Actually I have heard of it, and certain parameters were needed to be satisfied before that would happen but can't elaborate as to the outcome.
And your CPT book does give a pretty good definition of EM time based coding in the very last EM section paragraph. Find it and re-read. When counseling and/or coordination of care DOMINATES (more than 50%) ....then TIME shall be considered the KEY or CONTROLLING factor to QUALIFY for a particular Level of EM services (CAPS have been added) If the documentation satisfies the criteria and the provider has stated that over 50% of time has been spent with the patient in counseling/coordination of care the other elements for for the standard EM Visit do not come into play. Time IS the controlling factor. This is my understanding. And I'm open to debate or rebuttal as a learning experience.
---Suzanne E. Byrum CPC