I had a provider that billed 100% of her visits based on time. I ran it by WPSMedicare and they said as long as it was medically necessary and documented correctly it was fine. When I pushed on the medical necessity piece they would not give me more info. That is the only thing I struggle with. I have yet to find anywhere that defines what supports medical necessity of time based coding.
My provider was a specialist, perinatology. So there really wasn't any exam she could do, her paitient was the unborn baby, not the mom. Time is the only option for new/consult visits that are 3 of 3 for key components.
Laura, CPC, CPMA, CEMC
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