Payment for extended visit

nc_coder

Expert
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300
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I have a physician that spent over an hour in the exam room with a patient yesterday and well over 30 minutes on the phone with this same patient today. We filed the OV as a Level 5, but is there any way for him to get reimbursed for the extended time spent with the patient? i.e. modifier, extended services code, etc. By the way, this is a Medicare patient. I know we can't bill the telephone E/M since she is Medicare.
 

mitchellde

True Blue
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Columbia, MO
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did he meet the criteria for a level 5 or did you up code to the level 5 due to time. was time spent face to face documented? It is sometimes better to code the level documented by the three key components and add prolonged time. As far as the phone call you could try 99358 for prolonged non face to face which as a 30 minute minitmum, I am not sure if Medicare will pay but it is worth a try.
 

ollielooya

True Blue
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Everett, WA
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Nc_coder, if you do go ahead and bill as Debra is suggesting that you might try, can you please let us know how your MCR payer processes this claim? I'd really like to know...
---Suzanne E. Byrum CPC
 
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