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Thread: 99354

  1. #1
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    Default 99354

    When a patient is seen and is goes beyond the 99215/99205 time spent with patient, can you add the 99354 is it is only 5 or 10 minutes over?? Does it have to be in certain time increments?
    Thanks for any help..
    Patricia CPC, CANPC

  2. #2
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    Default

    No, the extended time must total 30 minutes or greater.

  3. #3
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    Default

    Thanks for the confirmation. That is what I thought.
    Patricia CPC, CANPC

  4. #4
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    Default

    You're welcome

  5. #5
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    Default

    Could you clarify one more thing.....In the CPT book it states under Excludes: Do not report any service that fails to extend into the next time period by 15 minutes or more.

    Can you clarify that statement for me please...
    Patricia CPC, CANPC

  6. #6
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    Default

    CPT states that prolonged service with direct patient contact is not reported separately when the duration is less than 30 minutes. I am not sure where you are seeing the statement you mention.

  7. #7
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    Default

    It is in the 2013 Optum CPT Expert pg 886 under prolonged services direct contact.

    www.optumcoding.com
    Patricia CPC, CANPC

  8. #8
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    Default

    I do not have that particular book but here is how my AMA CPT book describes it.

    less than 30 minutes - not reported separately
    30-74 minutes (30 min - 1 hr 14 min) - 99354 x1
    75-104 minutes (1 hr 15 min - 1 hr 44 min) - 99354 x1 and 99355 x1
    105 or more (1 hr 45 min or more) - 99354 x1 and 99355 x2 or more for each additional 30 min

    In other words, if the provider spent 1 hr 15 min, you would be able to add 99355 along with 99354.

  9. #9
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    Default

    Thank you so much!!!!
    Patricia CPC, CANPC

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