Wiki 99358/99359 for 2023

[mwing124@gmail.com]

If you see a patient at home and bill 99350 (highest level E/M) and the day prior to the E/M your MD spends an hour reviewing outside records, I'm confused how to report that time. Is it 99358 if a patient is non-Medicare and G0318 if they are Medicare? I see in table 24 of the final rule there is a window of time for reporting visits, but I'm not clear if that is for Medicare only or if it is also for commercial payors?
I know this is pretty specific, so any advice would be appreciated.
Thank you!

 

[AcadianaWOW]

Hi!!! Curious to find out if you ever got the answer to your question above!! I am having this same issue!!

 

[lgardner]

If you see a patient at home and bill 99350 (highest level E/M) and the day prior to the E/M your MD spends an hour reviewing outside records, I'm confused how to report that time. Is it 99358 if a patient is non-Medicare and G0318 if they are Medicare? I see in table 24 of the final rule there is a window of time for reporting visits, but I'm not clear if that is for Medicare only or if it is also for commercial payors?
I know this is pretty specific, so any advice would be appreciated.
Thank you!

my understanding is that you cannot bill for work done on a different DOS.

especially for the prolonged service codes.
per every MAC and CMS:
Total time is the sum of all time, with and without direct patient contact and including prolonged time, spent by the reporting practitioner on the date of service of the visit.