When Minutes Matter – How Carriers Define E&M Code Minutes Differently

There are many codes in the Evaluation and Management section of the CPT book that have an amount of time assigned to them.  Sometimes, the code is entirely defined by the minutes spent. Other times, the codes can be determined by the time spend as a secondary method of level selection. 

To understand the concepts of coding based on time, we need to take a step back and remember what our HIPPA defined rules say.  These rules defined that the HCPCS code system, of which CPT is a part, is THE coding system to be utilized for procedures and services.  But HIPPA did NOT indicate that the guidelines of CPT are the guidelines that must be followed.  So, for a particular code, CPT may indicate one way a code should be utilized while another insurance may have their own way.  Just as CPT guidelines may say that you only need to get past the halfway point of the time listed for a particular service, but CMS/Medicare guidelines state you must get all the way to the end of that time period.

Currently, there are Evaluation and Management time-based codes that are billed incorrectly to insurances, because of differing guidelines.  Your practice’s revenue could take a severe hit if incorrect coding is identified by payers.  The problem isn’t necessarily the difference between two levels of a particular service, but rather in the penalties for the error. 

Understanding the differing guidelines of codes is the goal of this webinar.  Tips on how to properly assign codes in working with physicians is an added benefit of it.

Webinar Objectives

• Time based codes – understanding which E&M codes have time requirements or options for billing
• How much time is required to meet guidelines for use of a particular code
• Differing guidelines – which codes do differing guidelines most severely affect chances of fraudulent billing

Webinar Agenda

• Overview of Evaluation and Management Codes
• Identifying codes that have time requirements
• Discussion regarding minimum time requirements for code selection
• Documentation of time for codes

Webinar Highlights

• Evaluation and Management codes – codes with time requirements
• Evaluation and Management codes – codes that have time as an option for level of service differentiation
• Documentation of time
• Differing guidelines from insurance carriers that cause billing headaches and concerns of billing fraud
• Tips on communicating with your providers to glean information needed to properly bill for services

Who Should Attend

Coders, Billers, Auditors, Office Managers, Office Administrators