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Thread: Opinions please-99214 w/prolonged?

  1. #1
    Join Date
    Apr 2007

    Default Opinions please-99214 w/prolonged?

    AAPC: Back to School
    We have a 4 year old who came in with asthma exac and severe resp distress. Pulse ox was 84. Gave her 3 neb treatments and then transferred by ambulance to hospital. Dr was with patient from 11:40am to 12:45 pm then rechk at 12:55. Patient picked up at 1:10pm. We have an extended hpi but only 2 ros and no pfsh but mdm is high. Thanks

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default Prolonged service

    The prolonged service codes can be added to ANY E/M code. Code the level that is documented, and then add the extended time spent with the patient (must be at LEAST 30minutes direct face-to-face time over and above the time spent in the base E/M).

    Two thoughts on your scenario ...
    1) Was the patient critically ill, and was the care provided critical care? CPT 99291 CAN be used outside of a hospital (though it is extremely rare and you will definitely be asked to provide documentation to support this). Physician must document critical nature of patient's condition and the fact that s/he provided at least 30 minutes of direct face-to-face critical care time.

    2) Since patient was sent to hospital ... was the physician the admitting physician? Did s/he see patient in hospital the same DOS? If so, then all services provided this same DOS are rolled into the Initial Hospital Visit level of service.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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