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Prolonged Service 99354 Prolonged service in the office or other outpatient setting requiring direct patient contact beyond the usual service; first hour.

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Presentation on theme: "Prolonged Service 99354 Prolonged service in the office or other outpatient setting requiring direct patient contact beyond the usual service; first hour."— Presentation transcript:

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2 Prolonged Service 99354 Prolonged service in the office or other outpatient setting requiring direct patient contact beyond the usual service; first hour 2

3 Prolonged Service 99354 Example 99213 Typical time = 15 min (found in CPT manual) If spend 15 + 60 = 75 minutes, bill 99213 + 99354 (list separately in addition to EM) 3

4 Prolonged Service 99354 Time Measurement A unit of time is attained when mid-point is passed An hour is attained when 31 minutes is elapsed 4

5 Prolonged Service 99354 Example 99213 Typical time = 15 min If spend 15 + 31 = 46 minutes, bill 99213 + 99354 5

6 Prolonged Service 99355 Prolonged service in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes 6

7 Prolonged Service 99354 Example 99213 Typical time = 15 min If spend 15 + 60 + 30 = 75 minutes, bill 99213 + 99354 + 99355 (list separately in addition to 99354) 7

8 Prolonged Service 99354 Example 99213 Typical time = 15 min If spend 15 + 60 + 16 = 91 minutes, bill 99213 + 99354 + 99355 (list separately in addition to 99354) 8

9 Prolonged Service PAYMENT (Medicare 2013) 99354 2.86 x 34.023 = $97.31 99355 2.8 x 34.023 = $95.26 9

10 CPTTypical Time for Code Threshold Time to Bill 99354 Threshold Time to Bill 99354 + 99355 99201104085 99202205095 992033060105 992044575120 992056090135 10

11 CPTTypical Time for Code Threshold Time to Bill 99354 Threshold Time to Bill 99354 + 99355 99212104085 99213154590 992142555100 992154070115 11

12 Prolonged Service Use 99354/99355 also with 99324-99337 Rest Home Services 99341-99350 Home Services 12

13 Coding Update file://localhost/Users/alanhomestead/Documents/My Documents B 3-8-13/Adventures 11-3-12/O - S/Presentations/Repository of My PowerPoints/1 Whats New Coding Update/2013 Coding Update.ppt file://localhost/Users/alanhomestead/Documents/My Documents B 3-8-13/Adventures 11-3-12/O - S/Presentations/Repository of My PowerPoints/1 Whats New Coding Update/2013 Coding Update.ppt 13


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