E&M Coding Based on Time

Question:

Our surgeon saw a new patient in the office yesterday. His documentation supported reporting the E&M using time instead of based upon MDM. My question is about the time calculation. Today, he reviewed an MRI that the patient brought in this morning and he wants to add that time to his total time from yesterday, the date the patient was seen. The reportable E&M would change from 99204 to 99205 if he is able to do this. He thinks yes, since it was within 24 hours of his encounter with the patient. Is this acceptable?

Answer:

Thank you for asking. This question is more common than you may think.
When coding by time, only the time spent on the actual date of the encounter is applicable. This work the next day may not contribute to the overall total time; any records reviewed prior to the date of the encounter for efficiency purposes or preparation for the day also may not count toward total time on the actual date of service.