Short answer to first question: THEY DON'T. There is no "long visit" There is extent and complexity of visits. Here is the CPT description and documentation requirements for 99215:
What Does CPT Code 99215 Mean?
CPT code 99215 is specifically used to document a comprehensive evaluation and management service for established patients. To qualify for this code, the visit must meet the following criteria:
Comprehensive History: The patient’s history must be well-documented, including a detailed assessment of their medical condition, family history, and social history.
Comprehensive Examination: The physical examination should be thorough, covering all systems related to the patient’s presenting problems.
High Complexity Medical Decision-Making (MDM): The physician must demonstrate a high level of decision-making. This involves analyzing multiple diagnoses, reviewing test results, and determining complex treatment options.
Using this code appropriately ensures that healthcare providers are compensated for the time, effort, and resources required to manage complex patient conditions.
Documentation Requirements for CPT Code 99215
Proper documentation is key to successfully using CPT code 99215. It is essential that the documentation captures all three critical components: history, examination, and decision-making. Here’s a breakdown of what’s required:
Comprehensive History: This must include an extended history of present illness, an extended review of systems (ROS), and a complete past, family, and social history (PFSH). The history should be documented thoroughly to reflect the patient’s complex health status.
Comprehensive Examination: The physician must document a detailed examination of at least eight organ systems or body areas. All pertinent findings, whether normal or abnormal, should be included in the documentation.
High Complexity MDM: The documentation must show a high level of decision-making, including multiple management options, a thorough review of test results, and an assessment of patient risks and benefits for each treatment option considered.
Please point out, right from this excerpt from CPT, the word "long"
Now, as an aside, CPT does make statements that ARE NOT PART OF THE CRITERIA such as "this visit will typically take a physician xxx minutes to complete", which is a suggestion/guideline, but not part of the requirements. Also, when the strict documentation guidelines do not fit the service, there is a way to document time spent---the most obvious example is psychiatry where 50 minutes is spent "just talking", but bedside management in an ICU setting can also be billed by time.
Two other points that I will try to make politely:
1)
"Yeah, may be slightly over a billion... follow all the threads regarding this."
Yep, social media, the place to get all the facts
. If it's on the internet, it must be true???
2)
"ten seconds of thyroid neck check, (didn't even have to swallow water this time), and was advised to reschedule in a year. That is my basis."
OK, that's your basis. My basis is using, documenting and reviewing these codes for 35 years. Please don't even think about equating the two.