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Wiki coding inpatient face to face family consult

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scarlet3ej

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Lockport, NY
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I have a dr who sat down with a pt's parents for 1 1/2 hour documented time to discuss pathology and an aggressive treatment plan all clearly documented in her notes.
This included going over MRI, pathology reports, surgical scheduling for port placement, radiation, chemo and other critical components necessary for the child's care.

The doctor coded this as a 99255, 99356 and 99357 I am leaning to 99358 for the 1st hour and 99359 for the half hour

is this correct?

Jean
 
Prolonged service

I would report 99356-99357 unless the payer follows Medicare rules requiring face-to-face time (i.e., patient to be present). CPT guidance for 99356-99357 states unit/floor time not face-to-face time as does 99255.
Cindy
 
99356 and 99357 are add on codes and must have a qualifying primary code if the visit level requires face to face with the patient then you cannot bill the add on prolong time. This leaves you with only the non face to face pronged codes to chose from you have to go with 99358-59
 
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