tci Part B Insider - 2004 Issue 11

Part B Coding Coach: Recoup $105 Extra Per Visit For Extended E/M Services

Your physician's time isn't free -- use prolonged service codes to bill for extra services.Big Mistake: Coders sometimes choose not to bill prolonged services because they believe carriers won't reimburse those codes. Even though not all carriers will pay, you still may be missing out on at least $105 per visit if you're not reporting prolonged services. Physicians may report extended times of service for inpatient and office visits because of time spent counseling and coordinating complicated treatments. You can bill for extended services using prolonged service codes (99354-99359) if the total reported time exceeds the typical time...

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