E/m visit with prolonged service on separate day

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Harlingen, TX
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I have a coding question regarding inpatient billing. I've been looking for information in regards to this, but I have yet to find anything conclusive.



Let's say a palliative care dr saw a patient on may 2, 2016 and billed for these services..let's say 99222.

Then he goes back may 5, 2016 to visit with the patients family and other doctors to discuss plan of care in regard to his palliative care needs, he writes his note, and then bills a 99356 for prolonged service.

Considering that 99356 cannot be billed by itself on a claim without the 99222 first, how would I actually bill for his services?


If he documented on the may 5th note that it was a continuation of may 2 visit, would I be able to bill the 99356 on the same claim as the may 2 visit? (doesn't sound right)

Any guidance on this matter would be appreciated



**Patient has MEDICARE.
 

smidge1

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Local Chapter Officer
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Vadnais Heights, MN
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Prolonged service coding

I have a coding question regarding inpatient billing. I've been looking for information in regards to this, but I have yet to find anything conclusive.



Let's say a palliative care dr saw a patient on may 2, 2016 and billed for these services..let's say 99222.

Then he goes back may 5, 2016 to visit with the patients family and other doctors to discuss plan of care in regard to his palliative care needs, he writes his note, and then bills a 99356 for prolonged service.

Considering that 99356 cannot be billed by itself on a claim without the 99222 first, how would I actually bill for his services?

If he documented on the may 5th note that it was a continuation of may 2 visit, would I be able to bill the 99356 on the same claim as the may 2 visit? (doesn't sound right)

Any guidance on this matter would be appreciated

**Patient has MEDICARE.
The short answer is NO, both codes must be provided on the same day of service. Physician must choose the E/M service for May 5th (99201-99215, 99241-99245, 99324-99337, 99341-99350) and code the correct prolonged service code (if you can) to meet the coding guidelines.

Hope this helps.
 
Messages
46
Location
Harlingen, TX
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Just to clarify...

The short answer is NO, both codes must be provided on the same day of service. Physician must choose the E/M service for May 5th (99201-99215, 99241-99245, 99324-99337, 99341-99350) and code the correct prolonged service code (if you can) to meet the coding guidelines.

Hope this helps.


So even if there is no F/F on the 5th, I'm able to bill an E/M?
(That's the part I'm having problems with)
 
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