Wiki CPT 99358 & 99359

Per Novitas:
Prolonged Services without Direct Face-to-Face Patient Contact
Codes 99358-99359 are used when a prolonged service is provided that is neither face-to-face time in the office or outpatient setting, nor additional unit/floor time in the hospital or nursing facility setting during the same session of an E/M and is beyond the usual physician or other qualified health care professional service time.

Report these codes in relation to other physician or other qualified health care professional services, including E/M at any level. These may be reported on a different date than the primary service to which it is related.

Procedure codes


Procedure CodeDefinition
99358Prolonged E/M before and/or after direct patient care; first hour
99359Each additional 30 minutes (list separately in addition to code for prolonged service)
Beginning Calendar Year (CY) 2017, these codes are separately payable under the Medicare Physician Fee Schedule.

Cannot be reported during the same service period as complex chronic care management (CCM) services or transitional care management services.
They are not reported for time spent in non-face-to-face care described by more specific codes having no upper time limit in the CPT code set.
Can only be used to report extended qualifying time of the billing physician or other practitioner (not clinical staff).
Cannot be reported in association with a companion E/M code that also qualifies as the initiating visit for CCM services. Practitioners should instead report the add-on code for CCM initiation, if applicable.
Documentation
Documentation about the duration and content of the medically necessary evaluation and management service and prolonged services billed is required in the medical record. The medical record must be appropriately and sufficiently documented by the physician or qualified NPP to show that the physician or qualified NPP personally furnished the direct face-to-face time with the patient specified in the CPT code definitions.

The start and end times of the visit should be documented in the medical record along with the date of service.

Here is the link to the page: https://www.novitas-solutions.com/webcenter/portal/MedicareJL/pagebyid?contentId=00081586
 
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