tci E/M Coding Alert - 2020 Issue Q1

Reader Question: Get the Timing Right Before Coding for Prolonged Service

Question: Our interventional radiologist saw a patient during an E/M service for a prolonged amount of time. Can I bill +99354 with 99214? Washington Subscriber Answer: If you are considering the use of prolonged evaluation and management (E/M) services code +99354 (Prolonged evaluation and management or psychotherapy service(s) (beyond the typical service time of the primary procedure) …), you need to know that you may submit code 99214 (Office or other outpatient visit for the evaluation and management of an established patient ...) so long as you reach 99214 using the 1995/1997 E/M guidelines. However, if you’re...

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