Primary Care Coding Alert

And code this scenario to become a 99358/+99359 master.

If you’ve ever been confused about how to use the non-face-to-face prolonged evaluation and management (E/M) codes 99358 (Prolonged evaluation and management service before and/or after direct patient care; first hour) and +99359 (… each additional 30 minutes (List separately in addition to code for prolonged service), or if you’re just trying to use them correctly, here’s a quick coding quiz to help you master them.

So, get out your CPT^® manual and a pad and pen, and let’s get started.

Question 1: When can you bill for 99358 and +99359?

Question 2: Which services cannot be billed with 99358 and +99359?

Question 3: Code this encounter: Your provider is due to see an adolescent patient for the first time today. Records from his school and from a previous primary care pediatrician are sent to assist in the initial exam. Prior to the appointment, your provider spends roughly 20 minutes reviewing the records and writing a summary. The patient then presents with his mother to the office. Your provider conducts an E/M service and a developmental test, then spends 25 minutes after the encounter reviewing more information that the mom brought in from a previous developmental and behavioral pediatrician.

Think you know the answers?