Evaluation and Management (E/M) Guidelines
Beginning with CPT 2021 and except for 99211, time alone may be used to select the appropriate code level for the office or other outpatient E/M services codes (99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215). Time may be used to select a code level in office or other outpatient services whether or not counseling and/or coordination of care dominates the service. Time may only be used for selecting the level of the other E/M services when counseling and/or coordination of care dominates the service. When time is used to select the appropriate level for E/M services codes, time is defined by the service descriptors.
Total time on the date of the encounter - For coding purposes, time for these services is the total time on the date of the encounter. It includes both the face-to-face time personally spent by the physician and/or other qualified health care professionals on the day of the encounter (includes time in activities that require the physician or other qualified health care professional and does not include time in activities normally performed by clinical staff). Physician/other qualified health care professionals time includes the following activities, when performed:
preparing to see the patient (eg, review of tests)
obtaining and /or reviewing separately obtained history
counseling and educating the patient/family/caregiver
ordering medications, tests or procedures
referring and communicating with other health care professionals (when not separately reported)
documenting clinical information in the electronic or other health record
independently interpreting results (not separately reported) and communicating results to the patient/family/caregiver
care coordination (not separately reported)
Time Descriptors:
99202 - 15-29 minutes
99203 - 20-44 minutes
99204 - 45-59 minutes
99205 - 60-74 minutes
99212 - 10-19 minutes
99213 - 20-29 minutes
99214 - 30-39 minutes
99215 - 40-54 minutes
(For services longer than 54 or 74 minutes use Prolonged Services Codes 99XXX)
About MediClaim Services
Mediclaim Services has been in business since July 1999 and we are experienced in billing several various specialities. We guarantee that our medical billing solutions represent the best value in third party medical billing.
Our medical billing services encompass the management of the entire claims processing cycle. From filing all the the insurance claims (primary, secondary, and tertiary) to sending patient statements. Patient billing statements direct the patient to call our 800 number to discuss their bill. This alleviates your office being over extended with patient calls. Our medical billing processes can be applied to any solo or group practice regardless of speciality or claim volume. The scalability of our product will provide you with the cost effective administrative infrastructure necessary to profitably grow your business.
We also understand that many practices have invested large amounts of time and money in their system. We are capable of utilizing the existing system to make the transition from internal billing to external a truly seamless transition.