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Time or detailed audit

  1. #1
    Default Time or detailed audit
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    Please advise.
    Dr.A submits cpt 99241 but time documented is 30 minutes so do we need to code cpt 99242.
    Do we code on time or 1995 documentation?
    Please advise.

    Alpana

  2. #2
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    You would want to reasonably code the service that is higher. In this case if the physician adequately documented that the face to face time with the patient and/or family was 30 minutes then I would code the 99242.
    Chelle Johnson, CPC CPMA CDEO CEMC CPCO CPPM AAPC Fellow
    Billing/Coding/Credentialing/Auditing Coordinator

    20+ years experience in Medical Billing and Auditing

  3. #3
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    Default Time of detailed audit
    Quote Originally Posted by kalpana View Post
    Please advise.
    Dr.A submits cpt 99241 but time documented is 30 minutes so do we need to code cpt 99242.
    Do we code on time or 1995 documentation?
    Please advise.

    Alpana
    But did the provider document that >50% of the visit was spent in counseling and/or coordinating care and is there documentation to substantiate that?

    If they didn't then the time spent is meaningless and you would code per the DG's.

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