# New OP Facility E/M G0463



## tfrick2 (Feb 15, 2014)

Does anybody know if we can bill for prolonged services (99354-99355) with the new Outpatient Clinic E/M code G0463? I've tried looking for guidance on this, but haven't found anything yet.


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## OCD_coder (Feb 15, 2014)

While I don't have any information that you can, the logic behind trying to use it isn't there.  Medicare created a "one code fits all" code with the G0463, in my mind this would eliminate the ability to bill for a prolonged service code.

But I am hoping someone can prove this thought  process wrong.


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## tfrick2 (Feb 17, 2014)

OCD_coder said:


> While I don't have any information that you can, the logic behind trying to use it isn't there.  Medicare created a "one code fits all" code with the G0463, in my mind this would eliminate the ability to bill for a prolonged service code.
> 
> But I am hoping someone can prove this thought  process wrong.




That's my thought as well. I just need to be able to explain that to the departments, which isn't so easy without documentation. Thank you for your input!


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## mitchellde (Feb 17, 2014)

you can add on the prolonged codes only to codes with a timed component and only to those codes listed under the 99354.  From what I am looking at the G0463 has no timed component.


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