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Mary Posted Fri 27th of September, 2013 17:26:28 PM

In A PCP Office ADHD CHILD COMES in. The Dr spends 35 minutes or more with pt and mother what is billed 99242 25 mod or the 99201 or what.

SuperCoder Answered Fri 27th of September, 2013 21:37:27 PM

We are working on this.

SuperCoder Answered Fri 27th of September, 2013 21:37:27 PM
with me
SuperCoder Answered Mon 30th of September, 2013 22:47:15 PM

You will bill a problem-based office visit code (99201-99215) based on the history, exam, and medical decision-making documented. Many times, however, these visits meet the guidelines for billing based on time (more than 50% of the visit was spent counseling/coordinating care). If your doctor's 35 minute visit had more than 50% of it spent discussing the ADHD/counseling the patient on it, ensure that the physician documented what was discussed, the total time, and the time spent counseling/coordinating care in the notes. If he did all of that, you can bill 99203 for a new patient or 99214 for an established patient based on the time guidelines in CPT.

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