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Thread: Prolonged Service Codes Time Requirements

  1. #1
    Join Date
    Apr 2007

    Question Prolonged Service Codes Time Requirements

    AAPC: Back to School
    It is my intrepretation in order to bill 99356 in addition to an inpatient hospital admit code 99223 you must have met the CPT time guidelines which in CPT 2009 book is listed as 70 minutes PLUS an additional 60 minutes before adding a 99356 for a total of 130 minutes. Each additional 30 minutes you would add also the 99357. But say the total time spent is 145 minutes. Is it correct to bill 99223 (70mins) for the admit, 99356 (60 mins) and 99357 (15 mins)? Or in order to add the 99357 the entire 30 mins must be met? This is where the confusion lies.

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default Determining prolonged code(s)

    Look at the table in CPT 2009 professional edition on page 26 where it tells you the exact time parameters for coding prolonged service.

    75 minutes beyond the basic E/M service is coded with 99356 and 99357.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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