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99354

P

pajohnson

Guru
Messages
189
Location
Kokomo, Indiana
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..
 
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...
 
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.
 
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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