Tip: Count time correctly under new CPT guidelines
APCs Weekly Monitor, February 25, 2011
Want to receive articles like this one in your inbox? Subscribe to APCs Weekly Monitor!
The AMA included a new subhead (Time) and guidelines for reporting time in the 2011 CPT® Manual.
The AMA changed the instruction to:
• Create general rules for codes that do not specify their own time rules
• Define rules for services that start on one calendar date and continue on another
• Restate that time is counted as face-to-face unless otherwise specified
Only report time units when the midpoint has been passed. For example, at least 31 minutes must pass in order to report a code with a one-hour unit of time in its description.
When using time to select an E/M code, pick the code with the closest typical time, even if it is less than the actual time spent on the encounter. In order to report an E/M code based on time, make sure to follow the time rule in the E/M section. Specifically, the provider must spend more than 50% of the visit performing counseling and coordination of care.
Remember that you may not count time twice. Review the services in which time is already a factor and be certain that you don’t count that time twice by relying on it to report another code
This tip is adapted from “2011 CPT changes feature new time guidelines, subsequent observation care codes” in the February issue of Briefings on APCs.
Want to receive articles like this one in your inbox? Subscribe to APCs Weekly Monitor!
Related Products
-
Modifier -59 Case Studies: Clarify Common Coding Confusion
Modifier -59 is a perennial problem area for outpatient coders. It shouldn’t be viewed as a way to guarantee payment but...
-
Outpatient Bed Charge Capture: Billing for Common and Complex Cases
During this 90-minute audio conference, our expert speakers walk you through common and complex cases and explain compliant...
-
Billing No-Cost and Low-Cost Devices: Tips to Avoid the Audit Fast Track
During this 90-minute audio conference, our speakers will use a case study to demonstrate best practices to help you comply...
-
Spinal ICD-9 and CPT Coding
During this two-hour audio conference, our speakers will discuss common coding errors for spinal diagnoses and procedures...
-
2012 OPPS Final Rule: Analyze the Impact and Manage the Changes
Expert speakers Jugna Shah, MPH, and Valerie A. Rinkle, MPA, return for this popular program. They review the final rule...
Most Popular
- Articles
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- Topic: CMS, OESS post new security compliance review information, checklist
- Capturing all necessary codes for IUD insertion and removal can be challenging
- HIPAA Q&A: Level of encryption needed for email
- What does case-mix index mean to you?
- QA:Coding multiple initial infusions
- Identify potential Medicaid RAC target areas
- OB services: Coding inside and outside of the package
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- HIPAA Q&A: Level of encryption needed for email
- Q&A: Follow CMS' coding guidelines when using modifier -25
- CMS has reformulated payments for some bilateral procedures
- Catch up on what's new with injections and infusions
- New conflicts of interest create new challenges
- Q/A. One injection code or two?
- What does case-mix index mean to you?
- ED-to-inpatient transfers are flawed with safety gaps
- Searched