1. 1 How to Code for MOLST Counseling Frank J Dubeck MD FACP CMO Medical Policy and Clinical Editing Excellus BCBS Nov 2009

2. 2 Counseling as an E&M Service  Counseling as an E&M visit  Prolonged service codes  Face to face time

3. 3 Base E&M Codes have “Usual Times” New Pt9920560 mins Est Pt9921540 mins Consult9924580 mins

4. 4 Prolonged Physician Service Codes  Face to Face Time 99354-99357  Inpatient vs Outpatient  Initial hour, additional 30 mins  Non Face to Face Time 99358-99359

5. 5 60120180 Established Patient 99215 99354 99355

6. 6 Time spent mins New Patient Office Established Patient OfficeConsult Outpatient CodeamtCodeamtCodeamt 60 99205 $234.6 5 $164. 35 65 $234.6 5 $164. 35 70 $234.6 5 99215+993 54 $283. 10 75 $234.6 5 $283. 10 80 $234.6 5 $283. 1099245 $296. 40 85 $234.6 5 $283. 10 $296. 40 90 99205+99 354 $353.4 0 $283. 10 $296. 40 95 $353.4 0 $283. 10 $296. 40 100 $353.4 0 $283. 10 $296. 40 105 $353.4 0 $283. 10 $296. 40 110 $353.4 0 $283. 10 99245+993 54 $415. 15 115 $353.4 0 99215+993 54+99355 $399. 95 $415. 15 120 $353.4 0 $399. 95 $415. 15 125 $353.4 0 $399. 95 $415. 15 130 $353.4 0 $399. 95 $415. 15 135 99205+99 354+9935 5 $470.2 5 $399. 95 $415. 15

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8. 8 Category II codes  1123F Advance care planning discussed and documented, advance care plan or surrogate decision maker documented in the medical record (GER)  1124F Advance care planning discussed and documented in the medical record, patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan (GER)

9. 9 What diagnosis code  V66.7 Encounter for palliative care  End-of-life care  Hospice care  Terminal care  Code First: underlying disease

10. 10 Thank You