Help please 99354/99355

TLC

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If a patient is seen in the office for hydration, pt in office for 6hours. Can the doctor use 99354/99355 for prolonged visit. If I read it right, it would be
99354x1 99355x8
99354-9:20-10:20 (first hour)
99355x8 for the following(each add 30min)
10:21-10:51
10:52-11:22
11:23-11:53
11:54-12:24
12:25-12:55
12:56-1:26
1:27-1:57
1:58-2:28
2:29-2:59
This just seems like a lot of "add on" charges, am I reading the book wrong or is this correct Please can anyone help, Thank you, sorry so long
 
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Those add on codes are for face-to face with the patient. You need to know exactly how much time actually spent w/ patient.

There are add-on codes for prolonged without face-to face:

99358 (first hour)
99359 (each 30 min)
 

TLC

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99354/99355

The 99358/99359 codes according to the book, seem to be occuring on seperate days. This pt was in the office for 6 hours, the 99354/99355 codes states in the book "Time spent providing prolonges services on a date of service, even when the time is NOT continuous"
 

mitchellde

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Yes you can bill the prolonged time but it must be provider face to face with patient time, and it cannot be during the same time you have IV fluids running. So if the IV is documented as stopped then the provider is with the patient then leaves the room and then fluids are started then stopped and then the provider comes back in the room , etc, But the documentation must be clear. Then yes you add the intervals together. However it is not necessarily the way you have it.
99354 is for the first 30 to 60 minutes after you subtract the visit level. So depending on the level of care documented. So what I see here is 330 minutes total so if you had say a level 4 visit level you must subtract out the 25 minutes for the level 4 which leaves you with 305 minutes
The 99254 will take you from 30 to 74 minutes (you must be 15 minutes into the next level)
75 to 104 is the first 99355
105 to 134 is the next 99355
135 to 164 the next
165 to 194
195 to 224
225 to 254
255 to 284
285 to 314 done
But as previously stated this must be patient with doc time and the IVs must not be running at this time. You must bill the 9921x in addition to the 99354 and the 99355
 
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