Physicians Practice - February 2008 - (Page 74)

CODING The trick to using these codes is recognizing when the prolonged service time begins and when the first service ends. FUZZY MATH inpatient prolonged service on a given day. Code 99355 or 99357 refers to each additional 30 minutes beyond the ﬁrst hour of service, depending on where the service takes place. These codes may also be used to report the ﬁnal 15 to 30 minutes of prolonged service on a given date. Service of less than 15 minutes beyond the ﬁrst hour or less than 15 minutes beyond the ﬁnal 30 isn’t reported. The trick to using these codes is recognizing when the prolonged service time begins and when the ﬁrst service ends. You must provide at least 30 minutes of prolonged services beyond the time associated with the basic service in order to use these codes. For example, if a 99214 ofﬁce visit, whose assigned time is 25 minutes, runs to 40 minutes, you haven’t reached the 30 minutes over the 25 needed to bill a 99354 in addition to the 99214. The visit would have to be at least 55 minutes long in total. The extra time need not be continuous — it could represent multiple re-exams within a larger time frame. The example in the CPT manual has a patient with asthma exacerbation who requires multiple nebulizer treatments followed by periodic re-examination by the physician over the next couple of hours. This may not happen often, but there is at least some compensation for the time spent. Look in your CPT manual for the standard time allotted for each E&M code. • Bill Dacey, CPC, MBA, MHA, is principal in the Dacey Group, a consulting firm dedicated to coding, billing, documentation, and compliance concerns. Dacey is a PMCC-certiﬁed instructor and has been active in physician training for over 18 years. He can be reached at billdacey@msn.com or via info@physicianspractice.com. 74 | PHYSICIANS PRACTICE | FEBRUARY 2008 WWW.PHYSICIANSPRACTICE.COM http://www.freedommd.com http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - February 2008

Physicians Practice - February 2008 Contents The Bigger Picture: Your Future is in Your Hands Letters Physicians Practice Pearls: Creating an A+ Practice Noteworthy Cover Story: Conquering Time: 5 Keys to a More Efficient Practice In Balance: A Family Affair Technology: Making EMRs Work in the Exam Room In Practice: "I've Got Some Bad News" The Tech Doctor - The EMR: Savior or Poseur? Ask the Experts NEW! Healthonomics: How to Handle Health Savings Accounts The Administrator's Desk: Finishing School for New Managers Human Resources: Is Your Partner Impaired The Great Practice Makeover: Too Well-Liked for His Own Good? Coding Idealab: 'Why I Blog' Classifieds Advertiser Index

Physicians Practice - February 2008

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