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When billing for time, will the total time for the visit be the resident's total time? Or resident's time plus attending's time?
When using the new time based billing rules, does charting time count as well?
A. Patrice Burgess
Do you have any examples of how notes should look to capture the appropriate information for billing as well as clinical care? Maybe a before and after with the old guidelines and the new guidelines?
It appears that the number and complexity of problems for 99215/05 appear to have two types of situations that can be used. In the old paradigm, a new problem requiring further work up would be consistent with a 15. How specifically will that change? Did I read that correctly that we have less options than under the old rules?
So, residents cannot bill based on time, only attending?
will travel and contraceptive counseling visits still be discounted?
What about when there is a discrepancy in charge between medical complexity and time? For example, if we are trying to minimize cost for an uninsured patient, can we face any problems if we bill for a brief visit even though there is a higher level of complexity or MDM?
For the portal/mychart based billing -- I have heard from my clinic that it is too difficult to get consent for this to bill. Did I understand correctly that I could insert a phrase into my response message asking for their consent for a digital discussion?
What kinds / number of problems are consistent with 99215
Are there any anticipated changes for inpatient billing along these lines?
Here is the link to the AMA site with the MDM chart: https://www.ama-assn.org/system/files/2019-06/cpt-revised-mdm-grid.pdf
In addition to the above link that Alyssa identified, The AMA CPT E/M website is found here: https://www.ama-assn.org/practice-management/cpt/cpt-evaluation-and-management
Per the AMA CPT chart is what caught my attention. They do not elucidate
No. How about an offline conversation??
Kent Moore can be reached at email@example.com or (913) 906-6398; I'm typically available between 8:00 a.m. and 4:30 p.m. (Central Time), Monday through Friday.
We have not discussed wellness visits... are we abandoning 9938/91+ or do they remain the same?
what’s the logic in only paying for charting time if it’s the same day?
Were these changes piloted in practice? Was quality of patient notes affected? Possibly improved?
I'd still like to know about travel and contraception.
you use different codes for those
let’s seem if i got this right...you can include time for charting if you close the chart the day of visit?
at this point when documenting the time spent for billing on time is the requirement only to state the total time spent or will we need to document start and stop times?
dovetailing on previous query - are there proposals for how to track this total time or are we just to "spit-ball"
Here is the coding manual direct link: https://www.ama-assn.org/system/files/2019-06/cpt-office-prolonged-svs-code-changes.pdf
For travel consults, we now use 99401-99404. These are time codes that are the same for contraception counseling only visits. My understanding if that's the only thing done at a visit, we can't use the usual 99211-99215. It's never made a lot sense since the payment is much lower for the 99400s
A. Patrice Burgess
Attorneys have billed for time for forever and I'm pretty sure they "spitball" it!
Danielle Bergan Debelak
Does the precharting need to be done on the same day of the visit to include that in total time?
I'd imagine "eliminating" H&P as elements for code selection would make some if not most of us document LESS on the subjective complaints and other non-relevant info (eg social history), this will NOT be liked by the medical attorneys, so I wonder if this will influence our malpractice rate and if it will give us/providers less protection.
What about the CLOSE the Chart detail? If you close it 2 days later, can you still report the time for the date of service? (say, I work on the day of service for 19 minutes, but then life happens and I don't actually close the chart until 2 days later ...I can still bill for the 19 minutes I did on the day of service? (and not the 10 extra minutes I spent the next day before I closed the chart)
charting as is...not worrying about what the patient reads to cover yourself
really great presentation!