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Wiki Prolonged Visits

tscobee

Networker
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59
Location
Sanger, TX
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I am needing help with the prolonged visit codes. I have a nurse practitioner that goes to assisted living facilities and will do a prolonged visit, (review of chart), on a different day. What code would I bill for the prolonged visit?
 
Hi there, doing the additional service on a different day doesn't necessarily make it prolonged. In addition, are you billing Medicare?
 
prolonged visits are for extra time spent beyond the time frame of the 99205/99215 codes on the SAME DAY. for medicare that would be 89 mins or more for the 99205 & 69 mins for the 99215. for commercial carriers it would be 75 mins & 55 mins respectively. also- prolonged service is an add on code & CANNOT be billed alone. it must be billed with the above 2 codes. not too familiar with nursing home visit codes but i suspect what your NP is trying to do is a little iffy!
 
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