Time based coding does include instances where counseling or coordination of care occupies more than half the visit or reults in prolonged services for an e/m coded outpatient or inpatient encounter. However, and please anyone jump in and correct me, e/m codes must meet the need for medical necessity in these cases. I'm not familiar with psych coding and meeting medical necessity reqired for time based coding.
Also, according to he above reference, simply prescribing a medication does not seem to meet the qualifications for 90862. Certainly the provider must initially prescribe the medication. However, during follow up visits when therapeutic levels are measured, clinical effects are assessed and MDM regarding maintaining or adjusting dosage or even changing medications are when 90862 seems more appropriate.
A provider may document complex MDM when initially prescribing a medication with respect to existing complicating factors, possible drug interactions, or narrow therapeutic ranges requiring frequent drug level monitoring, or high risk side effects. But once these considerations are documented, the basis of the visit would seem to lean back to an code that is not time dependent?
Not trying to give a yes or no answer. Just thinking through your post with details that might help lead to an answer.
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