tci Medicare Compliance & Reimbursement - 2010 Issue 19

Reader Questions: Limit Prolonged Services to Highest Category in 1 Instance

Question:Can the prolonged codes (+99354, Prolonged physician service in the office or other outpatient setting requiring direct [face-to-face] patient contact beyond the usual service; first hour [List separately in addition to code for office or other outpatient Evaluation and Management service]) and +99355 (Prolonged physician service in the office or other outpatient setting requiring direct [face-to-face] patient contact beyond the usual service; each additional 30 minutes [List separately in addition to code for prolonged physician service]) be billed with all established patient office visit codes (99211-99215)? For a 60 minute face-to-face visit, could I report 99214 with 99354? Or...

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