Anesthesia Coding Alert

Question: Can we bill 99358 in Florida? If yes, what is the reimbursement?

Florida Subscriber

Answer: CPT® 2015 includes two codes for prolonged services without direct face-to-face patient contact: 

• 99358 – Prolonged evaluation and management service before and/or after direct patient care; first hour

• 99359 – … each additional 30 minutes (List separately in addition to code for prolonged service). 

Medicare considers both codes to be included in the payment for other services and are therefore not separately billable. Many other payers have adopted this same stance, but check with each to verify their positions before assuming you shouldn’t submit a claim.