Wiki 99337 is time dependant or not

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SoundarR

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Hi,
Please explain me about 99337 code, wthether it is only time dependant. I got one chart where our NP spent 90 minutes in treating the rest home established patient. (99337 explains as 60 minutes with patient) My doubt is can i use 25 modifier in this case or i have to bill 99337 alone or any other code. Please explain me...

Thanks,
Soundar
 
This is either time based or key component based.

99337
Domiciliary or rest home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive interval history; A comprehensive examination; Medical decision making of moderate to high 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. The patient may be unstable or may have developed a significant new problem requiring immediate physician attention. Physicians typically spend 60 minutes with the patient and/or family or caregiver.

You can use a 25 modifier with this code if it is supported by documentation. What else was done that day?

Laura, CPC, CEMC
 
99337

If you have verified that there is at least 2 of the 3 components necessary for the 99337 code and you note that it is 30 minutes over the time guideline, I believe you would not report the modifier 25, but instead report the 99354 in addition to that code to denote the prolonged service for the 30 minutes.
 
Hi Laura,
No they didnt do any other procedures, then can i use 25 Modifier....
Thanks,
Soundar
 
moorefield said:
If you have verified that there is at least 2 of the 3 components necessary for the 99337 code and you note that it is 30 minutes over the time guideline, I believe you would not report the modifier 25, but instead report the 99354 in addition to that code to denote the prolonged service for the 30 minutes.
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Hi,
Sorry,In our software we can code only one code, so we cant bill both 99337 and 99354... What i have to do in this case

Thanks,
Soundar
 
If it is a software problem then talk to your vendor, I am not understanding that you can use only one CPT code on a claim, there is no need for a 25 modifier at all. IF you have met the criteria for the 99337 for the 2 out of 3 key components, and IF the NP documented the time spent, the you may submit
99337
99354
no modifer is needed for this scenario and you should be able to list as many codes as it takes for a single claim.
 
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