Staying Independent...Together

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   99215 and Medicare
 From: Michael Safran
 To: Member Forum
 Posted: 02-17-2017 09:22
 Message: In past 12-18 months I have had 3 requests for my records because of using 99215.   I suspect my use of 99214 and 99215 is making me an outlier.  My patients are scheduled every 30 miutes.  They tend to last approximately 40 minutes.    I dont  need to tell this group the complex nature of seniors problems and the savings to the system, etc.

The "get out of jail free" card seems to be using a modifier "GA" and having an "ABN" on file.
My question to group is how are others addressing this?   I realize that time is not the sole determination of a visit code but it is a very objective reality.)

Are you just managing the clock and informing patient(s that their problems are complex and we need to schedule more time - We know this is not easy for many of our patients who rely on rides, etc.
Are you having patients sign an ABN each visit?    Are you pausing visit at 25 minutes and asking patients to sign an ABN or schedule another visit? (Awkward).

I have a few patients who have made it clear they do not want to be responsible so it is "easier" to end the visit at 25 minutes.

I look forward to others suggestions.  Please dont just say that we should not accept medicare.   I understand and respect  that philosophy.  However, I like my patients and the relationships and dont want to change dramatically at this stage of my career.


Michael S. MD

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