Inpatient sbsq care extending 35 minutes

jwills13

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Hi,

I am looking for input.. my provider sees patient as inpatient and sometimes spends 60 minutes coordinating care with pharmacy, other physcians, ect. coding for the subsequent care only allows up to 35 minutes, what is the correct coding to add on additional time that my provider has spent coordinating care as well as face to face with patient...

thank you!
 

katemae84

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Sanford, ME
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You can look into the Prolonged Services codes (CPTs 99354 & 99355), but less than 30 minutes of extra time is included in the E/M and is not separately reported. For example, say your provider spends 60 minutes providing care for the patient and coordinating care makes up more than half of your provider's time. A time-based level of 99233 accounts for 35 of those minutes, which would mean that your "extra time" is only 25 minutes, so that time is bundled into your 99233 and can't be billed separately with Prolonged Services codes.
 
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