Results 1 to 3 of 3

5 Hour visit

  1. #1
    Default 5 Hour visit
    Medical Coding Books
    Our office had a patient come in with chief complaint of 1 day weakness/dehydration/hyperglycemia with mild hand/foot spasms & fatigue. The visit ended up being 5 hours for ongoing medical care and treatment, stabilization, IV fluids, glucose control, patient education, disease management & coordination of care because the patient refused ER evaluation and hospital admission. The physician wants to bill an acute care cpt code but I disagree because the entire visit was not face-to-face with the patient. I think this should be billed with the E/M code of 99215-25 96360 x 1 and 96361. The IV was started at 12:00 and at 1:30 the 2nd bag was started at 3:00 pt went to bathroom and came back and had infiltrated the IV site Could not insert new IV and the 2nd bag was almost complete. pt d/c at 4:00. Please help and as always Thank You in advance.

  2. Default
    Take a look at the prolonged services codes w/ direct face-to-face 99354-99357

    you would just have to break out the face to face time spent that was above the normal visit. According to CPT it doesn't have to be continuous. So a total of all time spent BEYOND the normal E/M visit.
    Rachell Lindley, CPC
    Multispecialty Clinic Coding
    Internal Medicine
    General Surgery
    Family Medicine

  3. #3
    Milwaukee WI
    Default BUt do NOT count
    But do NOT count the time for the infusion if you are billing that service separately.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

Similar Threads

  1. After Hour Codes
    By pfrancis1 in forum Neurology/Neurosurgery
    Replies: 0
    Last Post: 11-12-2014, 01:32 PM
  2. 24 Hour Combine
    By staceylh in forum Emergency Department
    Replies: 0
    Last Post: 08-26-2011, 12:42 PM
  3. 23 Hour Observation
    By mattamyc in forum Outpatient Facilities
    Replies: 2
    Last Post: 05-06-2011, 10:43 AM
  4. CPT 95920 per patient, per hour or only per hour
    By AHVC in forum General Surgery
    Replies: 1
    Last Post: 01-21-2011, 02:53 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.