Wiki Prolonged PHYS Services & E/M

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kacurtis

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Insurance is denying our charges for Prolonged Phys Services (99356 1st hour inpatient; 99357 each additional 30 mins inpatient). The ins states those codes are bundled w/ the inpatient E/M code we used (99223). According to the CPT 2012 book, 99356 indicates "list seperately in addition to code for inpatient E/M service" and lists the 99223 as one of the codes you can seperately bill for. My question is, do I continue to discuss w/ the ins company? Am I reading/comprehending this correctly? Help :confused:
 
Which insurance was it?? You might have to send in notes for an appeal review.

I have billed them both to Medicare with no mod's & gotten paid.
 
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