Wiki Prolonged time help G2212

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ny2scgirl

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Can prolonged time be used for multiple providers on the same day, same specialty? So, if Dr. A billed a 99233, 75 minutes and Dr. B saw the patient later in the day and saw the patient for 40 minutes, can I combine both provider's time and add G2212 to Dr. A's claim since he did the substantial amount of work?

Thank you,
Jennifer
 
G2212 is not reportable with 99233, unless something has changed that I am not aware of.
You can combine E&M time for providers of the same practice, same specialty/subspecialty. But make sure that there are no salary issues with reporting work RVUs for one provider where the other provider did some work. Often, salary and bonuses are calculated by practices/hospitals based on individual provider work.
 
Great advice above. I would just add that the "substantial amount of work" concept applies to Medicare split/shared policy and can only be used to report E/M services when a physician and a qualified health care professional, such as an NP, work together.
 
jkyles said:
Great advice above. I would just add that the "substantial amount of work" concept applies to Medicare split/shared policy and can only be used to report E/M services when a physician and a qualified health care professional, such as an NP, work together.
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I think this is where I am confused. If in the inpatient setting you can only bill one E/M per day and more than one provider of the same specialty sees the patient, the notes are supposed to be combined to find the level. Can we use prolonged codes after the threshold is met on 99233?
 
If you're coding the visit based on time and meet the time requirement for the add-on code, yes. But that's not the same as billing a split/shared visit to Medicare.
 
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