Pediatric Coding Alert

Question: A level four office visit took 55 minutes of physician-patient face-to-face time due to the service involving an interpreter, which the patient and family required to converse with the pediatrician. The pediatrician wants to code 99214 and prolonged services. Is this appropriate?Ohio SubscriberAnswer: Yes, you may use a prolonged service code in this situation because the time thresholds for billing both 99214 (25 minutes) (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity.Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem[s] and the patient's and/or family's needs. Usually, the presenting problem[s] are of moderate to high severity. Physicians typically spend 25 minutes face-to-face with the patient and/or family) and 99354 (30 minutes [...]