Primary Care Coding Alert

Question: A level four office visit with an established patient took 55 minutes of physician-patient face-to-face time due to the service involving an interpreter, which the patient and family required to converse with the family physician. The family physician wants to code 99214 and prolonged services. Is this appropriate?Answer: Yes, you may use a prolonged service code in this situation because the time thresholds for billing both 99214 (25 minutes) (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. . . . Physicians typically spend 25 minutes face-to-face with the patient and/or family) and 99354 (30 minutes more than 99214) (Prolonged physician service in the office or other outpatient setting requiring direct [face-to-face] patient contact beyond the usual service; first hour [List separately [...]