CPT Coding Changes

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1.  E & M question

Posted 10-24-2013 03:08 AM
I have another question. I know that E&M codes are not based on time. One of the sessions I attended in Texas recommended that we do NOT document the time spent we spend for E&M. The agency I work with says we must document the time spent on our notes AND on our billing sheet (or they return it to us to re-do)---even if we do not provide therapy.

Any thoughts about this or does this seem ok? It may be that I'm just paranoid. :)

Romnee Auerbach ANP, PMHNP-BC

OR-APNA Board Member
Portland, OR



2.  RE:E & M question

Posted 10-25-2013 10:43 AM
You definitely can bill on time if more than 50% of the session is in counseling and coordination of care activities which include:
Diagnostic results
Recommended diagnostic studies
Risks and benefits of management options
Instructions for management and/or follow-up
Importance of compliance with chosen management options
Risk factor reduction
Patient and family education
Most agencies typically collect time information. You also need to include time if you are doing a 90833 psychotherapy add-on code to your E&M code.  Hope this helps!

Mary Moller
Associate Professor, Specialty Director-Psychiatric Nursing
Yale University School of Nursing
New Haven CT
(203) 389-4277


3.  RE:E & M question

Posted 10-25-2013 12:51 PM
Hi Romnee,
Good to see you in San Antonio. I'm not sure if this is what your agency is requesting, but what we do in every note is indicate in the Plan section "x% of time spent on assessment and intervention and x% of time spent on collaboration and client education." The E & M part is embedded in my notes through the Review of Systems in the Objective element of my note. I don't understand why the billing sheet would require this but maybe that is through the CPT code that indicates length of appt. I'd be interested in what others have to say about this.

Barbara J Limandri, PhD, APRN, BC
Professor & APRN
Linfield College School of Nursing
and Portland Dialectical Behavior Therapy Program
Portland Oregon 97210