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Wiki New OP Facility E/M G0463

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tfrick2

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Does anybody know if we can bill for prolonged services (99354-99355) with the new Outpatient Clinic E/M code G0463? I've tried looking for guidance on this, but haven't found anything yet.:confused:
 
While I don't have any information that you can, the logic behind trying to use it isn't there. Medicare created a "one code fits all" code with the G0463, in my mind this would eliminate the ability to bill for a prolonged service code.

But I am hoping someone can prove this thought process wrong.
 
OCD_coder said:
While I don't have any information that you can, the logic behind trying to use it isn't there. Medicare created a "one code fits all" code with the G0463, in my mind this would eliminate the ability to bill for a prolonged service code.

But I am hoping someone can prove this thought process wrong.
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That's my thought as well. I just need to be able to explain that to the departments, which isn't so easy without documentation. Thank you for your input!
 
you can add on the prolonged codes only to codes with a timed component and only to those codes listed under the 99354. From what I am looking at the G0463 has no timed component.
 
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