Avoid costly billing errors by understanding time requirements and payer-specific guidelines

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

To understand the concepts of coding based on time, we need to step back and remember what our HIPAA-defined rules state. These rules indicate that the HCPCS code system, which includes CPT, is the coding system to be used for procedures and services. However, HIPAA does not specify that the guidelines of CPT must be followed. For a particular code, CPT may suggest one method for its utilization, while another insurance may have its own approach. While CPT guidelines may state that you only need to exceed the halfway point of the time listed for a particular service, CMS/Medicare guidelines require that you reach the end of that time period.

Currently, there are Evaluation and Management time-based codes that are billed incorrectly to insurance companies because of differing guidelines. Your practice’s revenue could suffer significantly if incorrect coding is identified by payers. The issue isn’t necessarily the differences between two levels of a particular service, but rather the penalties for the errors. 

Join industry expert Jill M. Young for an insightful session designed to demystify the complexities of coding guidelines. This webinar will provide a clear understanding of the varying coding rules while offering valuable tips on accurately assigning codes when collaborating with physicians—ensuring precision and compliance in your practice.

Webinar Objectives

• Navigating Time-Based E/M Codes – Understanding which E&M codes have time requirements or options for billing
• Meeting Time-Based Documentation Requirements: How much time is required to meet guidelines for the use of a particular code
• Managing Conflicting Guidelines Across Payers – Which codes do differing guidelines most severely affect the 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

Who Should Attend

• Coders
• Billers
• Auditors
• Office Managers
• Office Administrators