Count the minutes with care to report split/shared office visits in 2021

by: Julia Kyles, CPC Mar 6, 2020

Keep a calculator handy if your practice opts to report E/M office visits based on time next year. When a doctor and a non-physician practitioner such as a nurse practitioner (NP) share a visit you will count the time they spend separately and combine the time they spend together, noted Doris Branker, CPC, CIRCC, CPMA, CPC‐I, CANPC, CEMC, president of Sunrise, Fla.-based DB Healthcare Consulting.

You can count each provider's time as long as it’s not duplicative, Branker explained during her March 3 webinar. For example, if an NP spends five minutes on a patient’s care, a physician spends a separate five minutes and they spend five minutes together, “that’s a total of 15 minutes, not 20,” Branker said.

Review the scenario Branker included in her presentation and refer to the chart to test your time-coding accuracy:

The NP reviews the intake form done by the patient and medical assistant (6 minutes) and conducts and interview with the patient for additional history and performs an exam (5 minutes). The physician performs an additional examination in the presence of the NPP and discusses the patient case, then they order diagnostic testing and complete the note (13 minutes).

Code	Minutes
99202	15-29
99203	30-44
99204	45-59
99205	60-74
99211	N/A
99212	10-19
99213	20-29
99214	30-39
99215	40-54

Answer

The total time is 24 minutes. You would report 99202 for a new patient and 99213 for an established patient.

“I would not say the physician was present for 13 minutes and the NP was present for 13 minutes, so that’s 26, and add 11 [minutes] to it. I can’t do that because they met jointly ... and that’s duplicative time.” In addition, time spent by clinical staff such as a medical assistant is not counted, Branker said.

Practices should perform time studies to determine if time-based coding is a good fit for the group. If they decide to use the time-based method, they should create macros to assist with capturing each moment spent on each patient’s care, Branker suggested.

Editor’s note: Order an on-demand presentation of the 60-minute webinar E/M Update: Prepare Your Pain Practice, Protect Your Revenue, recorded March 3 and you’ll be eligible for 1 AAPC and 1 BMSC CEU. To order by phone, dial 1-855-CALL-DH1.

Blog Tags: E/M services

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