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need help with extend code 99354

  1. #1
    Location
    Tampa, Florida
    Posts
    63
    Default need help with extend code 99354
    Medical Coding Books
    I work in a internal med office and the physician usually bill a 99214 but the time she spend with the patient may be 40-60min and she also may give a b-12 injection, so i add a prlong code 99354 but it is being rejected by the insurance carrier. i usually code it like this:
    99214-25
    99354
    96372-59
    J3420

    everything is being paid except for the prolong code. am i coding this wrong or missing a modifier, can anyone help?

    Nickie, CPC

  2. #2
    Location
    Columbia, MO
    Posts
    12,526
    Default
    It may be your dx code. The dx must support a visit of this intensity, a 99214 plus a 99354 must be a minimum of 55 minutes face to face with the physician and the physician must document the time in the note, if you have this then appeal to get it paid.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Location
    Tampa, Florida
    Posts
    63
    Default
    o.k

    thanks
    Nickie, CPC

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