I know that cms and cpt state that when choosing to code based on time that the counseling must exceed 50% of the visit.
Is it defined anywhere that it must exceed 50% of the total visit time, or exceed 50% of the time associated with the code selected, I have read both as suggestions by others, but woud like CPT or CMS statement on the matter.
Examples would be typical time for a 99214 is 25 minutes.
documentation states 15 minutes of a 30 minute visit spent...etc.
How do I tell my physician that had he spent 5 minutes less with the patient then he would qualify for a 99214, otherwise he is now only going to get a 99212 (based on key elements) since 15 is not MORE than half of 30???? Especially when the code selection he is interested in acheiving is a 99214 and 15 minutes is MORE THAN half of 25??
Any supporting documentation in this matter would be appreciated.