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how to count time for prolonged vist with E/M

Leslie Posted Thu 28th of June, 2012 15:23:50 PM

I need some clarification on prolonged visit, please.
A physician bills a 99214 (25mins)
He does 2 X30mins interval EKG because the patient had syncope at the office.

What I understand is total time ( 25 minutes plus 60minutes = 85mins of visit)
Therefore, 99214 ( 25mins), 99354 ( first hour = 60mins) OR 99214(25mins), 99354 (35mins---which would be 25 +35= first 1 hour) and, 99355 (last 25 mins)

SuperCoder Answered Fri 29th of June, 2012 13:01:22 PM

Leslie, You must carve out any time for procedures from the prolonged service time calculation. Prolonged services is direct face-to-face time between the physician and the patient excluding any procedure or otherwise separately billable services. The above case does not qualify for prolonged service time coding. You would code only 99214.

Sincerely,
Jen
--
Jen Godreau, CPC, CPMA, CPEDC

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