Wiki Billing Office visit beyond 40 minutes

[akshar13]

Hello!

If Physician spend more than 40 minutes (e.g. 55 minutes or 80 minutes), how will I bill additional time beyond 40 minutes. I bill 99215 which cover 40 minutes but I don't know which additional code I should bill to cover more than 40 minutes time spent face to face with patient. Please advise.

Thanks

 

[mitchellde]

You should look at the prolonged time codes 99354-99355 and the rules. The minimum amount of time that must be documented is for a 99215 plus a 99354 is 70 minutes, the minimum for a 99215 plus a 99354 and a 99355 is 115 minutes. Also note that these can be appended to any visit level and are not restricted to a 99215 or 99205. So if you have a 99213visit level that took 45 minutes you can bill the 99313 plus the 99354. The Medicare manual has an entire section on these codes with a table of the visit levels and the minimum times.

 

[akshar13]

You should look at the prolonged time codes 99354-99355 and the rules. The minimum amount of time that must be documented is for a 99215 plus a 99354 is 70 minutes, the minimum for a 99215 plus a 99354 and a 99355 is 115 minutes. Also note that these can be appended to any visit level and are not restricted to a 99215 or 99205. So if you have a 99213visit level that took 45 minutes you can bill the 99313 plus the 99354. The Medicare manual has an entire section on these codes with a table of the visit levels and the minimum times.

Thanks for response. I was under impression that to bill 99215+99354 Physician should have spent 45+60=105 minutes but I think it is wrong.