You are allowed to consider each coding option and select the best/accurate one. If the patient is scheduled for an offce visit that includes evaluation and management but results in more than 50% counseling, code based on time. If the documentation supports a higher level code and meets medical necessity, feel confident coding the visit as such.
I, personally, would be hesitant to use a prolonged services code. 1) this code indicates increased work and/or effort on behalf of the provider, which doesnt seem to be the case as you use the term "routine" to describe these visits at your practice. 2) use of Typical E/M coding guidelines or time based coding, should be able to capture the nature of the visit adequately, so no real need to use the modifier.
Anyway, just my thoughts
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join