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Old 06-19-2013, 09:30 AM
pajohnson pajohnson is offline
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Default 99354

When a patient is seen and is goes beyond the 99215/99205 time spent with patient, can you add the 99354 is it is only 5 or 10 minutes over?? Does it have to be in certain time increments?
Thanks for any help..
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Old 06-19-2013, 09:35 AM
RRiley RRiley is offline
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No, the extended time must total 30 minutes or greater.
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Old 06-19-2013, 09:36 AM
pajohnson pajohnson is offline
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Thanks for the confirmation. That is what I thought.
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Old 06-19-2013, 09:36 AM
RRiley RRiley is offline
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You're welcome
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Old 06-19-2013, 09:51 AM
pajohnson pajohnson is offline
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Could you clarify one more thing.....In the CPT book it states under Excludes: Do not report any service that fails to extend into the next time period by 15 minutes or more.

Can you clarify that statement for me please...
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Old 06-19-2013, 10:05 AM
RRiley RRiley is offline
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CPT states that prolonged service with direct patient contact is not reported separately when the duration is less than 30 minutes. I am not sure where you are seeing the statement you mention.
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Old 06-19-2013, 10:10 AM
pajohnson pajohnson is offline
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It is in the 2013 Optum CPT Expert pg 886 under prolonged services direct contact.

www.optumcoding.com
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Old 06-19-2013, 10:57 AM
RRiley RRiley is offline
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I do not have that particular book but here is how my AMA CPT book describes it.

less than 30 minutes - not reported separately
30-74 minutes (30 min - 1 hr 14 min) - 99354 x1
75-104 minutes (1 hr 15 min - 1 hr 44 min) - 99354 x1 and 99355 x1
105 or more (1 hr 45 min or more) - 99354 x1 and 99355 x2 or more for each additional 30 min

In other words, if the provider spent 1 hr 15 min, you would be able to add 99355 along with 99354.
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Old 06-19-2013, 11:07 AM
pajohnson pajohnson is offline
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Thank you so much!!!!
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