Results 1 to 2 of 2

Counseling & Education--50% of time

  1. #1
    Default Counseling & Education--50% of time
    Medical Coding Books
    Can anyone tell me a typical way to code for an E/M visit whereas 50% or more of the time spent in the prenatal visit is spent on counseling and education?

    Is it more typical to choose one of the higher E/M level codes or would it just as accurate to code a lower E/M visit based on the level of history, exam and MDM and THEN add 99354 for Prolonged Face to Face?

    The practice I work for is a birth center with Midwives and they give extensive counseling and educational guidance on a routine basis. I just don't want to trigger an audit due to consistently coding a high E/M code.

    Any suggestions or knowledge in this area? Thank you in advance!

  2. #2
    Default Time- based
    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

Similar Threads

  1. Replies: 3
    Last Post: 09-14-2013, 02:46 PM
  2. Replies: 1
    Last Post: 09-27-2012, 03:09 AM
  3. Documenting counseling time
    By ajcook in forum E/M
    Replies: 3
    Last Post: 03-10-2008, 07:45 PM
  4. time reguardless of counseling
    By DeniseDenise in forum E/M
    Replies: 1
    Last Post: 02-20-2008, 08:57 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.