CPT Code 90792 Time Length Providers require at minimum 60 minutes up to 120 minutes of time to render an exhaustive diagnostic interview and examination of their mental health clients in order to code procedure code 90792.

The changes affect Current Procedural Terminology (CPT) codes 99202-99215. Time will be based on the total time spent on the date of the face-to-face encounter, including both face-to-face and non-face-to-face time. There no longer are “typical times” but defined ranges (see Table 1).

When documenting time, include only the time you spend face-to-face with the patient. If a nurse or other hospital member counseled the patient, you can not include it; you can count only physician counseling time. Your documentation needs to demonstrate that more than 50 percent of the visit was spent on counseling.

The hospitalist then asks a resident to assist with the remaining counseling efforts (20 minutes). Code 99232 (inpatient visit, 25 minutes total visit time) would be appropriate to report.

When assigning E/M level based on time: Report the total time spent. Count both the face-to-face and non-face-to-face time that you spend before, during and after the visit on that same day. Remember to include QHP time for split/shared visits.

Total time may be used alone to select the appropriate code level for office visit E/M services (99202-99205, 99212-99215)….Selecting E/M Codes by Total Time.

The times listed in the CPT® code book were considered the average time a physician spends caring for a patient, and while this was a step in the right direction, it did not take all the subjectivity away. We were still left with ambiguous guidelines.

In the world of coding, time is perplexing. On the one hand, time is built into the evaluation and management (E/M) codes, so physicians are told to base their E/M code selection on the history, exam and medical decision-making elements, not on time spent. Times are listed for each service in the CPT manual only as a guideline.

For a family physician, getting everything done may require extended office hours or long nights spent catching up however, a way to make time work to your advantage – by using time-based coding for some of your patient encounters. Prior to 1992, time was an implicit component of evaluation and management (E/M) coding.

When time is the controlling factor in a patient’s visit, be sure to capture the appropriate time-based service code. A unit of time is attained when the midpoint is passed. For example, an hour is attained when 31 minutes have elapsed (more than midway between zero and 60 minutes).