Q: Recently it seems I am getting a significant number of patients whose appointments are very time-consuming. Although I can quickly ascertain their chief complaints, do the examination, and determine the treatments, it takes a long time to go over the various diagnoses, the treatment options, and risks. Frequently, I go over the information two or three times before I can leave the exam room. I'm unclear about billing visits based on time. Must I meet the regular documentation criteria in addition to charting the time I spent? How is time documented? Do I count the time spent with the patient during the entire encounter or do I separate out the time I spent discussing diagnoses, treatment options, etc.?