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Inpt SNF New w/prolonged service

  1. #1
    Question Inpt SNF New w/prolonged service
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    I am wondering if anyone can assist me? DSHS will only allow you to bill an inpatient E & M for inpt SNF up to 3 hours per day. My MD saw a new patient face to face for end of life and spent 3 hours face to face time w/family and patient. Notes state over 180 mins spent face to face & a comprehensive Hx, a comprehensive exam with medical decision making of high complexity. The 99306 is initial visit per day and typically 45 mins. How should I bill this to ensure my MD gets paid for all her time spent face to face w/pt and family?

  2. #2
    Location
    Columbia, MO
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    you append prolonged time.. take 180 and subtract your 45 minutes for the visit level, so long as that is the level met by the documentation. 180-45= 135
    99356 for 30 -74 minutes
    99357 for 75-104 minutes
    99357 x 2 for 105 - 134 minutes
    99357 x3 for 135 - 164 minutes
    so you can bill
    99306
    99356
    99357 x3

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Default
    Quote Originally Posted by mitchellde View Post
    you append prolonged time.. take 180 and subtract your 45 minutes for the visit level, so long as that is the level met by the documentation. 180-45= 135
    99356 for 30 -74 minutes
    99357 for 75-104 minutes
    99357 x 2 for 105 - 134 minutes
    99357 x3 for 135 - 164 minutes
    so you can bill
    99306
    99356
    99357 x3
    Thank you for your response but Medicaid will not allow the 99306 nor the prolonged services. I coded it exactly like you suggested. Any recommendations?

  4. #4
    Default
    Oops sorry, I also used a modifier 25 on the 99306.

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