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consultation

Susan Posted Thu 14th of January, 2016 11:54:58 AM

Should doctor document the total time and counseling time for consultation? Can you give me an example?

SuperCoder Answered Fri 15th of January, 2016 07:02:37 AM

Yes the doctor should document the total and counseling time for consultation. A physician spends 25 minutes in the consultation patient’s chronic conditions and an additional 30 minutes counseling the patient. Since the physician spent more than half the visit counseling, he or she can bill based on time. The total time of the visit is 55 minutes, which is only 15 minutes longer than the average time for 99243.

Susan Posted Mon 18th of January, 2016 11:31:16 AM

Should we bill the total time which is fifty five minutes? Why should we bill 99243? Can you clarify it or give me a better example?

SuperCoder Answered Tue 19th of January, 2016 05:33:35 AM

Yes we should bill the total time spent with the patient. CPT code 99243 says-Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 40 minutes are spent face-to-face with the patient and/or family. Billing of this cpt code was just an example, otherwise range for consultation codes is from 99241-99245.
The Consultation Note must include the following:
1. Total time of the visit must be documented.
2. The content of the counseling and/or coordination of care must be documented.
3. The note must clearly state that greater than 50% of the total time was spent in counseling and/or coordination of care.
An example of this documentation is as follows: Total visit 30 minutes, 20 minutes spent counseling patient on side effects of medication (99242).

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