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Urology Coding Alert

Reader Questions:

Capture Long E/M With +99354

Question: My pediatric urologist spent 105 minutes with a new patient in the office. Is CPT 99205 the only code I can bill?Massachusetts SubscriberAnswer: No, you should also look at the prolonged office visit codes +99354-+99355 (Prolonged physician service ... requiring direct [face-to-face] 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 urologist spent 105 minutes with the patient, then you can bill 99205 for the first 60 minutes plus +99354 to capture payment for the extra time.Remember that codes +99354-+99357 are time-based and are add-on codes. You do not need to append a modifier to these codes and you should not decrease their reimbursement when billed with other primary E/M codes.Important: Remember that there is a [...]


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