When the billing of CPT code 99214 service is based on time, the CMS requires that 25 minutes be spent face-to-face with the patient, with more than half of that time spent counseling or coordinating care for the patient’s conditions. Literature estimates are 13.5 minutes for colonoscopy ...
We identified physicians’ specialty based on the code listed on the plurality of their Medicare services in any given year as in prior work18-21 and limited our sample to specialties with at least 5000 office-based physicians billing Medicare during our study period. We required physicians...
Different diagnoses are not required for reporting the E/M service on the same date as the procedure or other services with a global fee period. Modifier -25 is added to the E/M code on the claim. Both the medically necessary E/M service and the procedure must be appropriately and suffic...