to face, 99354 (prolonged services) would be inappropriate; however, would a modifier 22 for increased services be appropriate? Also note, this is a Medicare client.

Any feedback is greatly appreciated, thank you~
 

LindaEV

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Local Chapter Officer
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Coding based on time has to be because more than 50% of the total time was spent in counseling and/or coordination of care. You cannot code based solely on face-to-face time. Documentation should reflect total time spent, time spent in C/COC or that more than 50% of total time was spent, and the nature of C/COC

22 would not be appropriate for an e/m code.
 
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