Billing For Visits When the Majority of the Visit is Spent Counseling:
If more than 50% of the time of the visit is spent in counseling or education, then you are able to bill according to the amount of time spent face-to-face with the patient. These are for patients that have a medical problem to begin with.
99201 99202 99203 99204 99205
10 min. 20 min. 30 min. 45 min. 60 min.
99211 99212 99213 99214 99215
5 min. 10 min. 15 min 25 min 40 min.
Documentation requires that you list the total time of the visit, the time spent in counseling, and the subject discussed. Time can over-ride all other requirements.
Counseling ICD-9 Codes (These would be used secondary to the medical condition being treated.)
V65.3 Dietary surveillance and counseling (For this code there must be a problem also listed such as obesity, underweight, diabetes)
V65.43 Substance use/abuse (tobacco, drugs) (The code for the specific drug abuse should be listed, i.e. 305.1 tobacco abuse)
V65.43 Injury prevention
V65.49 Other specified counseling