Inpt SNF New w/prolonged service

DeeLonna

Contributor
Messages
16
Location
Tacoma, WA
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I am wondering if anyone can assist me? DSHS will only allow you to bill an inpatient E & M for inpt SNF up to 3 hours per day. My MD saw a new patient face to face for end of life and spent 3 hours face to face time w/family and patient. Notes state over 180 mins spent face to face & a comprehensive Hx, a comprehensive exam with medical decision making of high complexity. The 99306 is initial visit per day and typically 45 mins. How should I bill this to ensure my MD gets paid for all her time spent face to face w/pt and family?
 

mitchellde

True Blue
Messages
13,538
Location
Columbia, MO
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2
you append prolonged time.. take 180 and subtract your 45 minutes for the visit level, so long as that is the level met by the documentation. 180-45= 135
99356 for 30 -74 minutes
99357 for 75-104 minutes
99357 x 2 for 105 - 134 minutes
99357 x3 for 135 - 164 minutes
so you can bill
99306
99356
99357 x3
 

DeeLonna

Contributor
Messages
16
Location
Tacoma, WA
Best answers
0
you append prolonged time.. take 180 and subtract your 45 minutes for the visit level, so long as that is the level met by the documentation. 180-45= 135
99356 for 30 -74 minutes
99357 for 75-104 minutes
99357 x 2 for 105 - 134 minutes
99357 x3 for 135 - 164 minutes
so you can bill
99306
99356
99357 x3
Thank you for your response but Medicaid will not allow the 99306 nor the prolonged services. I coded it exactly like you suggested. Any recommendations?
 
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