Thank you for clearing that up.

You still have to meet the complexity in other words if you are just counseling someone on risk factor reduction, or the importance of med compliance you cannot use a very high level of E/M. So complexity is still part of the E/M. For something like med management you're most likely going to code a 99212/99213 in order to code to a 99214 if you're basing it on time you have to have face to face time of 23 minutes looking at an 8 minute rule so complexity still has to be a part of it and your documentation has to fit. 

I'm trying to help you with complexity, just make sure if you are trying to code strictly by time the documentation needs to fit the complexity of what the patient is being counseled for. 99214 is going to something that can end up getting flagged if it's the only E/M code that you're billing for every patient, at this point by Medicare. It's a higher paying code and we have RAC audits targeting 99214-99215. Those apply to anyone billing that level of E/M on a regular basis.

With new changes and these are big changes for psychiatry there are going to be questions and issues.

Sharon who is our psych expert may have more to say on this topic as well.

I know that if you're going to choose it based solely on time and only address one issue for a 99214 that can be problematic.

Karen Habel, CDA, CMBSI, CDBSI

Nothing I say shall be construed as legal advice; always check with your own financial or legal advisors for your specific situation.




Last Edited By: sporty981 Dec 20 12 6:07 AM. Edited 1 times.