• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki prolonged services question

Create Wiki
W

wbradhoward

Guest
Messages
25
Location
Loveland, CO
Best answers
0
When attempting to determine the appropriate E/M codes to use when an extensive amount of time has been spent with the patient (and documented appropriately :) ), how do you figure out the initial E/M code to use?
For example, if you have a 90 minute established patient office visit, do you automatically have to use the highest level est. pt code 99215 with 99354? Or can you bill a 99213 with 99354 and 99355? What determines the established visit code (99211-99215) that you use in conjunction with the prolonged visit code?
 
You code the visit level based on what is met by the three key components. So if the components equal a level 3 then a 99213 is what you code. A 99213 is allotted 15 minutes on average, you take total time spent and subtract the 15 minutes, so in your example, 90 minutes less the 15 leaves 75. 99354 is 30-74 minutes, 99355 is 75- 104 min so you would bill the 99213, 99354, and the 99355.
 
Last edited:
You must log in or register to reply here.
Top