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Prolonged services

  1. #1
    Talking Prolonged services
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    I was wondering if a pt comes in for ac asthma exac and is in office for 2 hours while treatments are being done and pulse ox is being watched would you bill the 99214 w/99354 99355 or 99215 w/99354? Thanks:d

  2. #2
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    The physician is with the patient the whole time or just staff?

    99354
    Prolonged physician service in the office or other outpatient setting requiring direct (face-to-face) patient contact beyond the usual service; first hour (List separately in addition to code for office or other outpatient Evaluation and Management service)


    I know you are dealing with peds and probably not Medicare but this is still good information on coding prolonged care.

    http://www.wpsmedicare.com/part_b/ed...longedcare.pdf

    Laura, CPC, CEMC

  3. #3
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    Quote Originally Posted by HBULLOCK View Post
    I was wondering if a pt comes in for ac asthma exac and is in office for 2 hours while treatments are being done and pulse ox is being watched would you bill the 99214 w/99354 99355 or 99215 w/99354? Thanks:d
    The physician must document the face to face time spent with the patient not the entire time the patient was in the office. Everytime the physician leaves the room the time must be stopped and not started until he enters the room again. The visit level will be what is met by the documentation of the hx, exam , decision making, then take that time from the level in the CPT book and subtract from total time face to face and if you have 30 min or more then start adding prolonged time. Ex:
    Assume the documentation supports a level 3 estb, and the face to face time was 2 hours
    99213 = 15 min --- 120min - 15 min = 105 min left
    99354
    99355 x 2

    Debra A. Mitchell, MSPH, CPC-H

  4. #4
    Default Prolonged service
    Thanks for your response....you explained this great..aprreciate your help!!!

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