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Queries for Professional Coding

Posted: Fri Sep 28, 2018 7:06 am
by kellyr
Is it compliant to query a provider(professional coding) for a CPT code that is time based, such as critical care or conscious sedation? The provider has documented all criteria to meet both of these codes except for the time. I say no you cannot query for this reason, you are not clarifying any information in the medical record, you are requesting that the time element be added in order to bill the encounter. Please post any and all thoughts/opinions! Thank you.

Re: Queries for Professional Coding

Posted: Wed Oct 10, 2018 2:54 pm
by Shoshana
I agree with you, Kelly. It would seem as though the physician were being "lead" to a level of service.