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prolonged physician service codes in the office setting

  1. #1
    Default prolonged physician service codes in the office setting
    Medical Coding Books
    Does anyone have a concrete description for code 99354? I have a provider that is using this code 'willy nilly'. He has been adding the code on if the patient is in the office for an hour or more. Not that the patient is being seen by the provider that whole time. Patient may be being monitored for blood pressure issues or chest pain, ekg etc.

    I am having a difficult time with the provider understanding the correct use of this code. Any suggestions?

  2. #2
    Per CPT, prolonged services involve DIRECT patient care, which translates to face-to-face in the office. It does not need to be continuous but whatever total time the provider documents must be only when face-to-face with the patient.
    Melissa Tescher, CPC, CPMA, CEMC Compliance and Coding Specialist
    Willamette Valley Professional Services member National Advisory Board 2013-2015

  3. #3
    Austin, Texas
    Train the doctor to jot down the times as he checks the patient each time. Then add the total time.
    Marcus Murphy, CPPM

  4. #4
    ST Paul, MN
    Hello. I did some research on this and the April 2012 CPT Assistnt has a wonderful description/definition of 99354 that you may find helpful (sorry I don't have a link).
    Brian Johnsen, CPC
    St Paul, MN

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