K57.30 - Diverticulosis of large intestine without perforation or abscess, without bleeding

Clinical Definition

Reimbursement discussions with insurers or requests for prior authorizations regarding patient care represent administrative work that is essential for care coordination but occurs outside direct patient care time.

Documentation Requirements

• Start and stop times must be documented

• Total time spent (in minutes)

• Insurance company or entity contacted

• Purpose of discussion/interaction

• Patient's name and identifier

• Outcome of discussion

• Identity/role of insurance representative

• Must not include time spent on:

  • Direct patient care

  • Travel time

  • Teaching

  • Staff supervision

Common Synonyms

• Insurance calls

• Prior auth requests

• Coverage verification

• Benefits check

• Payer discussion

Coding Conflicts

Excludes1:

• Face-to-face patient care time

• Clinical staff time

• Regular care coordination activities

Excludes2:

• Time spent in telephone calls with patients

• Online digital E/M services

• Clinical staff time

Scribing.io Automation

The AI scribe automatically:

• Timestamps the start/end of insurance discussions

• Calculates total duration

• Tags key elements like insurance company name and representative

• Identifies discussion purpose and outcome

• Differentiates from direct patient care activities

• Creates structured documentation format for billing compliance

Best practices include using phrases like "spoke with [insurance rep name] regarding [specific issue]" and "total time spent: [X] minutes on insurance discussion."