Wiki Time Vs medical decision making

[mitan287@hotmail.com]

Hi
I just wonder if we can override the time on the office visit note? Example: an establish patient spend total of 25 minutes support code is 99213, however, based on MDM, patient has 2 stable chronic illnesses and prescription drug was sent support code is 9914. Should will bill 99214 instead?

 

[sls314]

Hi
I just wonder if we can override the time on the office visit note? Example: an establish patient spend total of 25 minutes support code is 99213, however, based on MDM, patient has 2 stable chronic illnesses and prescription drug was sent support code is 9914. Should will bill 99214 instead?

You're not required to use time - you can choose your level based on MDM or time.

 

[sls314]

Do you have a CPT book? The information is listed in the E/M chapter.

Also, here's a link to the AMA's information about the 2021 E/M changes:

https://www.ama-assn.org/system/files/2019-06/cpt-office-prolonged-svs-code-changes.pdf

On page 8, you'll see the following text:

Instructions for Selecting a Level of Office or Other Outpatient E/M Services

Select the appropriate level of E/M services based on the following:

1. The level of the MDM as defined for each service, OR
2. The total time for E/M services performed on the date of the encounter

 

[Jessim929]

Hi
I just wonder if we can override the time on the office visit note? Example: an establish patient spend total of 25 minutes support code is 99213, however, based on MDM, patient has 2 stable chronic illnesses and prescription drug was sent support code is 9914. Should will bill 99214 instead?

You can bill either for time or MDM. I tell my providers that time is the backup plan - mainly for level 5 visits - to cement the code if the diagnosis or MDM isn't strong enough to warrant the code.