to use prolonged time you take the total face to face time and subtract the visit time per the CPT book for the level of service documented. The time left over must be a minimum of 30 additional minutes before you can append prolonged time.
for instance to code bothe a 99213 and a 99354 you must have a minimum of 45 minutes of face to face time documented. you take the 15 minutes assigned in the CPT book for the 99213 and subtract from 99354. So he has a total of 35 minutes documented with a 99233 documented which is you say is 35 minutes ( my book is not present) then when you subtract there is 0 minutes left for prolonged time so no you may not. You will need a minimum of 65 total minutes documented. Even though he spent additional floor time with family, he does not document that time so we can only use the 35 minutes documented.
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