tci E/M Coding Alert - 2013 Issue 1

Reader Question: Remember Prolonged Service Codes for Extra Long Visits

Question: My pediatric physician spent 105 minutes with a new patient in the office. Is 99205the only code I can bill? Massachusetts Subscriber Answer: No, you should also look at the prolonged office visit codes +99354-+99355 (Prolonged  service ... requiring direct patient contact ...). Here’s why: Code 99205 (Office or other outpatient visit for the evaluation and management of a new patient ... Physicians typically spend 60 minutes face-to-face with the patient and/or family) requires 60 minutes of face-to-face time. But if your physician spent 105 minutes with the patient, then you can bill 99205 for the first 60 minutes...

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